Jefferson Radiology poor service

[lobelsteve]

Not asking for advice.
My sister had MR shoulder done Tuesday. She got the CD at visit. No official read after 5 days.
That’s crap. What’s wrong with the service line there? She is a physician as well.
Hey Jeff: you stink.

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[GoPelicans]

Look at it yourself if you have the cd shoulders are easy

 

[lobelsteve]

Cd mailed to me. But i didn’t order it and not treating. How long is turnaround time for an MRI there? Never more than 24 hrs in my system.

 

[Radology]

Not sure if you’re talking about Jefferson radiology in Connecticut or the hospital system in Philadelphia.

But the hospital system in Philadelphia massively overextended itself with mergers the past two decades and is now paying the price for it. I’ve anecdotally heard outpatient studies take multiple weeks for a read

And the Connecticut private practice is on the tail end of a private equity sale, so I would not be surprised if they’re overextended and understaffed for other reasons

 

[Fpg1245]

I’ve noticed that reads have deteriorated since I’ve been out. You can’t speak to the reading rad anymone and the interpretations leave much to be desired. Be it Jefferson Philly or Jefferson CT. They are basically just reading studies as fast as they can so they can move on to the next.

Quality control is lax and there’s very little that can be done as it’s becoming heavily consolidated

 

[Radology]

Nobody can keep up with volumes anymore since there are not enough radiologists, and seemingly every patient who steps foot into the hospital is thrown into the scanner for a pan scan with inadequate history .

Radiologists can choose to work 50% longer hours, give up 50% of their vacation, work 50% faster, or leave backlogs

There’s is no good choice right now

 

[GadRads]

I’ve noticed that reads have deteriorated since I’ve been out. You can’t speak to the reading rad anymone and the interpretations leave much to be desired. Be it Jefferson Philly or Jefferson CT. They are basically just reading studies as fast as they can so they can move on to the next.

Quality control is lax and there’s very little that can be done as it’s becoming heavily consolidated

Too much volume. Imaging is also overused. For example I was on call the other day, and from 5-9 pm, we read over 90+ CTs and MRIs, 150+ X-rays and ultrasounds. Thankfully there were 3 of us reading, and we read faster than average.

It is too much work these days.

 

[Fpg1245]

Too much volume. Imaging is also overused. For example I was on call the other day, and from 5-9 pm, we read over 90+ CTs and MRIs, 150+ X-rays and ultrasounds. Thankfully there were 3 of us reading, and we read faster than average.

It is too much work these days.

I can certainly see that. I mean look at the guidelines for a lot of maladies especially cancer…imaging galore

 

[Cognovi]

I can certainly see that. I mean look at the guidelines for a lot of maladies especially cancer…imaging galore

If our imaging volumes were growing based on guideline directed care, I'd be fine with it, especially cancer. But they're growing because the bedside clinicians are no longer comfortable relying on their bedside clinical acumen and order imaging for random things not covered in guidelines. More and more aches, lumps, nonlocalized issues, even rashes. Also it's because radiologists let it happen, as we would rather take the fistful of money and shove it in our pockets rather than expend more time pushing back on unindicated studies in order to get paid less. We are just stockpiling. We're not expanding residencies much. We are pushing through the pain in case the AI armageddon ever occurs, which apparently everyone outside of radiology thinks is imminent.

 

[Radology]

For anyone who honestly believes AI is imminent, look no further than Amazons “AI-powered” cashier-less grocery stores

Despite thinking we were shopping in the future, all AI stood for in this case was “Alotof Indians” watching videos of people shopping

 

[Clean7795]

If our imaging volumes were growing based on guideline directed care, I'd be fine with it, especially cancer. But they're growing because the bedside clinicians are no longer comfortable relying on their bedside clinical acumen and order imaging for random things not covered in guidelines. More and more aches, lumps, nonlocalized issues, even rashes. Also it's because radiologists let it happen, as we would rather take the fistful of money and shove it in our pockets rather than expend more time pushing back on unindicated studies in order to get paid less. We are just stockpiling. We're not expanding residencies much. We are pushing through the pain in case the AI armageddon ever occurs, which apparently everyone outside of radiology thinks is imminent.

1. We don't get paid to reject studies.

2. You make enemies when you reject studies. As a resident I rejected hundreds of urgent CT & MR studies, and it didn't really matter as long as I was right. As an attending there's a longitudinal relationship with the other doc (assuming we're working in the same hospital/healthcare system) that's generally not worth disrupting or receiving a complaint for.

3. Your gatekeeping power is limited. It's as easy as waiting until the next rad comes on and asking for the scan then.

I reject egregiously nonindicated scans, but otherwise it's impractical and bad for mental health to put any significant effort into gatekeeping.

 

[vm26]

1. We don't get paid to reject studies.

2. You make enemies when you reject studies. As a resident I rejected hundreds of urgent CT & MR studies, and it didn't really matter as long as I was right. As an attending there's a longitudinal relationship with the other doc (assuming we're working in the same hospital/healthcare system) that's generally not worth disrupting or receiving a complaint for.

3. Your gatekeeping power is limited. It's as easy as waiting until the next rad comes on and asking for the scan then.

I reject egregiously nonindicated scans, but otherwise it's impractical and bad for mental health to put any significant effort into gatekeeping.

Well said...Also often easier/less bandwidth consuming to just read the study than fight it....The down-side of all this are the spreadsheets that CMS looks at (increased volume/expenditure), which ultimately leads to more reimbursement cuts. I would think theres a breaking point but I've feeling this way for the past 5-10 years (and CMS has been cutting for at least past 25 years)

 

[Hypothalamus]

There is a tidal wave of volume across radiology and not enough radiologists to read. It's the same story everywhere. We get the white hot job market but in turn you have the extreme workload, burnout, and groups grumbling within about who is and isn't reading enough RVUs.

 

[vm26]

There is a tidal wave of volume across radiology and not enough radiologists to read. It's the same story everywhere. We get the white hot job market but in turn you have the extreme workload, burnout, and groups grumbling within about who is and isn't reading enough RVUs.

We are at an inflection point. Can PP groups get enough hospital subsidies to change the downward trend of $/wRVU?...At this point PP's that do not get subsidies will struggle with retainment and recruitment, and many may simply implode

 

[Radology]

private practices tend to benefit more from
The explosion in volumes, because they pretty much eat what they kill. Lose a partner to retirement? His/her salary gets splits between the rads who are left

Academic places will tend to give a fixed salary with fixed rvu bonuses while skimming off the top

 

[Steve_Zissou]

Nobody can keep up with volumes anymore since there are not enough radiologists, and seemingly every patient who steps foot into the hospital is thrown into the scanner for a pan scan with inadequate history .

Radiologists can choose to work 50% longer hours, give up 50% of their vacation, work 50% faster, or leave backlogs

There’s is no good choice right now

“CTA chest, abdomen, and pelvis. Indication: pain.” And obviously, no note or other comment anywhere.

 

[Ho0v-man]

“CTA chest, abdomen, and pelvis. Indication: r/o pain.” And obviously, no note or other comment anywhere.

ftfy

 

[meister]

private practices tend to benefit more from
The explosion in volumes, because they pretty much eat what they kill. Lose a partner to retirement? His/her salary gets splits between the rads who are left

Academic places will tend to give a fixed salary with fixed rvu bonuses while skimming off the top

This is only true if you haven’t been whittled to the bone and can hire.