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2004 Survey of Radiologists

OVERVIEW

The Radlinx Group and U.S. Radiology Partners are affiliated firms specializing in remote, off-site teleradiology services and radiology management for hospitals, medical groups, and individual physician practices.

Periodically, we conduct surveys regarding trends in radiology administration, staffing, and related issues to determine what challenges are important to radiology department administrators and radiologists and what steps they are taking to address these challenges.

This report summarizes The Radlinx Group/U.S. Radiology Partners' 2004 Survey of Radiologists and is the second such survey of radiologists that we have conducted.

The Survey is intended to provide insight into the priorities and plans of radiologists in group practice and may be useful to radiologists, group practice managers, physician recruiters, health care executives and others who follow radiology delivery and management trends.

METHODOLOGY

The 2004 Survey of Radiologists was mailed to 2,000 radiologists, either solo practitioners or partners of radiology group practices, in November, 2003. Names of radiologists were provided to The Radlinx Group/U.S. Radiology Partners at random by a national health care database firm and included radiologists in all 50 states.

By December, 2003, 276 completed surveys had been received for a response rate of 13.8 percent. Survey results were compiled over the following month and the Summary Report was completed in the first week of January, 2004. U.S. Radiology Partners conducted a similar survey of radiologists which was released in April of 2002 using a similar methodology. Results of the 2002 Survey are included in this Summary Report where applicable. Questions used in the 2004 Survey varied in some instances from those used in 2002, so a direct comparison cannot be made in all cases.

Number of Surveys Mailed:
2004
2002
2,000
2,000

Number of completed surveys received:
2004
2002
276
240

Response rate:
2004
2002
13.8%
12%

QUESTIONS ASKED AND RESPONSES RECEIVED
All numbers rounded to the nearest full digit

1. How large is your practice/group?

 
2004
2002
1 - 2 physicians
11%
43%
3 - 5 physicians
5%
23%
5 - 10 physicians
22%
11%
10 or more physicians
59%
22%
N/A
3%
1%

2. Please rank the following issues in terms of priority level for your group or practice in the next 12 months. One indicates a top priority, two a medium priority, and three a low level priority.

 
1
2
3
N/A
Improving tracking to avoid lost films
18%
28%
51%
3%
Upgrading/transitioning to digital/PACS/teleradiology
54%
25%
18%
3%
Improving report turnaround/patient throughput
46%
33%
19%
2%
Rising malpractice rates
45%
42%
11%
2%
Declining reimbursement
61%
33%
4%
2%
Staffing radiologists and technologists
52%
37%
10%
1%
Improving patient service
36%
51%
10%
3%
Improving relations with referring physicians
31%
49%
17%
3%
Improving hospital relations
20%
49%
27%
4%
Improving relations among your radiologists
12%
46%
38%
4%
Competition from other radiologists or hospitals
17%
35%
46%
2%
Outsourcing night/weekend call and/or coverage
21%
25%
48%
6%

3. In the last fiscal year, did your group/practice see an increase or decrease in revenue, or did revenues stay the same?

 
2004
2002
Revenues increased
46%
48%
Revenues decreased
28%
23%
Revenues stayed the same
24%
21%
N/A
2%
8%

4. In the last fiscal year, did your group/practice see an increase in imaging volume, a decrease, or did imaging volume stay the same?

 
2004
2002
Volume increased
83%
78%
Volume decreased
3%
4%
Volume stayed the same
12%
13%
N/A
2%
5%

5. Is your group overburdened due to increasing volume and/or under staffing?

 
2004
2002
Yes, overburdened
57%
N/A
No, not overburdened
42%
N/A
N/A
1%
N/A

6. If yes, how are you dealing with this situation? (check all that apply)

 
2004
2002
Working longer hours
47%
N/A
Actively recruiting more radiologists
46%
N/A
Using locum tenens radiologists
16%
N/A
Using, or considering, off-site alternatives
11%
N/A
Planning to relocate
2%
N/A
Planning to retire in next year
5%
N/A
Other
4%
N/A
N/A
39%
N/A

7. If your group uses locum tenens physicians, how are you using them? (check all that apply)

 
2004
2002
For vacation coverage
48%
N/A
To staff FTE shortages
40%
N/A
Fill in for ill/disabled physicians
10%
N/A
Other
2%
N/A

8. Please assess your staffing needs in the following areas.

 
Over Staffed
Appropriately Staffed
Under Staffed
N/A
 
2004
2002
2004
2002
2004
2002
2004
2002
Radiologists
4%
0%
47%
40%
48%
49%
1%
11%
Imaging technologists
2%
2%
53%
35%
40%
56%
5%
7%

9. Are staffing shortages in your group/practice diminishing quality of care (i.e. by limiting access, delaying turnaround, etc?)

 
2004
2002
Yes
29%
33%
No
67%
60%
N/A
4%
7%

10. If you could retire tomorrow, would you?

 
2004
2002
Yes
39%
N/A
No
50%
N/A
Unsure
11%
N/A

11. On average, approximately how many studies do each of your radiologists read a year?

 
2004
2002
0 - 5,000
0%
4%
5,001 - 10,000
7%
16%
10,001 - 15,000
23%
29%
15,001 - 20,000
41%
32%
Over 20,000
26%
16%
N/A
4%
7%

12. Do your feel radiologists with your group/practice are reading an appropriate number of studies?

 
2004
2002
Yes, appropriate number
53%
54%
No, too many studies
36%
35%
No, too few studies
8%
7%
N/A
3%
4%

13. Does your group/practice offer 24-hour physician/radiologist coverage?

 
2004
2002
Yes
89%
71%
No
11%
23%
N/A
0%
6%

14. Do you currently use teleradiology?

 
2004
2002
Yes
87%
70%
No
13%
23%
N/A
0%
7%

15. If no, are you planning to implement a teleradiology system in the next 12-18 months?

 
2004
2002
Yes
13%
34%
No
87%
66%

16. If you do use teleradiology, how do you use it (check any that apply)

 
2004
2002
For night time call/coverage
74%
70%
For outsourcing to off-site radiologists
28%
24%
Other
12%
6%
N/A
14%
0%

17. Are you outsourcing to a nighthawk group?

 
2004
2002
Yes
32%
N/A
No
68%
N/A

18. Due to overwhelming volumes, understaffing, or other reasons, do you need
additional coverage during the day?

 
2004
2002
Yes
37%
N/A
No
63%
N/A

19 If you are not now outsourcing nighttime or daytime studies off-site, have you considered doing so?

 
2004
2002
Yes, nighttime only
30%
N/A
Yes, daytime only
1%
N/A
Yes, both day and night
2%
N/A
No need or interest in outsourcing
35%
N/A
N/A
32%
N/A

20. Do you feel it appropriate for U.S. hospitals or medical groups to send studies to radiologists in other countries, such as India or Australia?

 
2004
2002
Yes, appropriate
30%
N/A
No, inappropriate
64%
N/A
N/A
6%
N/A

TRENDS AND OBSERVATIONS

The Radlinx Group/U.S. Radiology Partners' 2004 Survey of Radiologists suggests that like many other types of physicians, radiologists are working harder and longer today but are not necessarily realizing financial benefits from their additional labor.

The majority of radiologists responding to the 2004 survey (83%), indicated that imaging volumes in their practices increased in the last fiscal year, while 12% said volumes remained the same. Only 3% indicated imaging volumes had declined (2% provided no answer to this question.)

By contrast, only 46% of radiologists surveyed indicated that practice revenues increased in the last fiscal year, while 28% said revenues decreased, and 24% said they remained the same (2% provided no answer to this question.). These figures are consistent with responses to the same questions generated by the 2002 Survey, in which 78% of radiologists indicated that imaging volumes in their practices had increased, while only 48% indicated that revenues had increased.

The majority of respondents to the 2004 Survey (57%) indicated that their practices are overburdened due to increasing volumes and/or understaffing, and 47% indicated they are working longer hours to cope with this situation. In addition, the number of imaging studies radiologists are reading per year appears to be increasing. In 2002, 80% of radiologists surveyed indicated they are reading 10,000 or more studies per year, while in 2004, 93% of radiologists surveyed indicated they are reading 10,000 or more studies per year. In 2002, only 48% of radiologists surveyed indicated they were reading over 15,000 studies per year, while in 2004, 67% indicated they are reading 15,000 or more studies per year. Only 16% of radiologists surveyed in 2002 indicated they were reading 20,000 or more studies per year, while in 2004, 26% indicated they are reading 20,000 studies or more a year. Over one third of radiologists surveyed in 2002 (35%) indicated radiologists in their practices were reading too many studies, while in 2004 that number increased slightly to 36%.

Rising volumes have created staffing challenges for many radiologists. Close to half of radiologists surveyed (48%) indicated their practices are understaffed with radiologists, while 40% indicated their practices are understaffed with imaging technologists. Understaffing has led to quality concerns for many radiologists. Twenty-nine percent of radiologists in the 2004 survey indicated that staffing shortages in their practice are diminishing the quality of care they are able to provide by limiting access to care or delaying turnaround of studies, down slightly from 33% in 2002.

Based on these responses, it is not surprising that declining reimbursement and staffing radiologists/technologists rank as top priorities for radiologists in the next 12 months. Upgrading/transitioning to PACS/teleradiology, malpractice, and improving report turnaround also were identified as top priorities in the next 12 months for a significant number of radiologists.

The Rise of Teleradiology and Off-Site Reading

The 2004 Survey suggests that teleradiology has become an increasingly common feature of radiology practice. Eighty-seven percent of radiologists in the 2004 survey indicated their practices use teleradiology, compared to only 70% in 2002. The Radlinx Group/U.S. Radiology Partners' marketing records suggest that less than 10% of radiology practices employed teleradiology as recently as the year 2000. Teleradiology has become a necessity as demand for every day, round-the-clock imaging services increases while the available workforce remains relatively static.

Of those radiologists who are using teleradiology, close to one third (32%) are outsourcing this function to an off-site, after hours call/coverage (nighthawk) group. Of those radiologists who are not outsourcing to an off-site group, 33% have considered doing so. Though no previous survey numbers are available, we believe this represents a very significant growth in the use of nighthawk services over as little as two to three years ago. Given the limited supply of radiologists, the off-site, nighthawk option allows radiology practices and hospitals to shift imaging studies to locations where available reading capacity exists. Continuous, round-the-clock coverage can be maintained without overtaxing the time or resources of local radiologists.

As the name implies, nighthawk coverage generally is provided during night or weekend hours. The 2004 Survey suggests, however, that the need for additional coverage is no longer just a night time issue. Close to 40% of radiologists surveyed indicated that due to overwhelming volumes or understaffing, they need additional coverage during the day.

While a significant number of radiologists are sending studies off-site to nighthawk groups, the majority of radiologists surveyed do not approve of sending studies overseas to be read by radiologists in countries such as India or Australia. Sixty-four percent of radiologists surveyed indicated they do not believe this practice is appropriate, while 30% indicated they believe it is appropriate (6% provided no answer to this question.)

In addition, the rising demands of the medical profession appear to have affected a significant number of radiologists. About four out of ten radiologists surveyed (39%) indicated that they would retire tomorrow if they could, while 11% indicated they were unsure. Only half of radiologists surveyed indicated they would not retire tomorrow if they had the opportunity.