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Thumar VD, Chen JY. Analysis of Requirements within Neuroradiology Job Advertisements in a Specific Timeframe. AJNR Am J Neuroradiol 2024:ajnr.A8373. [PMID: 39089874 DOI: 10.3174/ajnr.a8373] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2024] [Accepted: 04/24/2024] [Indexed: 08/04/2024]
Abstract
BACKGROUND AND PURPOSE The neuroradiology job market is constantly changing along with the skill sets needed by fellowship graduates to participate successfully in the job market. This study aimed to establish a baseline of employer requirements in the neuroradiology job market within the study timeframe. MATERIALS AND METHODS The American Society of Neuroradiology and American College of Radiology job boards were queried for neuroradiology positions between August 12, 2022, and December 31, 2022. The positions and requirements were categorized into academic versus private practice, general diagnostic radiology, full-subspecialized neuroradiology, hybrid remote/onsite, outpatient, inpatient/emergency, general interventional radiology procedures, and neuroradiology procedures. Exclusion criteria included neurointerventional only, remote-only, pediatric-only, no preference for neuroradiology, and duplicate posts within and between the job boards. RESULTS Of 1777 total job posts, 179 were neuroradiology-specific and the remainder were general. Of the 179 neuroradiology-specific jobs, 55 neuroradiology jobs were academic and 124 jobs were private practice. A higher proportion of private practice jobs required general diagnostic interpretations (83% versus 26%), a higher proportion of academic jobs required neuroradiology procedures (56% versus 31%), and a higher proportion of private practice jobs required general interventional radiology procedures (22% versus 0%). Thirty-nine percent of all neuroradiology-specific onsite jobs required neuroradiology procedures, and 15% required general interventional radiology procedures. CONCLUSIONS Because there was a sizable difference between general radiology and procedure requirements between academic and private practice positions, tailoring fellowship training for career aspirations of neuroradiology fellows should be considered to adapt to the skills needed for the evolving job market. In the queried timeframe, 61% of neuroradiology-specific onsite jobs did not have a specific procedure skill requirement for job applicants. This article serves as a single snapshot of the job market and its requirements for neuroradiologists, to aid in planning training to meet the needs of employers.
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Affiliation(s)
- Vishal D Thumar
- From the Department of Radiology (V.D.T., J.Y.C.), University of California, San Diego Health System, San Diego, California
| | - James Y Chen
- From the Department of Radiology (V.D.T., J.Y.C.), University of California, San Diego Health System, San Diego, California
- Department of Radiology (J.Y.C.), San Diego Veterans Affairs Medical Center, San Diego, California
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Mathur D, Barnacle BD, Magera RW, Fazal Z, Zafar AM. System-based strategies for mitigating burnout in radiology. Emerg Radiol 2024:10.1007/s10140-024-02275-5. [PMID: 39073731 DOI: 10.1007/s10140-024-02275-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2024] [Accepted: 07/17/2024] [Indexed: 07/30/2024]
Abstract
BACKGROUND Burnout is a chronic problem prevalent in radiology, with a significant burden on individuals and healthcare systems. DISCUSSION A substantial portion of the literature on managing burnout has focused on individual-based remedies. We posit that burnout is a systemic problem and present an overview of some system-based strategies that could be employed to mitigate burnout in radiology. These include managing workload, optimizing work shifts, maximizing autonomy, limiting work-life conflicts, creating opportunities for professional fulfillment, utilizing user-friendly electronic medical records (EMR), deploying efficient picture archiving and communication systems (PACS), building system redundancy, leadership transparency, and fostering a healthy work environment. CONCLUSION: System-based strategies can help mitigate burnout.
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Affiliation(s)
- Diya Mathur
- MD/MBA Candidate at Dartmouth Geisel School of Medicine and Tuck Business School, 1 Rope Ferry Road, Hanover, NH, 03755, USA
| | - Brian D Barnacle
- Dartmouth Health, Department of Radiology, 1 Medical Center Drive, Lebanon, NH, 03766, USA.
| | - Ruth W Magera
- Dartmouth Health, Department of Radiology, 1 Medical Center Drive, Lebanon, NH, 03766, USA
| | - Zanira Fazal
- Dartmouth Health, Department of Internal Medicine, 1 Medical Center Drive, Lebanon, NH, 03766, USA
| | - Abdul M Zafar
- Dartmouth Health, Department of Radiology, 1 Medical Center Drive, Lebanon, NH, 03766, USA
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Thakore NL, Lan M, Winkel AF, Vieira DL, Kang SK. Best Practices: Burnout Is More Than Binary. AJR Am J Roentgenol 2024. [PMID: 39016454 DOI: 10.2214/ajr.24.31111] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2024]
Abstract
Burnout among radiologists is increasingly prevalent, with potential for substantial negative impact on physician well-being, care delivery, and health outcomes. To evaluate this phenomenon using reliable and accurate means, validated quantitative instruments are essential. Variation in measurement can contribute to wide-ranging findings. This article evaluates radiologist burnout rates globally and dimensions of burnout as reported using different validated instruments and provide guidance on best practices to characterize burnout. Fifty-seven studies between 1990 and 2023 were included in a systematic review, and 43 studies were included in a meta-analysis of burnout prevalence using random effects models. Reported burnout ranged from 5% to 85%. With the Maslach Burnout Inventory (MBI), burnout prevalence varied significantly depending on instrument version. Among MBI subcategories, the prevalence of emotional exhaustion was 54% (95% CI, 45-63%), depersonalization was 52% (95% CI, 41-63%), and low personal accomplishment was 36% (95% CI, 27-47%). Other validated burnout instruments showed less heterogeneous results; studies using the Stanford Professional Fulfillment Index yielded burnout prevalence of 39% (95% CI, 34-45%), whereas the Validated Single-Item instrument yielded 34% (95% CI, 29-39%). Standardized instruments for prevalence alongside multidimensional profiles capturing experiences may better characterize radiologist burnout, including change over time.
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Affiliation(s)
| | - Michael Lan
- NYU Grossman School of Medicine, New York, NY
| | | | - Dorice L Vieira
- Health Sciences Library, NYU Grossman School of Medicine, New York, NY
| | - Stella K Kang
- Associate Professor, Department of Radiology, NYU Langone Health, New York, NY
- Department of Population Health, NYU Langone Health, New York, NY
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4
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Ho M, Agrawal R, Lam D, Hartman J, Sandstrom CK, Chorath K, Bhargava P, Wu L. Flipping the script: A multiyear assessment and comparison of flipped classroom versus traditional didactic teaching at two academic institutions. Curr Probl Diagn Radiol 2024:S0363-0188(24)00121-X. [PMID: 39019713 DOI: 10.1067/j.cpradiol.2024.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2024] [Accepted: 07/08/2024] [Indexed: 07/19/2024]
Abstract
RATIONALE AND OBJECTIVES Historically radiology resident education has taken the form of workstation and didactic teaching. Due to increasing clinical demand and administrative burden for academic radiologists, the need for more efficient and effective teaching has increased. Flipped classroom teaching, where trainees independently learn material prior to interactive teaching sessions with faculty, is a possible alternative. While the use of flipped teaching in radiology has been studied in the medical student setting, its use in the radiology residency setting has been less published. MATERIALS AND METHODS At two academic institutions (University of Washington and Northwestern), exam scores from five PGY-2 Core rotations were collected. Flipped teaching was used for one rotation at the University of Washington (FR). The influence of teaching method, rotation, and institution on exam score was examined. Resident surveys were also collected to understand perceptions of flipped classroom teaching. RESULTS At the University of Washington, the mean exam score for the flipped rotation was significantly higher than the majority of other rotations utilizing traditional teaching (p<0.05). Between the University of Washington and Northwestern, there was no difference in exam scores when comparing comparable rotations. Among residents at the University of Washington, the flipped teaching rotation was perceived as more educationally valuable than traditional teaching rotations. CONCLUSION Flipped classroom teaching is at least as effective as the traditional teaching model and associated with better performance on standardized exams at one institution. Among residents, flipped learning is also associated with higher perceived educational value.
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Affiliation(s)
- Michelle Ho
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States
| | - Rishi Agrawal
- Department of Thoracic Imaging, University of Texas MD Anderson Cancer Center, 1400 Pressler Street, Unit 1478, Houston, TX 77030-4008, United States
| | - Diana Lam
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States
| | - Jason Hartman
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States
| | - Claire K Sandstrom
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States
| | - Kevin Chorath
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States
| | - Puneet Bhargava
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States
| | - Lei Wu
- Department of Radiology, University of Washington, 1959 NE Pacific Street, Seattle, WA 98195, United States.
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5
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Becker M. How to prepare for a bright future of radiology in Europe. Insights Imaging 2023; 14:168. [PMID: 37816908 PMCID: PMC10564684 DOI: 10.1186/s13244-023-01525-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 09/16/2023] [Indexed: 10/12/2023] Open
Abstract
Because artificial intelligence (AI)-powered algorithms allow automated image analysis in a growing number of diagnostic scenarios, some healthcare stakeholders have raised doubts about the future of the entire radiologic profession. Their view disregards not only the role of radiologists in the diagnostic service chain beyond reporting, but also the many multidisciplinary and patient-related consulting tasks for which radiologists are solicited. The time commitment for these non-reporting tasks is considerable but difficult to quantify and often impossible to fulfil considering the current mismatch between workload and workforce in many countries. Nonetheless, multidisciplinary, and patient-centred consulting activities could move up on radiologists' agendas as soon as AI-based tools can save time in daily routine. Although there are many reasons why AI will assist and not replace radiologists as imaging experts in the future, it is important to position the next generation of European radiologists in view of this expected trend. To ensure radiologists' personal professional recognition and fulfilment in multidisciplinary environments, the focus of training should go beyond diagnostic reporting, concentrating on clinical backgrounds, specific communication skills with referrers and patients, and integration of imaging findings with those of other disciplines. Close collaboration between the European Society of Radiology (ESR) and European national radiologic societies can help to achieve these goals. Although each adequate treatment begins with a correct diagnosis, many health politicians see radiologic procedures mainly as a cost factor. Radiologic research should, therefore, increasingly investigate the imaging impact on treatment and outcome rather than focusing mainly on technical improvements and diagnostic accuracy alone.Critical relevance statement Strategies are presented to prepare for a successful future of the radiologic profession in Europe, if AI-powered tools can alleviate the current reporting overload: engaging in multidisciplinary activities (clinical and integrative diagnostics), enhancing the value and recognition of radiologists' role through clinical expertise, focusing radiological research on the impact on diagnosis and outcome, and promoting patient-centred radiology by enhancing communication skills.Key points • AI-powered tools will not replace radiologists but hold promise to reduce the current reporting burden, enabling them to reinvest liberated time in multidisciplinary clinical and patient-related tasks.• The skills and resources for these tasks should be considered when recruiting and teaching the next generation of radiologists, when organising departments and planning staffing.• Communication skills will play an increasing role in both multidisciplinary activities and patient-centred radiology.• The value and importance of a correct and integrative diagnosis and the cost of an incorrect imaging diagnosis should be emphasised when discussing with non-medical stakeholders in healthcare.• The radiologic community in Europe should start now to prepare for a bright future of the profession for the benefit of patients and medical colleagues alike.
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Affiliation(s)
- Minerva Becker
- Unit of Head and Neck and Maxilofacial Radiology, Division of Radiology, Diagnostic Department, Geneva University Hospitals, University of Geneva, Rue Gabrielle Perret Gentil 4, Geneva 14, CH 1211, Switzerland.
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6
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Oprisan A, Baettig-Arriagada E, Baeza-Delgado C, Martí-Bonmatí L. Prevalence of burnout syndrome in Spanish radiologists. RADIOLOGIA 2023; 65:307-314. [PMID: 37516484 DOI: 10.1016/j.rxeng.2021.09.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Accepted: 09/07/2021] [Indexed: 07/31/2023]
Abstract
BACKGROUND AND AIMS The primary objective was to analyze the prevalence and degree of professional burnout in radiologists in Spain. Secondary objectives were to identify possible factors that increase or decrease the risk of burnout to enable preventive and corrective measures, decrease the stress associated with this condition, and thereby increase radiologists' performance and satisfaction at work. MATERIAL AND METHODS This cross-sectional observational study used a voluntary, anonymous online survey of attending radiologists and residents through Google Forms®. The survey was structured into three sections: a qualitative assessment of the degree of professional burnout with the Maslach Burnout Inventory Human Services Survey (MBI-HSS), a series of sociodemographic and work-related questions, and a final section centered on possible causes of stress and improvements to the working environment. The results of the survey were analyzed statistically to determine which variables were associated with burnout syndrome as well as to identify possible risk factors and protective factors. RESULTS After disseminating the survey through social networks and email contacts, we received a total of 226 responses (175 from attending radiologists and 51 from residents; 52% men; mean age, 41 ± 11 years; age range, 25-68). The prevalence of the syndrome was 33%, without significant differences between attending radiologists and residents. No risk factors associated with burnout were identified. Teaching in the workplace was the only protective factor. CONCLUSIONS One-third of the respondents had burnout syndrome. Because the consequences of this syndrome can affect professionals' personal life and their ability to do their jobs, early detection and intervention should be prioritized.
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Affiliation(s)
- A Oprisan
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain.
| | - E Baettig-Arriagada
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain
| | - C Baeza-Delgado
- Grupo de Investigación Biomédica en Imagen (GIBI230), Instituto de Investigación Sanitaria La Fe, Valencia, Spain
| | - L Martí-Bonmatí
- Área Clínica de Imagen Médica, Hospital Universitario y Politécnico La Fe, Valencia, Spain; Grupo de Investigación Biomédica en Imagen (GIBI230), Instituto de Investigación Sanitaria La Fe, Valencia, Spain; Académico de Número de la Real Academia Nacional de Medicina de España, Spain
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7
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Lexa FJ, Parikh JR. Leadership: Causing and Curing Burnout in Radiology. J Am Coll Radiol 2023; 20:500-502. [PMID: 36914082 PMCID: PMC10149620 DOI: 10.1016/j.jacr.2023.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 03/02/2023] [Accepted: 03/06/2023] [Indexed: 03/15/2023]
Abstract
Burnout in US radiology has reached crisis proportions. Leaders play critical roles in both causing and preventing burnout. This article will review the current state of the crisis and how leaders can work to stop causing burnout as well as developing proactive strategies for preventing and mitigating burnout.
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Affiliation(s)
- Frank J Lexa
- Professor and Vice Chair of Faculty Affairs, Department of Radiology, University of Pittsburgh, Pittsburgh, Pennsyvania; and UPMC International Vice President, the American College of Radiology Chief Medical Officer, The Radiology Leadership Institute of the ACR.
| | - Jay R Parikh
- Professor and Division Wellness Lead, Department of Breast Imaging, Division of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, Houston, Texas
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8
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Rao SA, Deshpande NG, Richardson DW, Brickman J, Posner MC, Matthews JB, Turaga KK. Alignment of RVU Targets With Operating Room Block Time. ANNALS OF SURGERY OPEN 2023; 4:e260. [PMID: 37600898 PMCID: PMC10431441 DOI: 10.1097/as9.0000000000000260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/09/2023] [Indexed: 02/24/2023] Open
Abstract
Background Surgeon productivity is measured in relative value units (RVUs). The feasibility of attaining RVU productivity targets requires surgeons to have enough allocated block time to generate RVUs. However, it is unknown how much block time is required for surgeons to attain specific RVU targets. We aimed to estimate the effect of surgeon and practice environment characteristics (SPECs) on block time needed to attain fixed RVU targets. Methods We computationally simulated individual surgeons' annual caseloads under a variety of SPECs in the following way. First, empirical case data were sampled from ACS NSQIP in accordance with surgeon specialty, case-mix complexity, and RVU target. Surgeons' operating schedules were then constructed according to the block length, turnover time, and scheduling flexibility of the practice environment. These 6 SPECs were concurrently varied over their ranges for a 6-way sensitivity analysis. Results Annual operating schedules for 60,000,000 surgeons were simulated. The number of blocks required to attain RVU targets varied significantly with surgeon specialty and increased with increased case-mix complexity, increased turnover time, and decreased scheduling flexibility. Intraspecialty variation in block requirement with variation in environmental characteristics exceeded interspecialty variation with fixed environmental characteristics. Multivariate linear models predicted block utilization across surgical specialties with consideration for the stated factors. An online tool is shared with which to apply these results to one's particular practice. Conclusions Block time required to attain RVU targets varies widely with SPECs; intraspecialty variation exceeds interspecialty variation. The feasibility of attaining RVU targets requires alignment between targets and allocated operating time with consideration for surgical specialty and other practice conditions.
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Affiliation(s)
- Saieesh A. Rao
- From the Department of Surgery, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Nikita G. Deshpande
- Division of Biological Sciences, Department of Medicine, University of Chicago, Chicago, IL
| | - Douglas W. Richardson
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| | - Jon Brickman
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| | - Mitchell C. Posner
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| | - Jeffrey B. Matthews
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
| | - Kiran K. Turaga
- Division of Biological Sciences, Department of Surgery, University of Chicago, Chicago, IL
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9
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Alexander R, Waite S, Bruno MA, Krupinski EA, Berlin L, Macknik S, Martinez-Conde S. Mandating Limits on Workload, Duty, and Speed in Radiology. Radiology 2022; 304:274-282. [PMID: 35699581 PMCID: PMC9340237 DOI: 10.1148/radiol.212631] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Research has not yet quantified the effects of workload or duty hours on the accuracy of radiologists. With the exception of a brief reduction in imaging studies during the 2020 peak of the COVID-19 pandemic, the workload of radiologists in the United States has seen relentless growth in recent years. One concern is that this increased demand could lead to reduced accuracy. Behavioral studies in species ranging from insects to humans have shown that decision speed is inversely correlated to decision accuracy. A potential solution is to institute workload and duty limits to optimize radiologist performance and patient safety. The concern, however, is that any prescribed mandated limits would be arbitrary and thus no more advantageous than allowing radiologists to self-regulate. Specific studies have been proposed to determine whether limits reduce error, and if so, to provide a principled basis for such limits. This could determine the precise susceptibility of individual radiologists to medical error as a function of speed during image viewing, the maximum number of studies that could be read during a work shift, and the appropriate shift duration as a function of time of day. Before principled recommendations for restrictions are made, however, it is important to understand how radiologists function both optimally and at the margins of adequate performance. This study examines the relationship between interpretation speed and error rates in radiology, the potential influence of artificial intelligence on reading speed and error rates, and the possible outcomes of imposed limits on both caseload and duty hours. This review concludes that the scientific evidence needed to make meaningful rules is lacking and notes that regulating workloads without scientific principles can be more harmful than not regulating at all.
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Affiliation(s)
- Robert Alexander
- From the Departments of Ophthalmology (R.A., S.M., S.M.C.), Radiology (S.W.), Neurology (S.M., S.M.C.), and Physiology & Pharmacology (S.M., S.M.C.), SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203; Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pa (M.A.B.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (E.A.K.); and Department of Radiology, Rush University Medical College and University of Illinois, Chicago, Ill (L.B.)
| | - Stephen Waite
- From the Departments of Ophthalmology (R.A., S.M., S.M.C.), Radiology (S.W.), Neurology (S.M., S.M.C.), and Physiology & Pharmacology (S.M., S.M.C.), SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203; Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pa (M.A.B.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (E.A.K.); and Department of Radiology, Rush University Medical College and University of Illinois, Chicago, Ill (L.B.)
| | - Michael A Bruno
- From the Departments of Ophthalmology (R.A., S.M., S.M.C.), Radiology (S.W.), Neurology (S.M., S.M.C.), and Physiology & Pharmacology (S.M., S.M.C.), SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203; Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pa (M.A.B.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (E.A.K.); and Department of Radiology, Rush University Medical College and University of Illinois, Chicago, Ill (L.B.)
| | - Elizabeth A Krupinski
- From the Departments of Ophthalmology (R.A., S.M., S.M.C.), Radiology (S.W.), Neurology (S.M., S.M.C.), and Physiology & Pharmacology (S.M., S.M.C.), SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203; Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pa (M.A.B.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (E.A.K.); and Department of Radiology, Rush University Medical College and University of Illinois, Chicago, Ill (L.B.)
| | - Leonard Berlin
- From the Departments of Ophthalmology (R.A., S.M., S.M.C.), Radiology (S.W.), Neurology (S.M., S.M.C.), and Physiology & Pharmacology (S.M., S.M.C.), SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203; Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pa (M.A.B.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (E.A.K.); and Department of Radiology, Rush University Medical College and University of Illinois, Chicago, Ill (L.B.)
| | - Stephen Macknik
- From the Departments of Ophthalmology (R.A., S.M., S.M.C.), Radiology (S.W.), Neurology (S.M., S.M.C.), and Physiology & Pharmacology (S.M., S.M.C.), SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203; Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pa (M.A.B.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (E.A.K.); and Department of Radiology, Rush University Medical College and University of Illinois, Chicago, Ill (L.B.)
| | - Susana Martinez-Conde
- From the Departments of Ophthalmology (R.A., S.M., S.M.C.), Radiology (S.W.), Neurology (S.M., S.M.C.), and Physiology & Pharmacology (S.M., S.M.C.), SUNY Downstate Health Sciences University, 450 Clarkson Ave, Brooklyn, NY 11203; Department of Radiology, Penn State Milton S. Hershey Medical Center, Hershey, Pa (M.A.B.); Department of Radiology and Imaging Sciences, Emory University, Atlanta, Ga (E.A.K.); and Department of Radiology, Rush University Medical College and University of Illinois, Chicago, Ill (L.B.)
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Higgins MC, Siddiqui AA, Kosowsky T, Unan L, Mete M, Rowe S, Marchalik D. Burnout, Professional Fulfillment, Intention to Leave, and Sleep-Related Impairment among Radiology Trainees across the United States (US): A Multisite Epidemiologic Study. Acad Radiol 2022; 29 Suppl 5:S118-S125. [PMID: 35241358 DOI: 10.1016/j.acra.2022.01.022] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2021] [Revised: 01/28/2022] [Accepted: 01/31/2022] [Indexed: 12/25/2022]
Abstract
OBJECTIVE To examine the prevalence of burnout among radiology trainees in the United States, and to study the relationships between burnout and professional fulfillment (PF), intent-to-leave (ITL), sleep-related impairment and self-compassion by gender. METHODS This cross-sectional study was conducted via an anonymous electronic survey sent to 11 large academic medical centers (Physician Wellness Academic Consortium) between January 2017 and September 2018. The survey included the Professional Fulfillment Index (PFI) and an abbreviated form of the PROMIS Sleep-related impairment (SRI) scale. Two-sample t-tests and chi-square exact tests were used for analysis (p < 0.05). RESULTS Two hundred forty-seven radiology residents responded to the survey. Out of these, 36.2% reported burnout, 37.4% endorsed PF, 64.8% reported sleep-related impairment, 7.6% expressed ITL. There were no significant differences between genders. Burnout was associated with reduced PF, increased sleep-impairment (p < 0.001 for both) and increased ITL (p = 0.02). Lower PF, peer support, perceived appreciation for and meaningfulness in work, alignment of organizational and personal values, self-compassion, and higher sleep impairment were associated with burnout (p < 0.001 for all). Burnout was associated with perceptions of less support from department leaders (p = 0.003), control over schedules (p = 0.001) and helpfulness of electronic health record systems (p = 0.01). ITL was associated with reduced PF, perceived work appreciation, and leadership support (p = 0.03, p = 0.04, and p = 0.007, respectively). DISCUSSION Burnout is prevalent among radiology residents. Many demonstrate sleep-impairment and reduced professional fulfillment, with a lesser fraction desiring to leave their institution. Key factors to burnout included peer and organizational support, electronic health record systems helpfulness, and personal factors like self-compassion and work appreciation.
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11
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Seghers MC, Seghers VJ, Sher AC, Jadhav SP, States LJ, Trout AT, Alazraki AL, Sammer MBK. Working from home during the COVID-19 pandemic: surveys of the Society for Pediatric Radiology and the Society of Chiefs of Radiology at Children's Hospitals. Pediatr Radiol 2022; 52:1242-1254. [PMID: 35229184 PMCID: PMC8885321 DOI: 10.1007/s00247-022-05299-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Revised: 12/19/2021] [Accepted: 01/23/2022] [Indexed: 12/25/2022]
Abstract
BACKGROUND Due to the COVID-19 pandemic, some pediatric radiologists have shifted to working from home; the long-term ramifications for pediatric radiologists and departments have not yet been defined. OBJECTIVE To characterize experiences of working from home associated with the COVID-19 pandemic and guide expectations after the pandemic is controlled, via separate surveys of Society for Pediatric Radiology (SPR) and Society of Chiefs of Radiology at Children's Hospitals (SCORCH) members. MATERIALS AND METHODS Two separate surveys were conducted. In the first, SPR members were surveyed Jan. 11 through Feb. 8, 2021. The response rate was 17.0% (255 of 1,501). Survey questions included demographics, information on the ability to work from home and subjective experiences ranked on a scale of 0 to 10. The survey enabled segregation and comparison of responses between those with and without home PACS. In the second survey, SCORCH members were surveyed Dec. 8, 2020, through Jan. 8, 2021. The response rate was 51.5% (51/99). Survey questions included the logistics of working from home, technical specifications and the expectations on clinical duties performed from home. The Wilcoxon rank test was used to determine statistical significance of compared variables between respondents with and without home PACS in SPR members, and expectations between SPR and SCORCH members. Descriptive statistics summarized demographic questions and free text responses. RESULTS The majority of member respondents (81.2%, 207/255) had a home PACS and most departments provided home PACS to faculty (94.1%, 48/51). Overall, radiologists who could work from home were satisfied with their ability to work from home (mean rating: 8.3/10) and were significantly more satisfied than predicted by those without home PACS (5.9/10, P<0.0001). Respondents overwhelmingly indicated they were less able to teach trainees (mean rating: 2.7/10) and had decreased emotional engagement (mean rating: 4.4/10), but had improved research productivity and cognitive ability for research when working from home (mean rating for both: 5.3/10). Regarding the expectations of the ability to work from home after no longer needing to address the pandemic, department chairs generally favored fewer rotations from home, with 97.9% (47/48) indicating working from home should be 60% or fewer assignments, compared with 84.1% (164/195) of individual radiologists (P=0.071). CONCLUSIONS Due to the COVID-19 pandemic, there has been a shift to working from home using PACS. Results of these SPR and SCORCH member surveys can help inform future decisions regarding pediatric radiologists working from home once the pandemic has been controlled.
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Affiliation(s)
- Matthew C. Seghers
- grid.89336.370000 0004 1936 9924Dell Medical School, The University of Texas at Austin, Austin, TX USA
| | - Victor J. Seghers
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Andrew C. Sher
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Siddharth P. Jadhav
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
| | - Lisa J. States
- grid.239552.a0000 0001 0680 8770Department of Radiology, The Children’s Hospital of Philadelphia, Philadelphia, PA USA ,grid.25879.310000 0004 1936 8972Department of Radiology, University of Pennsylvania, Philadelphia, PA USA
| | - Andrew T. Trout
- grid.239573.90000 0000 9025 8099Department of Radiology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA ,grid.24827.3b0000 0001 2179 9593Department of Radiology, University of Cincinnati College of Medicine, Cincinnati, OH USA
| | - Adina L. Alazraki
- grid.428158.20000 0004 0371 6071Department of Radiology, Children’s Healthcare of Atlanta, Atlanta, GA USA ,grid.189967.80000 0001 0941 6502Department of Radiology, Emory University, Atlanta, GA USA
| | - Marla B. K. Sammer
- grid.416975.80000 0001 2200 2638Edward B. Singleton Department of Radiology, Texas Children’s Hospital, 6701 Fannin Street, Suite 470, 77030 Houston, TX USA ,grid.39382.330000 0001 2160 926XDepartment of Radiology, Baylor College of Medicine, Houston, TX USA
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12
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Leveraging diversity, equity and inclusion for promoting wellness in the radiology workplace. Pediatr Radiol 2022; 52:1724-1729. [PMID: 35088132 PMCID: PMC8794737 DOI: 10.1007/s00247-022-05292-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/11/2021] [Accepted: 01/18/2022] [Indexed: 11/23/2022]
Abstract
Over the last decade, health care professionals in the field of radiology have experienced increasing rates of burnout. A study in 2017 showed high prevalence of burnout in pediatric radiology, and other studies have identified several drivers for burnout. An important factor in promoting wellness and mitigating burnout is leveraging diversity, equity and inclusion in the workplace. This manuscript highlights the importance of diversity in high-functioning teams as well as the critical role of equity and inclusion in the workplace to help create an organization where people belong and can effectively succeed.
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Chen JY, Vedantham S, Lexa FJ. Burnout and work-work imbalance in radiology- wicked problems on a global scale. A baseline pre-COVID-19 survey of US neuroradiologists compared to international radiologists and adjacent staff. Eur J Radiol 2022; 155:110153. [DOI: 10.1016/j.ejrad.2022.110153] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Revised: 12/27/2021] [Accepted: 01/04/2022] [Indexed: 11/03/2022]
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Richards TJ, Anderson KL, Anderson JS. "Fully automated segmentation of the corticospinal tract using the TractSeg algorithm in patients with brain tumors". Clin Neurol Neurosurg 2021; 210:107001. [PMID: 34749021 DOI: 10.1016/j.clineuro.2021.107001] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 10/11/2021] [Accepted: 10/12/2021] [Indexed: 11/18/2022]
Abstract
OBJECTIVE Tractography has been used to define the presurgical location of white matter tracts, but this is subjective and time-intensive, making incorporation to imaging workflow at scale problematic. The objective is to validate a fully automated pipeline using the TractSeg algorithm (Wasserthal et al. NeuroImage 2018;183:239-253) to segment the corticospinal tract in patients with brain tumors adjacent to the corticospinal tract. METHODS The process of importing a structural MPRAGE sequence and raw diffusion weighted images from PACS, executing the TractSeg algorithm, overlaying the resulting bilateral corticospinal tracts on the MPRAGE image, and exporting this composite image to PACS was automated. This procedure was used to segment the corticospinal tract in 28 patients with brain masses adjacent to or displacing the corticospinal tract. These segmentations were compared with both manual deterministic tractography performed with DSI Studio using seeds placed in the pons and an automated tractography method in DSI Studio. RESULTS The automated algorithm was able to segment the bilateral corticospinal tracts in all 28 patients whereas the manual reference method and DSI Studio based automated tractography were unsuccessful in 2 and 1 patients, respectively. In all cases, the TractSeg segmentations very closely matched the manual segmentations. Also, TractSeg appeared to include larger portions of the lateral corticospinal tract fibers than the other 2 methods. CONCLUSION The TractSeg algorithm demonstrated robust performance in segmenting the corticospinal tract in patients with brain tumors adjacent to this tract. The algorithm is fast to perform and has great potential for optimizing and streamlining neurosurgical planning.
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Affiliation(s)
- Tyler J Richards
- University of Utah School of Medicine, Department of Radiology and Imaging Sciences, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140, USA.
| | - Keri L Anderson
- University of Utah School of Computing, Department of Computer Science, Merrill Engineering, 50 Central Campus Dr, Salt Lake City, UT 84112, USA.
| | - Jeffrey S Anderson
- University of Utah School of Medicine, Department of Radiology and Imaging Sciences, 30 North 1900 East #1A071, Salt Lake City, UT 84132-2140, USA.
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15
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Oprisan A, Baettig-Arriagada E, Baeza-Delgado C, Martí-Bonmatí L. Prevalencia del síndrome de desgaste en radiólogos españoles. RADIOLOGIA 2021. [DOI: 10.1016/j.rx.2021.09.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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16
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Richards TJ, Schmitt JE, Wolansky LJ, Nayate AP. Radiology Performed Fluoroscopy-Guided Lumbar Punctures Decrease Volume of Diagnostic Study Interpretation - Impact on Resident Training and Potential Solutions. J Clin Imaging Sci 2021; 11:39. [PMID: 34345529 PMCID: PMC8326109 DOI: 10.25259/jcis_2_2021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2021] [Accepted: 06/16/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives: Lumbar punctures performed in radiology departments have significantly increased over the last few decades and are typically performed in academic centers by radiology trainees using fluoroscopy guidance. Performing fluoroscopy-guided lumbar punctures (FGLPs) can often constitute a large portion of a trainee’s workday and the impact of performing FGLPs on the trainee’s clinical productivity (i.e. dictating reports on neuroradiology cross-sectional imaging) has not been studied. The purpose of the study was to evaluate the relationship between the number of FGLPs performed and cross-sectional neuroimaging studies dictated by residents during their neuroradiology rotation (NR). Material and Methods: The number of FGLPs and myelograms performed and neuroimaging studies dictated by radiology residents on our neuroradiology service from July 2008 to December 2017 were retrospectively reviewed. The relationship between the number of FGLPs performed and neuroimaging studies (CT and MRI) dictated per day by residents was examined. Results: Radiology residents (n = 84) performed 3437 FGLPs and myelograms and interpreted 33402 cross-sectional studies. Poisson regression demonstrated an exponential decrease in number of studies dictated daily with a rising number of FGLPs performed (P = 0.0001) and the following formula was derived: Number of expected studies dictated per day assuming no FGLPs × e-0.25 x number of FGLPs = adjusted expected studies dictated for the day. Conclusion: We quantified the impact performing FGLPs can have on the number of neuroimaging reports residents dictate on the NR. We described solutions to potentially decrease unnecessary FGLP referrals including establishing departmental guidelines for FGLP referrals and encouraging bedside lumbar punctures attempts before referral. We also emphasized equally distributing the FGLPs among trainees to mitigate procedural burden.
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Affiliation(s)
- Tyler John Richards
- Department of Radiology, University of Utah, Salt Lake City, Utah, United States
| | - James Eric Schmitt
- Department of Penn Radiology, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania, United States
| | - Leo J Wolansky
- Department of Diagnostic Imaging and Therapeutics, University of Connecticut School of Medicine, Farmington, Connecticut, United States
| | - Ameya P Nayate
- Department of Radiology, University Hospitals Cleveland Medical Center, Cleveland, Ohio, United States
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17
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Parikh JR, Bender CE. How Radiology Leaders Can Address Burnout. J Am Coll Radiol 2021; 18:679-684. [PMID: 33958083 DOI: 10.1016/j.jacr.2020.12.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2020] [Revised: 11/08/2020] [Accepted: 12/02/2020] [Indexed: 12/23/2022]
Abstract
The 2018 Annual Workforce Survey conducted by the ACR Commission on Human Resources demonstrated that, although the majority of radiology practice leaders acknowledge radiologist burnout as a significant problem, only about one in five leaders responded that their practices were either extremely or very effective at addressing physician burnout. Moving forward, leaders will be increasingly held accountable and expected to describe to their teams their reasons for not addressing burnout. In this article, common misperceptions that may contribute to radiology practice leaders not addressing burnout are described, followed by outlining practical skills that leaders should develop to effectively address burnout.
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Affiliation(s)
- Jay R Parikh
- Professor of Radiology, Division Wellness Lead, Division of Diagnostic Imaging, The University MD Anderson Cancer Center, Houston, Texas.
| | - Claire E Bender
- Professor, Department of Radiology, Mayo Clinic, Rochester, Minnesota
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18
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Clinician-Scientists: Can They Survive in the Modern Era? J Am Coll Radiol 2021; 18:192-197. [PMID: 33413899 DOI: 10.1016/j.jacr.2020.09.023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/25/2020] [Accepted: 09/02/2020] [Indexed: 11/22/2022]
Abstract
Clinician-scientists are commonly characterized as health care professionals who are proficient in both research and clinical practice. Their dual expertise positions them to play a vital role in translating research outcomes to clinical practice. However, economic changes in the past few decades are threatening their very survival. The purposes of this article are to review some of the economic forces that pose the greatest risks to clinician-scientists in the modern era and to glean lessons from the business world in overcoming these challenges. Health care consolidation and decreasing reimbursements are putting increasing financial pressure on academic institutions, leaving them more inclined to cut back on departmental research support. Innovative companies commit a certain percentage of their revenue to research and discovery. Academic institutions should similarly view their research budget as research and discovery that will sustain the future growth of radiology. They should quantify and define expectations for academic productivity, focus on return on investment, and bolster the infrastructure to foster commercial partnerships that can provide additional revenue to support the research mission. Success in academics does not occur by accident. It requires more than individual talent and hard work. It also requires institutional leaders who are committed to developing future academic leaders and supporting innovation.
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Parikh JR, Sun J, Mainiero MB. What Causes the Most Stress in Breast Radiology Practice? A Survey of Members of the Society of Breast Imaging. JOURNAL OF BREAST IMAGING 2021; 3:332-342. [PMID: 34056593 PMCID: PMC8139609 DOI: 10.1093/jbi/wbab012] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Indexed: 11/14/2022]
Abstract
OBJECTIVE The objective of this study is to determine the major stressors affecting practicing breast radiologists. METHODS All members of the Society of Breast Imaging within the United States received an email invitation to complete an anonymous survey evaluating stressors that may contribute to physician burnout. Stressors evaluated included pace at work, work-life balance, care of dependents, job security, financial strain, decreasing reimbursement, new regulations, delivering bad news, fear of getting sued, and dealing with difficult patients, radiologists, and administrators. RESULTS The overall response rate was 13.5% (312/2308). For those who opened the email, response rate was 24.6% (312/1269). The most prevalent stressors reported were working too fast (222/312, 71.2%), balancing demands of work with personal life (209/312, 70.0%), fear of getting sued (164/312, 52.6%), and dealing with difficult administrators (156/312, 50%). Prevalence of stress related to new regulation requirements, job security, financial strain, decreased reimbursement, dependent care, call, delivering bad news, and dealing with difficult patients, difficult referrers, and difficult radiologists were present in fewer than 50% of respondents. CONCLUSION The most prevalent sources of stress in breast imaging radiologists relate to working too fast and balancing demands of work with time needed for personal life.
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Affiliation(s)
- Jay R Parikh
- University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX, USA
| | - Jia Sun
- University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX, USA
| | - Martha B Mainiero
- Alpert Medical School of Brown University, Department of Diagnostic Imaging, Providence, RI, USA
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20
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Santavicca S, Hughes DR, Fleishon HB, Lexa F, Rubin E, Rosenkrantz AB, Duszak R. Radiologist-Practice Separation: Recent Trends and Characteristics. J Am Coll Radiol 2021; 18:580-589. [PMID: 33197406 DOI: 10.1016/j.jacr.2020.10.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 10/05/2020] [Accepted: 10/06/2020] [Indexed: 11/26/2022]
Abstract
PURPOSE To assess recent trends and characteristics in radiologist-practice separation across the United States. METHODS Using the Medicare Physician Compare and Medicare Physician and Other Supplier Public Use File data sets, we linked all radiologists to associated group practices annually between 2014 and 2018 and assessed radiologist-practice separation over a variety of physician and group characteristics. Multivariate logistic regression modeling was used to estimate the likelihood of radiologist-practice separation. RESULTS Of 25,228 unique radiologists associated with 4,381 unique group practices, 41.1% separated from at least one group practice between 2014 and 2018, and annual separation rates increased 38.4% over time (13.8% from 2014 to 2015 to 19.2% from 2017 to 2018). Radiologist-practice separation rates ranged from 57.4% in Utah to 26.3% in Virginia. Separation rates were 42.8% for general radiologists versus 38.2% for subspecialty radiologists. Among subspecialists, separation rates ranged from 43.0% for breast imagers to 33.5% for cardiothoracic radiologists. Early career status (odds ratio [OR] = 1.286) and late (OR = 1.554) career status were both independent positive predictors of radiologist-practice separation (both P < .001). Larger practice size (OR = 0.795), radiology-only (versus multispecialty) group (OR = 0.468), academic (versus nonacademic) practice (OR = 0.709), and abdominal (OR = 0.820), musculoskeletal (OR = 0.659), and neuroradiology (OR = 0.895) subspecialization were independent negative predictors (all P < .05). CONCLUSIONS With over 40% of radiologists separating from at least one practice in recent years, the US radiologist workforce is highly and increasingly mobile. Because reasons for separation (eg, resignation, practice acquisition) cannot be assessed using administrative data, further attention is warranted given the manifold financial, operational, and patient care implications.
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Affiliation(s)
- Stefan Santavicca
- School of Economics, Georgia Institute of Technology, Atlanta, Georgia.
| | - Danny R Hughes
- Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia; Professor, School of Economics and Director, Health Economics and Analytics Lab (HEAL) Georgia Institute of Technology, Atlanta, Georgia
| | - Howard B Fleishon
- Chair, ACR Board of Chancellors, American College of Radiology, Reston, Virginia; Associate Professor, Department of Radiology and Medical Imaging, Emory University, Atlanta, Georgia and Chief of Radiology Services, Emory Johns Creek Hospital, Johns Creek, Georgia
| | - Frank Lexa
- Professor and Vice Chair-Faculty Affairs, Department of Radiology, University of Pittsburgh and UPMC International. Chief Medical Officer, The Radiology Leadership Institute and Chair of the Commission on Leadership and Practice Development of the American College of Radiology
| | - Eric Rubin
- Director, CT Division, Southeast Radiology Limited, Ridley Park, Pennsylvania
| | - Andrew B Rosenkrantz
- Professor of Radiology and Urology, Director of Prostate Imaging, Director of Health Policy, and Section Chief of Abdominal Imaging, Department of Radiology, NYU Grossman School of Medicine, and NYU Langone Health, New York, New York
| | - Richard Duszak
- Professor and Vice Chair of Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, and Emory Healthcare, Atlanta, Georgia
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21
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Masur JH, Schmitt JE, Lalevic D, Cook TS, Bagley LJ, Mohan S, Nayate AP. Am I Ready to Be an Independent Neuroradiologist? Objective Trends in Neuroradiology Fellows' Performance during the Fellowship Year. AJNR Am J Neuroradiol 2021; 42:815-823. [PMID: 33664112 DOI: 10.3174/ajnr.a7030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2020] [Accepted: 11/19/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Aside from basic Accreditation Council for Graduate Medical Education guidelines, few metrics are in place to monitor fellows' progress. The purpose of this study was to determine objective trends in neuroradiology fellowship training on-call performance during an academic year. MATERIALS AND METHODS We retrospectively reviewed the number of cross-sectional neuroimaging studies dictated with complete reports by neuroradiology fellows during independent call. Monthly trends in total call cases, report turnaround times, relationships between volume and report turnaround times, and words addended to preliminary reports by attending neuroradiologists were evaluated with regression models. Monthly variation in frequencies of call-discrepancy macros were assessed via χ2 tests. Changes in frequencies of specific macro use between fellowship semesters were assessed via serial 2-sample tests of proportions. RESULTS From 2012 to 2017, for 29 fellows, monthly median report turnaround times significantly decreased during the academic year: July (first month) = 79 minutes (95% CI, 71-86 minutes) and June (12th month) = 55 minutes (95% CI, 52-60 minutes; P value = .023). Monthly report turnaround times were inversely correlated with total volumes for CT (r = -0.70, F = 9.639, P value = .011) but not MR imaging. Words addended to preliminary reports, a surrogate measurement of report clarity, slightly improved and discrepancy rates decreased during the last 6 months of fellowship. A nadir for report turnaround times, discrepancy errors, and words addended to reports was seen in December and January. CONCLUSIONS Progress through fellowship correlates with a decline in report turnaround times and discrepancy rates for cross-sectional neuroimaging call studies and slight improvement in indirect quantitative measurement of report clarity. These metrics can be tracked throughout the academic year, and the midyear would be a logical time point for programs to assess objective progress of fellows and address any deficiencies.
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Affiliation(s)
- J H Masur
- From the Department of Radiology (J.H.M., J.E.S., D.L., T.S.C., L.J.B., S.M.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - J E Schmitt
- From the Department of Radiology (J.H.M., J.E.S., D.L., T.S.C., L.J.B., S.M.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - D Lalevic
- From the Department of Radiology (J.H.M., J.E.S., D.L., T.S.C., L.J.B., S.M.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - T S Cook
- From the Department of Radiology (J.H.M., J.E.S., D.L., T.S.C., L.J.B., S.M.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - L J Bagley
- From the Department of Radiology (J.H.M., J.E.S., D.L., T.S.C., L.J.B., S.M.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - S Mohan
- From the Department of Radiology (J.H.M., J.E.S., D.L., T.S.C., L.J.B., S.M.), Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania
| | - A P Nayate
- Department of Radiology (A.P.N.), University Hospitals Cleveland Medical Center, Cleveland, Ohio
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22
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Lexa FJ. Duty Hour Limits for Radiologists: It's About Time. J Am Coll Radiol 2021; 18:208-210. [PMID: 33413903 DOI: 10.1016/j.jacr.2020.06.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Accepted: 06/22/2020] [Indexed: 10/22/2022]
Affiliation(s)
- Frank J Lexa
- Chief Medical Officer of The Radiology Leadership Institute and Chair of the Commission on Leadership and Practice Development of the American College of Radiology, Reston, Virginia.
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Kalantarova S, Mickinac N, Santhosh S, Malik S, Surovitsky M, Madsen L, Rapoport I, Lee C, Hoffmann JC. Preventing Physician Burnout in Breast Imaging: Scope of the Problem and Keys to Success. Curr Probl Diagn Radiol 2020; 50:734-737. [PMID: 33069520 DOI: 10.1067/j.cpradiol.2020.09.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Accepted: 09/15/2020] [Indexed: 11/22/2022]
Abstract
Physicians, including radiologists and specifically breast imagers, face many challenges, and stressors during their daily routine, many of which can contribute to burnout. While there is an increasing body of literature evaluating burnout, including its prevalence in and impact on radiologists, there is a relative lack of information specifically addressing this topic as it relates to breast imaging. This article reviews key concepts in burnout, describes the potential impact on physicians at all levels of training and work, highlights unique aspects to the specialty of breast imaging that may contribute to burnout, and suggests tool and/or strategies that may help to combat and prevent burnout among breast imagers.
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Affiliation(s)
| | | | - Sharon Santhosh
- University at Buffalo Jacobs School of Medicine, Buffalo, NY
| | - Swati Malik
- New York Institute of Technology School of Osteopathic Medicine, Westbury, NY
| | | | - Laura Madsen
- Department of Radiology, NYU Winthrop Hospital, Mineola, NY
| | - Irina Rapoport
- Department of Radiology, NYU Winthrop Hospital, Mineola, NY
| | - Cindy Lee
- Department of Radiology, NYU Winthrop Hospital, Mineola, NY
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Ayyala RS, Baird GL, Sze RW, Brown BP, Taylor GA. The growing issue of burnout in radiology - a survey-based evaluation of driving factors and potential impacts in pediatric radiologists. Pediatr Radiol 2020; 50:1071-1077. [PMID: 32474773 DOI: 10.1007/s00247-020-04693-2] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2019] [Revised: 03/27/2020] [Accepted: 04/23/2020] [Indexed: 11/29/2022]
Abstract
BACKGROUND Burnout in medicine, and specifically radiology, has been receiving more attention. Little data-driven literature is available regarding risk factors/causes to ultimately help guide the development of potential solutions. OBJECTIVE To survey pediatric radiologists, a cohort with a documented high prevalence of burnout, and to understand the impact of clinical demands on nonclinical tasks and the implications of burnout on mental health. MATERIALS AND METHODS A survey of Society for Pediatric Radiology (SPR) North America attendings was performed regarding institutional factors contributing to burnout, including call burden, clinical demands, departmental support and administrative/academic tasks. Questions regarding mental health and wellness resources were also included. Generalized linear modeling assuming binomial distribution was used for analyses with SAS 9.4. RESULTS The response rate was 305/1,282 (24%) with 53% of respondents female. Respondents reported that both the number and complexity of clinical cases have increased since they first started practice as an attending, while the time for interpretation has not changed, P<0.0001. Using a scale of 0 (never), 1 (rarely), 2 (sometimes), 3 (frequently) and 4 (always), covering multiple hospitals (2.2) and administrative tasks (2.4) were the most stressful job factors. For those in administrative roles, the most stressful job factors were job-related tasks affected teaching duties (2.0) and decreased overall job satisfaction (2.0). Of the respondents, 52% said they know a physician affected by work stress-related mental illness and 25% know a physician who has contemplated or committed suicide. While 39% of the respondents have resources available to address burnout, only 33% utilize these resources. CONCLUSION Increasing clinical demands and additional institutional/departmental factors play a potential role in burnout, which has serious implications for the mental health of pediatric radiologists.
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Affiliation(s)
- Rama S Ayyala
- Department of Diagnostic Imaging, Rhode Island Hospital - Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
| | - Grayson L Baird
- Department of Diagnostic Imaging, Rhode Island Hospital - Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA
| | - Raymond W Sze
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Brandon P Brown
- Department of Radiology, Riley Hospital for Children at Indiana University Health, Indianapolis, IN, USA
| | - George A Taylor
- Department of Radiology, Boston Children's Hospital, Boston, MA, USA
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25
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Parikh JR, Sun J, Mainiero MB. Prevalence of Burnout in Breast Imaging Radiologists. JOURNAL OF BREAST IMAGING 2020; 2:112-118. [PMID: 38424894 DOI: 10.1093/jbi/wbz091] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2019] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Burnout is defined as a psychological syndrome arising as a response to chronic prolonged interpersonal job-related stress. Physician burnout has been increasingly recognized over the past decade as an epidemic within the United States. The goal of this study was to ascertain the prevalence of burnout amongst practicing breast imaging radiologists. METHODS A survey contained demographic questions based on workforce surveys carried out by the American College of Radiology and a validated condensed version of the Maslach Burnout Inventory (MBI) evaluating the three aspects of burnout. The radiologist members of the Society of Breast Imaging (SBI) received the survey internally from the SBI as a weekly e-mail with a web link to the survey from February 19, 2019, to March 13, 2019. The link allowed respondents to complete the survey anonymously. The authors were blinded to the SBI mailing list and the SBI was blinded to the responses. RESULTS A total of 370 breast imaging radiologists from the SBI responded to the survey. Overall, 290 out of 370 (78.4%) were highly burned out in at least 1 measured dimension of burnout; 197 out of 362 (54.4%) were highly burned out in at least 2 dimensions of burnout; and 27 out of 362 (7.5%) were highly burned out in all 3 dimensions of burnout. However, rates of personal accomplishment were high, with only 8.8% experiencing high burnout in the dimension of personal accomplishment. CONCLUSION Our study demonstrates a high prevalence of burnout amongst breast imaging radiologists. Burnout rates were highest in the youngest breast imaging radiologists.
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Affiliation(s)
- Jay R Parikh
- University of Texas MD Anderson Cancer Center, Department of Breast Imaging, Houston, TX
| | - Jia Sun
- University of Texas MD Anderson Cancer Center, Department of Biostatistics, Houston, TX
| | - Martha B Mainiero
- Alpert Medical School of Brown University, Department of Diagnostic Imaging, Providence, RI
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26
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Lexa FJ, Fessell DP, Gunderman RB. Radiologists in the Matrix: Serving Multiple Masters in Complex Organizations. J Am Coll Radiol 2020; 17:203-206. [DOI: 10.1016/j.jacr.2019.07.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2019] [Accepted: 07/02/2019] [Indexed: 11/28/2022]
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27
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Dabrowiecki A, Villalobos A, Krupinski EA. Impact of blue light filtering glasses on computer vision syndrome in radiology residents: a pilot study. J Med Imaging (Bellingham) 2019; 7:022402. [PMID: 31824984 DOI: 10.1117/1.jmi.7.2.022402] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 11/18/2019] [Indexed: 11/14/2022] Open
Abstract
Computer vision syndrome (CVS) is an umbrella term for a pattern of symptoms associated with prolonged digital screen exposure, such as eyestrain, headaches, blurred vision, and dry eyes. Commercially available blue light filtering lenses (BLFL) are advertised as improving CVS. Our pilot study evaluates the effectiveness of BLFL on reducing CVS symptoms and fatigue in a cohort of radiologists. A prospective crossover study was conducted with ten radiology residents randomized into two cohorts: one wearing BLFL first then a sham pair (non-BLFL), and the other wearing a sham pair first then BLFL, over two weeks during normal clinical work. Participants filled out a questionnaire using the validated computer vision syndrome questionnaire (CVS-Q) and the Swedish Occupational Fatigue Inventory (SOFI). The majority of symptoms [11/16 (68.8%) and 13/16 (81.3%) symptoms on the CVS-Q and SOFI, respectively] were reduced (i.e., symptoms less severe) with the BLFL compared to the sham glasses. Females rated symptoms of sleepiness and physical discomfort in the SOFI, and overall CVS-Q, as more severe. Postgraduate year (PGY)-2 residents rated all symptoms as more severe than PGY-3/4s. BLFL may ameliorate CVS symptoms. Future studies with larger sample sizes and participants of different ages are required to verify the potential of BLFL.
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Affiliation(s)
- Alexander Dabrowiecki
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, Georgia, United States
| | - Alexander Villalobos
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, Georgia, United States
| | - Elizabeth A Krupinski
- Emory University School of Medicine, Department of Radiology and Imaging Sciences, Atlanta, Georgia, United States
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28
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Tso HH, Parikh JR. Embracing social media in the era of work-life integration. Clin Imaging 2019; 58:191-193. [PMID: 31479851 DOI: 10.1016/j.clinimag.2019.07.011] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 07/09/2019] [Accepted: 07/29/2019] [Indexed: 12/31/2022]
Abstract
Radiology practices are leveraging social media for networking, education, branding, and marketing. This change inherently requires radiologists to increase their engagement in social media and may negatively affect work-life integration and contribute to radiologist burnout. In this article, we describe specific strategies that radiology practices may deploy to help balance work-life integration.
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Affiliation(s)
- Hilda H Tso
- Department of Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., CPB5.3208, Houston, TX 77030, USA.
| | - Jay R Parikh
- Department of Radiology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd., CPB5.3208, Houston, TX 77030, USA
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29
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Ayyala RS, Ahmed FS, Ruzal-Shapiro C, Taylor GA. Stressors contributing to burnout amongst pediatric radiologists: results from a survey of the Society for Pediatric Radiology. Pediatr Radiol 2019; 49:714-722. [PMID: 31069472 DOI: 10.1007/s00247-019-04370-z] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2018] [Revised: 02/04/2019] [Accepted: 02/21/2019] [Indexed: 11/25/2022]
Abstract
BACKGROUND A recent study showed a high prevalence of burnout in pediatric radiology. OBJECTIVE The purpose of this study is to evaluate potential stressors contributing to burnout in pediatric radiology. MATERIALS AND METHODS Society for Pediatric Radiology members received an invitation for an anonymous survey evaluating stressors contributing to burnout. Stressors evaluated included call burden, financial stress, work-life balance, health care evolution and job market changes, and radiology as a career choice. Additional questions regarding demographics were obtained. RESULTS The response rate was 460/1,453 (32%). The prevalence of emotional exhaustion was 66% (286/435), depersonalization was 61% (265/433) and perceived lack of personal accomplishment was 15% (67/436). In a backward selective logistic regression model, work-life imbalance and call burden were the only significant factors predicting higher emotional exhaustion (P<0.001). Using a similar model, work-life imbalance, call burden and decreased rate of reimbursement were significantly associated with higher probability of depersonalization (P=0.033, 0.0002 and 0.015, respectively). Emotional exhaustion and depersonalization were significantly associated with higher odds of a radiologist's wish to work in another medical specialty (P=0.011 and 0.002, respectively). CONCLUSION Key stressors contributing to burnout in pediatric radiology include work-life imbalance, pediatric call burden and a decreased rate of reimbursement. Burnout in pediatric radiology is a serious issue that needs to be addressed and prioritized on the individual and departmental/institutional levels and further investigated to develop effective interventions to mitigate it.
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Affiliation(s)
- Rama S Ayyala
- Department of Diagnostic Imaging, Rhode Island Hospital - Hasbro Children's Hospital, Warren Alpert Medical School of Brown University, 593 Eddy St., Providence, RI, 02903, USA.
| | - Firas S Ahmed
- Department of Radiology, Columbia University Medical Center, New York, NY, USA
| | - Carrie Ruzal-Shapiro
- Department of Radiology, Columbia University Medical Center, Morgan Stanley Children's Hospital, New York, NY, USA
| | - George A Taylor
- Department of Radiology, Boston Children's Hospital, Harvard Medical School, Boston, MA, USA
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30
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Ayyala RS, Ahmed FS, Ruzal-Shapiro C, Taylor GA. Prevalence of Burnout Among Pediatric Radiologists. J Am Coll Radiol 2019; 16:518-522. [DOI: 10.1016/j.jacr.2018.08.016] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 08/10/2018] [Accepted: 08/17/2018] [Indexed: 10/28/2022]
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31
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Mainiero MB, Parikh JR. Recognizing and Overcoming Burnout in Breast Imaging. JOURNAL OF BREAST IMAGING 2019; 1:60-63. [PMID: 38424870 DOI: 10.1093/jbi/wby003] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
Burnout is a psychological syndrome created by chronic job stress, and it is typified by emotional exhaustion, depersonalization, and feelings of decreased personal accomplishment. In physicians, burnout occurs at alarming rates, and it is on the rise. High burnout rates are ubiquitous in radiology across multiple subspecialties. We know of no study specifically examining burnout among breast imaging radiologists, but given the rates across multiple specialties in radiology, we must assume that a significant portion of breast imaging radiologists also experience burnout. As breast imaging increases in volume and complexity, we must find new ways of practicing that help achieve a healthy work environment.
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Affiliation(s)
- Martha B Mainiero
- Alpert Medical School Brown University, Department of Radiology, Providence, RI
| | - Jay R Parikh
- University of Texas MD Anderson Cancer Center, Department of Radiology, Houston, TX
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32
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Cohan RH, Davenport MS. Productivity, Meet Burnout. Acad Radiol 2018; 25:1513-1514. [PMID: 30487071 DOI: 10.1016/j.acra.2018.08.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2018] [Accepted: 08/12/2018] [Indexed: 11/15/2022]
Affiliation(s)
- Richard H Cohan
- Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109-5030.
| | - Matthew S Davenport
- Department of Radiology, University of Michigan Hospital, Ann Arbor, MI 48109-5030
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Zha N, Patlas MN, Neuheimer N, Duszak R. Prevalence of Burnout among Canadian Radiologists and Radiology Trainees. Can Assoc Radiol J 2018; 69:367-372. [DOI: 10.1016/j.carj.2018.05.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 05/07/2018] [Accepted: 05/25/2018] [Indexed: 01/01/2023] Open
Abstract
Purpose Physician burnout is on the rise compared to the average population, and radiology burnout rates are ranked high compared to other specialties. We aim to assess radiologist and radiology trainee burnout in Canada. Methods A survey using the abbreviated 7-item Maslach Burnout Inventory that characterizes burnout symptoms into personal accomplishment, emotional exhaustion, and depersonalization was sent to all eligible members of the Canadian Association of Radiologists in January 2018. The anonymous survey was hosted on SurveyMonkey for 1 month. A reminder e-mail was sent halfway through the survey period. Results Overall, 262 of 1401 invited radiology trainees and radiologists completed the survey (response rate 18.7%). With regards to personal accomplishment, we observed that (1) burnout in this domain improved with increased years worked and (2) milder symptoms were observed in community radiologists compared with their academic counterparts. In comparison with other studies of radiologist burnout, we found mild burnout symptoms in personal accomplishment, but severe symptoms in the burnout domains of both emotional exhaustion and depersonalization. Conclusions Canadian radiologists and radiology trainees reported above average burnout symptoms with regard to both emotional exhaustion and depersonalization. Future research directions include exploring etiologies of burnout and implementation of treatment strategies based on these identified problem areas.
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Affiliation(s)
- Nanxi Zha
- Division of Emergency/Trauma Radiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Michael N. Patlas
- Division of Emergency/Trauma Radiology, Department of Radiology, McMaster University, Hamilton, Ontario, Canada
| | - Nick Neuheimer
- Canadian Association of Radiologists, Ottawa, Ontario, Canada
| | - Richard Duszak
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, United States
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