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Teleradiology Spurs Evolution of Radiology Practice

Teleradiology is helping reshape radiology practice. Most practices utilize telerad service for some portion of their night or weekend call and, perhaps, some subspecialty reads. How radiology groups are changing—in size, teleradiology use, imaging centers they operate, the number of facilities they serve, etc—may greatly impact how radiologists’ jobs will change.

Radiology Today looked at a list of 35 U.S.-based telerad companies that were operating back in 2006. Of those 35, we found 31 that were clearly still in business. Four had merged with or were acquired by other companies, and there were four new companies on a list we accessed recently. There was also one company formed after 2006 that was subsequently acquired by another before this year.

Hospitals typically still contract with a radiology group for imaging professional services, but arrangements different from using the local radiology group are popping up around the country. There have been some situations where hospitals contract with a management group instead of a traditional radiology group. In other places, a teleradiology service handles much of the day-side reads, too.

Radisphere, which used to market itself as a subspecialty teleradiology group, began promoting itself as a national radiology practice instead of a teleradiology group. Some very large regional practices provide huge numbers of teleradiology interpretations in addition to providing their own night coverage. Some medical systems are hiring their own radiologists and bringing imaging in-house.

While the traditional group arrangement (augmented with some off-hour teleradiology cover) still predominates, other setups for delivering imaging care keep appearing on the scene. There doesn’t seem to be a consensus of what combination of on-site radiologists and off-site reads is the optimal hybrid practice. And optimal is in the eye of the beholder. Many radiologists feel they are losing control in their relationships with hospitals and that they’re in competition with telerad outfits. At the same time, plenty of groups are happy with their teleradiology partners.

There’s no doubt that how imaging services are delivered is evolving. Reimbursement reduction, prior authorization, and healthcare reform will continue to prod change. While all these factors create some angst among radiologists, the demand for imaging services will only push upward in the coming years as aging boomers demand more healthcare services. This will happen despite the dampening effects of cost cutting and prior authorization. Radiologists won’t see the rapid growth of the early 2000s, but imaging remains valuable and vital to healthcare.

Radiologists are increasingly facing the same worry other physicians came to grips with in the late 1980s and early 1990s: Just being in practice no longer guarantees success. Medicine, like the rest of the business world, is becoming increasingly competitive and requires people and organizations to adapt to stay successful.

— Jim Knaub is editor of Radiology Today.