Samir Mehta, a practicing radiologist from VA Palo Alto and Head of Clinical Operations at Sirona Medical, talks about the increasing demands of modern-day radiology.
When I decided I wanted to be a radiologist, I saw it as a great opportunity to follow my passion for science, medicine and physiology. I saw a radiologist as someone who could solve a puzzle that no one else in healthcare could solve; putting the pieces back together for each patient. I certainly didn’t get into radiology to feel like a robot on a production line. It’s nothing new for a rad to complain about being overworked, but I hope my personal experience can demonstrate how technology has caused some of the problems we face on a daily basis, and more importantly, how it can be used to solve them.
The technology creep
Advancements in technology have largely been for the benefit of the patient and the wider healthcare system with little consideration for the rad. CT scans are a simple example of this. As CT scanners have become more commonplace, physicians are much more inclined to order hi-res CAT scans, even if a simple X-ray would suffice. Because they know the power and efficiency of the technology, it’s easy for referring physicians and patients to think “just to be on the safe side” without really considering the knock-on effect for the rad. That extra 10 or 20 percent of volume during the workday could be enough to prevent a rad giving another case the necessary time and attention, potentially resulting in a serious mistake. Even if it doesn’t, the anxiety that rads feel from the extra work looming over them will inevitably lead to burnout and a lower standard of patient care.
Lots of rads have to juggle multiple pieces of software. Many practices use two or three PACS systems and a separate worklist, which means lots of application switching and interrupted flow . And then there are the interruptions from outside. For me, there’s usually 2 or 3 phone calls or messages per hour from referring physicians, technicians, or colleagues, but it can be much more for certain sub-specialties.
To make matters worse…
Your mind is on all the time, and you can’t take the breaks you need. Practices have been known to reduce lunch breaks to the point where it is barely a break at all, sending out reminders warning rads they are taking too long. I understand that I am in a well-paid profession where time is money, but it is much harder to achieve the ultimate goal of ‘good patient care’ if rads are treated as gophers rather than medical professionals.
If the volume of cases and general demands on a rad are going up, then it’s about time technology picked up the slack. It’s ridiculous that I have to manually label 30+ spines every day, and yet modern computational power is quite clearly capable of recognizing and labeling patterns that are far more intricate than a simple spine. If Instagram can apply beauty filters to a selfie and Google can translate foreign language with the point of a camera, why do I have to label spines over and over again? It’s a waste of my valuable time. I’m labeling, dragging and dropping to the point where my arms and wrists hurt at the end of the day… this is not why I went to med school! I came into this wanting to interpret images and give my medical opinion, not spend half of my day rearranging windows on a computer screen. It’s an absurd irony that rads are getting arthritis in the very joints they examine as part of their job.
How technology can fix this
Spine labeling is just one example of how a rad-focused piece of software could harness the power of modern technology to reduce our cognitive burden, but there are many more quick wins that can be achieved. Eliminating the stress of multi-tasking across different apps would make a real difference to rads and would require nothing more than one piece of software that integrates worklist, viewer and reporter. Making it cloud-based would solve another problem that many rads face, me included. Why should we have to retrain our dictation software just because we use it on another computer?
The simple answer: we shouldn’t. Like the other irritations I have outlined, the solution lies in technological capability we take for granted in other areas of life. We have used web browsers to access services remotely for decades, so surely it’s time we had this flexibility in radiology?
Quite deliberately, I have not discussed the more complex aspects of radiology that could benefit from advanced machine learning and AI… I want to emphasize how much improvement can be made with nothing more than intuitive design and proper consideration for a rad’s workflow. We really ought to be using technology more intelligently than simply increasing the volume of imagery across the medical profession, which is why I’m working with Sirona to develop an intuitive platform for rads like me. It’s time we stop complaining about burnout and do something about it!