Academic medical centers on the hot seat for ED radiology coverage

Despite the fact that they have a reputation for the highest standards of care, academic medical centers often fall short on radiology services in the emergency department, according to an article published online last week in the Journal of the American Medical Association.

Only 10 percent of academic medical centers have seven-day, 24-hour coverage from attending radiologists Stephen Ledbetter, M.D., an assistant professor of radiology at the Harvard Medical School and chief of radiology at Brigham and Women's Hospital in Boston, told JAMA. During off hours, an emergency department is more likely to be covered by a resident than an attending radiologist, the article notes.

"Traditionally, academic medical centers used residents and their judgment on emergency imaging tests during the off hours," Sandra M. Schneider, M.D., a professor of emergency medicine at the University of Rochester (N.Y.) Medical Center's School of Medicine and Dentistry said in the article. "As an attending, I'm less comfortable with this, and as a patient, I'd be even less comfortable with it."

The need to have more comprehensive radiology coverage in EDs has been driven by a number of circumstances. For example, patients are utilizing EDs at far greater levels than in the past, with the expectation that imaging will be available 24 hours a day. In addition, EDs increasingly are reliant on advanced imaging technologies and the radiological expertise necessary for acute medical decision-making, resulting in the growth of emergency radiology as a subspecialty in the field of radiology.

To that end, Ledbetter said that "[as] an advocate for establishing emergency radiology, the physical presence of a radiologist, engaging with the emergency physician to provide emergency radiology, is the right way to go."

Proper radiology coverage of an ED is a quality care issue. Considering the specialty's renewed emphasis on patient-centered care, it's an issue that deserves some attention. - Mike  @FierceHealthIT


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