Clearly the dept is operating outside the “range of normal variation” based off the reactions.
Before we even discuss “creep”. I’m always skeptical when I hear increasing volume; it may indicate that some studies (ct, mr, X-ray) aren’t truly necessary, thus freeing up time.
Also, before people are concerned about midlevel creep, to properly read a chest X-ray, it requires correlation with prior imaging and basal knowledge of CT imaging, for which radpeer is a somewhat illogical metric to use; the study looks into productivity but not temporal quality or referral reactions (an ER h/p is different quality than an IM h/p)
It appears they should explore internal home moonlighting, maybe a quicker pacs system, more efficient resident read out style (when I was a resident 10 years ago, the attending just told me the findings and we would go and dictate it, going through many scans; they clearly don’t have a shortage of attendings/residents/money, erecting a new hospital from what I read), exploring a “teaching” and “non teaching” X-ray service (possibly increasing efficiency), moonlighting low probability xrays such as outpatients or those performed at small community centers to old trainees, put pressure on referral services to leverage finances, and to “stop chasing scans.” Extender may have utility for fielding phone calls and general reading room coordination but comparing them to residents is illogical and nonproductive for patient care.