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Subspecialization in radiology: effects on the diagnostic spectrum of radiologists and report turnaround time in a Swiss university hospital

  • ABDOMINAL RADIOLOGY
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Abstract

Purpose

To analyze the changes in the work profiles of radiologists and the reporting time after the implementation of professional subspecialization in the radiology department of a Swiss university hospital.

Methods

In a retrospective analysis, the overall number of different radiologic examinations performed in the department of radiology of the largest Swiss university hospital was documented for 2014 and 2016 before and after the implementation of subspecialized reporting (subspecialities: abdominal, musculoskeletal, cardiothoracic, emergency, and pediatric imaging) in May 2015. For six selected radiologists, the number and types of reported examinations as well as the related radiology report turnaround times (RTATs) were analyzed in detail and compared between the two 1-year periods.

Results

Overall, there was a significant increase of 10.3% in the total number of examinations performed in the whole department in 2016 compared with 2014. For four of the six radiologists, the range of different types of examinations significantly decreased with the introduction of subspecialized reporting (p < 0.05). Furthermore, there was a significant change in the subset of the ten most commonly reported types of examinations reported by each of the six radiologists. Mean overall RTATs significantly increased for five of the six radiologists (p < 0.05).

Conclusions

Implementation of subspecialized reporting led to a change in the structure and a decrease in the range of different examination types reported by each radiologist. Mean RTAT increased for most radiologists. Subspecialized reporting allows the individual radiologist to focus on a special field of professional competence but can result in longer overall RTAT.

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References

  1. Liebscher L, Sherry C, Breslau J et al (2012) The general radiologist in the 21st century. J Am Coll Radiol 9:554–559

    Article  Google Scholar 

  2. Margulis AR (1992) Subspecialization and certification in radiology. AJR Am J Roentgenol 159:1113–1114

    Article  CAS  Google Scholar 

  3. Bosmans JM, Weyler JJ, De Schepper AM, Parizel PM (2011) The radiology report as seen by radiologists and referring clinicians: results of the COVER and ROVER surveys. Radiology 259:184–195

    Article  Google Scholar 

  4. Huppertz A, Schmidt M, Wagner M et al (2010) Whole-body MR imaging versus sequential multimodal diagnostic algorithm for staging patients with rectal cancer: cost analysis. RoFo 182:793–802

    Article  CAS  Google Scholar 

  5. Maurer MH, Hamm B, Teichgraber U (2011) ServiceBlueprinting as a service management tool in radiology. Eur J Radiol 79:333–336

    Article  Google Scholar 

  6. Shukla N, Keast JE, Ceglarek D (2014) Improved workflow modelling using role activity diagram-based modelling with application to a radiology service case study. Comput Methods Programs Biomed 116:274–298

    Article  Google Scholar 

  7. Smith GG, Thrall JH, Pentecost MJ et al (2009) Subspecialization in radiology and radiation oncology. J Am Coll Radiol 6:147–159.e144

    Article  Google Scholar 

  8. Rosenkrantz AB, Wang W, Hughes DR, Duszak R Jr (2017) Generalist versus subspecialist characteristics of the U.S. Radiologist Workforce. Radiology. https://doi.org/10.1148/radiol.2017171684:171684

    Article  PubMed  PubMed Central  Google Scholar 

  9. Bell ME, Patel MD (2014) The degree of abdominal imaging (AI) subspecialization of the reviewing radiologist significantly impacts the number of clinically relevant and incidental discrepancies identified during peer review of emergency after-hours body CT studies. Abdom Imaging 39:1114–1118

    Article  Google Scholar 

  10. Lindgren EA, Patel MD, Wu Q, Melikian J, Hara AK (2014) The clinical impact of subspecialized radiologist reinterpretation of abdominal imaging studies, with analysis of the types and relative frequency of interpretation discrepancies. Abdom Imaging 39:1119–1126

    Article  Google Scholar 

  11. Smith-Bindman R, Miglioretti DL, Johnson E et al (2012) Use of diagnostic imaging studies and associated radiation exposure for patients enrolled in large integrated health care systems, 1996–2010. JAMA 307:2400–2409

    Article  CAS  Google Scholar 

  12. Levin DC, Rao VM, Parker L, Frangos AJ (2013) Analysis of radiologists’ imaging workload trends by place of service. J Am Coll Radiol 10:760–763

    Article  Google Scholar 

  13. Stern C, Boehm T, Seifert B, Kawel-Boehm N (2018) Subspecialized radiological reporting expedites turnaround time of radiology reports and increases productivity. RoFo. https://doi.org/10.1055/s-0044-100728

    Article  PubMed  Google Scholar 

  14. Cassel CK, Reuben DB (2011) Specialization, subspecialization, and subsubspecialization in internal medicine. N Engl J Med 364:1169–1173

    Article  CAS  Google Scholar 

  15. Bell RH Jr, Banker MB, Rhodes RS, Biester TW, Lewis FR (2007) Graduate medical education in surgery in the United States. Surg Clin North Am 87(811–823):v–vi

    Google Scholar 

  16. Bosmans JM, Peremans L, De Schepper AM, Duyck PO, Parizel PM (2011) How do referring clinicians want radiologists to report? Suggestions from the COVER survey. Insights Imaging 2:577–584

    Article  Google Scholar 

  17. Breslau J (2012) Point: generalism vs subspecialization–the ACR should encourage radiologists to structure their practices around a model of subspecialization. J Am Coll Radiol 9:535–536

    Article  Google Scholar 

  18. The European Society of Radiology (2010) The future role of radiology in healthcare. Insights Imaging 1:2–11

    Article  Google Scholar 

  19. Lam CZ, Nguyen HN, Ferguson EC (2016) Radiology resident’ satisfaction with their training and education in the united states: effect of program directors, teaching faculty, and other factors on program success. AJR Am J Roentgenol 206:907–916

    Article  Google Scholar 

  20. Walker EA, Petscavage-Thomas JM, Fotos JS, Bruno MA (2017) Quality metrics currently used in academic radiology departments: results of the QUALMET survey. Br J Radiol 90:20160827

    Article  Google Scholar 

  21. Narayan A, Cinelli C, Carrino JA et al (2015) Quality measurements in radiology: a systematic review of the literature and survey of radiology benefit management groups. J Am Coll Radiol 12:1173–1181.e1123

    Article  Google Scholar 

  22. Strax R (2012) Counterpoint: Generalism vs subspecialization—the ACR should develop a practice model to support general radiologists. J Am Coll Radiol 9:537–538

    Article  Google Scholar 

  23. Council European (2014) Directive 2013/59/Euratom on basic safety standards for protection against the dangers arising from exposure to ionising radiation and repealing Directives 89/618/Euratom, 90/641/Euratom, 96/29/Euratom, 97/43/Euratom and 2003/122/Euratom. OJ EU L13:1–73

    Google Scholar 

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Authors and Affiliations

  1. Department of Radiology, Inselspital, Bern University Hospital, University of Bern, Freiburgstrasse 10, 3010, Bern, Switzerland

    Tobias P. Meyl, Johannes T. Heverhagen & Martin H. Maurer

  2. Department of Radiology, Charité - University Medicine Berlin, Charitéplatz 1, 10117, Berlin, Germany

    Maximilian de Bucourt

  3. Department of Social Medicine, Epidemiology and Health Economics, Charité - University Medicine, Luisenstrasse 57, 10117, Berlin, Germany

    Anne Berghöfer

  4. University Outpatient Clinic, Center of Sports Medicine, Hochschulambulanz der Universität Potsdam, Am Neuen Palais 10, Haus 12, 14469, Potsdam, Germany

    Anne Berghöfer & Alexander Huppertz

  5. Department of Radiology, NYU School of Medicine, NYU Langone Medical Center, 660 First Avenue, 3rd Floor, New York, NY, 10016, USA

    Andrew B. Rosenkrantz

  6. Department of Radiology, LMU University Hospital, Marchionistr. 15, 81377, Munich, Germany

    Florian Streitparth

Authors
  1. Tobias P. Meyl
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  2. Maximilian de Bucourt
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  3. Anne Berghöfer
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  4. Alexander Huppertz
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  5. Andrew B. Rosenkrantz
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  6. Florian Streitparth
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  7. Johannes T. Heverhagen
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  8. Martin H. Maurer
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Correspondence to Martin H. Maurer.

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Meyl, T.P., de Bucourt, M., Berghöfer, A. et al. Subspecialization in radiology: effects on the diagnostic spectrum of radiologists and report turnaround time in a Swiss university hospital. Radiol med 124, 860–869 (2019). https://doi.org/10.1007/s11547-019-01039-3

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  • DOI: https://doi.org/10.1007/s11547-019-01039-3

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