Patient care delivered by diagnostic radiology residents is associated with higher costs and slower turnaround times, according to new findings published in Academic Radiology. However, residents can still make a positive impact by providing “correct and comprehensive” reports and timely after-hours care.
“Determining the true costs of health care is a challenge exacerbated in academic medical centers (AMCs) due to the intertwined missions of clinical care, education, and research,” wrote Marta E. Heilbrun, MD, department of radiology and imaging sciences at Emory University School of Medicine in Atlanta, and colleagues.
Heilbrun et al. aimed to better understand the costs associated with diagnostic radiology residents and their overall contributions to patient care. The team used data from a single institution with 45 clinical faculty members, 24 residents and 13 fellows.
Overall, the annual cost of a diagnostic radiology resident was determined to be $99,109, 34% more than the sum total of their salary and benefits ($74,059). The total cost of providing care was $4.36 per minute when a trainee and faculty member were both involved, 16% more than care provided by just a faculty member ($3.66 per minute).
Also, the median time from a completed imaging examination to a finished, available radiology report was 213 minutes with a trainee. Without a trainee involved, the median time to a finished report was 51 minutes.
The authors emphasized, however, that trainees can still provide noteworthy value.
“A potential offset of the cost is if faculty effort is streamlined by a resident's participation in patient care,” they wrote. “If the resident's observations and conclusions are correct and comprehensive, then the faculty may be able to provide a more focused review with a resultant time savings. If the attending finalizes the resident's report with minimal or no edits there is a potential savings.”
Interpreting studies after hours, when there is less “direct faculty supervision” and attending radiologists review reports the following day, is another key way residents can make a difference.
Heilburn and colleagues did note that there are differences between residents in radiology and other specialties.
“The volume of patients that a radiologist and by extension a diagnostic radiology resident interacts with is significantly greater than that of other medical specialties,” the authors wrote. “The duration of time that a radiologist spends with a single patient is also shorter. Our residents spend a significant amount of time receiving education that is independent of direct patient care via lectures and case conferences. These differences make it difficult to directly extrapolate the observations from this study to other graduate medical education training programs.”