What to Do When You Have the Scanner but No Radiologist Coverage

Radiologist coverage is the one piece of an imaging service line that a capital budget can't buy. A hospital can approve a new CT or MRI in a single meeting. Finding someone to interpret what it produces can take a year.

The gap is bigger than you might guess. The headline number from a recent Academic Radiology study is 6.4 million Americans living in counties with no local radiologist and no scanners. A larger group sits one step up from that. About 36% of U.S. counties, home to roughly 25.9 million people, have imaging equipment but no local radiologist. Across the country, about 54% of counties have no documented local radiologist at all. The machines are in place and the readers are missing.

The shortage is local, and so are the stuck jobs

National shortage figures hide where the trouble is. A hospital in a metro area, with several imaging groups competing for its reads, has one kind of problem. A critical access hospital a long drive from the nearest radiologist has another. The first is choosing a vendor. The second has a coverage gap that money alone can rarely solve.

In our experience, candidates for small-market radiology jobs ask about call burden, location, and workflow before they ask about pay.

A radiologist who is the only reader for a small hospital is on call every day of the year. Raise the salary and it is still that job.

Four ways to get images read

Most hospitals end up choosing among four models, and each solves a different problem.

Permanent on-site radiologist

Brings continuity, a presence in the department, and relationships with the physicians who send you studies. It also takes the longest to fill, and in a one-reader hospital it asks a single person to carry the entire schedule.

Locum radiologist

Can be on your schedule in weeks, which keeps the scanner productive while a permanent search runs. Some facilities also use a locum assignment as a trial period for both sides before committing to a long-term hire.

Teleradiology

Reaches beyond your zip code and can cover nights, weekends, and subspecialty reads that a small department can't staff. It can't walk down to the ED, perform a procedure, or sit in on tumor board.

A blend of the models

Assigns each tool to the work it handles best. Tele covers overflow and after-hours reads. A local radiologist, permanent or locum, handles whatever needs a person in the building. This arrangement also makes the permanent search easier. A candidate weighing a rural radiology job responds very differently to a posting that names the backup for nights and vacations.

Questions to settle before you post the job

• Which studies at your facility require a radiologist on site?
• What turnaround do your ED and referring physicians expect?
• Who reads at 2 a.m. and on holidays?
• What happens to the schedule when your reader takes a week off?

If you can't answer those, the job posting will inherit the confusion, and candidates will read it that way.

What your board will ask

Boards see an MRI as an asset, and they want to know it's being used and that referring physicians trust the department. A coverage plan with named backup answers both questions. Patients notice, too. The Academic Radiology study found that in counties with neither scanners nor radiologists, Medicare beneficiaries had about 6% fewer imaging events than those in fully served counties. Imaging that isn't close gets used less.

The facilities that handle this well decide how reads will get done before they decide who to hire. The coverage model comes first, and the job posting follows from it.

Optigy recruits radiologists for hospitals and health centers, on both locum and permanent searches. If you're building a coverage plan for a facility with imaging equipment and no one to read it, we can help you choose the model that fits and find the radiologist to staff it. Contact us to start the conversation.