Radiology practice varies too widely, former teleradiologist says

Teleradiologist Richard Abramson says there is wide variability in the practice, a problem the profession must address, he writes in the May issue of Radiology.

Now at Vanderbilt University School of Medicine, Abramson spent more than two years at a large teleradiology practice, where he held 30 state medical licenses, served more than 400 different hospital institutions and rendered more than 50,000 preliminary interpretations for sites throughout the United States.

During that time, he found alarming differences in how often patients were scanned and for what reasons, and variations in image quality, in how practices used the information, in follow-up recommendations and in information exchange with emergency department physicians. The industry has a unique opportunity to "biopsy" current practice, he writes.

He found that different sites had vastly different protocols for complaints such as trauma and headache, for instance.

"I see this as a problem affecting not only quality of care, but also our ability as radiologists to position ourselves as information technology experts within larger healthcare systems," he says in an interview with As we enter the era of accountable care organizations, radiologists are going to have to assert leadership in these nonclinical areas to avoid even further marginalization and commoditization, and we need to start by getting our own house in order."

However, in research from Thomas Jefferson University in Philadelphia and Northwestern University in Chicago, radiologists rated themselves as less knowledgeable than other physicians about imaging costs, medical malpractice, healthcare policy and quality assurance, Diagnostic Imaging reports.

At, Abramson said the feedback he's gotten from his article has validated the issues he raised, but ultimately has been discouraging in the picture it paints of the state of practice.

American Telemedicine Association CEO Jonathan Linkous recently cited outsourced radiology services as being so prevalent they "may be the first form of telemedicine that becomes a true standard of care."

Meanwhile, Dr. Paul J. Chang, medical director of enterprise imaging at University of Chicago Hospitals, recently spoke on the growing commoditization of radiology, referring to the growing number of "Ebay for radiology" sites offering imaging services online.

"We have to have the emphasis on the value proposition," he said, according to HealthImaging. "Everything we do, when it comes to radiology or imaging IT in the enterprise, has to directly result in measurable improvements in either efficiency, quality, safety, outcomes--in other words, value."

To learn more:
- read the Radiology article
- read the interview
- read the HealthImaging article
- read the Diagnostic Imaging article

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