May 2019

The Road to Wellness

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Physician wellness is recognized as a critical component of enhancing the quality of healthcare. An epidemic of symptoms related to stress and burnout among medical professionals, including radiologists, is threatening not only healthcare providers at a personal level but also the entire healthcare system. In this special issue of the Bulletin, you will hear personal stories of burnout and resilience. Lori Deitte, MD, FACR, and Lotte N. Dyrbye, MD, MHPE, will discuss strategies for addressing burnout at the individual, institutional, and national levels. Cheri L. Canon, MD, FACR, will share ideas for creating a culture of wellness in the workplace. Reed A. Omary, MD, will demonstrate how he incorporates exercise and nature into his daily work schedule.

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Missed Opportunities

Can we decrease no shows in radiology using predictive models and personalized approaches?

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The percentage of radiology patients who did not show up for their appointments may sound insignificant: between 2.26 and 3.36 percent, based on a 16-year study of outpatient imaging appointments.1 However, when these patients miss an imaging appointment, the department loses money, time, and the ability to provide care, says Puneet Bhargava, MD, professor of radiology at the University of Washington in Seattle. Even though the overall percentage of no shows may seem relatively small, it’s still worth analyzing the no-show problem across a healthcare system. And recent studies show predictive models and personalized intervention can help decrease these rates and connect patients with the care they need.

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The Times They Are a-Changin’

We must build an infrastructure and commit resources to respond to a fluid political climate.

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In May 2016, I became chair of the ACR Commission on Economics, inheriting a group of dedicated volunteers. One message I communicated to our team at that time was that shifts in socioeconomic policy are not only inevitable, but also hard to predict. Therefore, we must build and maintain processes and infrastructure to respond. Three years later, it is worth reviewing where and how socioeconomic policy has changed and how our actions and direction have been affected.
 

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Relieving the Burden

As physicians, we’re all searching for strategies to thrive in a demanding environment.

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We know that healthy physicians take the best care of their patients, provide a happy workplace environment, and can reduce costs while boosting value. But what happens when they burn out? Burnout — a work-related syndrome characterized by emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment — inversely impacts quality of care, patient satisfaction, productivity, and access to care.1 Although rates vary at different stages of physicians’ careers, burnout is still higher among physicians as a whole when compared to the rest of the working population.2 And some believe radiologists are particularly prone to its disruptive and far-reaching consequences. Burnout can lead to depression, substance abuse, and suicide. It is also linked to inappropriate workplace behavior, reduced productivity, absenteeism, and staff turnover.3,4

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Credit Appropriate Imaging

R-SCAN™ drives quality improvement with PI-CME and new CDS registry.

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ACR launched the Radiology Support, Communication, and Alignment Network (R-SCAN™) in 2015 to bring radiologists and referring clinicians together to streamline ordering, lower costs, and improve imaging appropriateness. As of April 1, 2019, practices conducting an R-SCAN quality improvement (QI) project can now earn 20 AMA PRA Category 1 Credits™ for Performance Improvement Continuing Medical Education (PI-CME).

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Controlling the Burn

The ACR is making headway on enhancing wellness among radiology professionals.

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Healthcare is changing. Many improvements have been made to streamline work, create better quality care, and lower costs in medicine. Initiatives around EHRs, public reporting and transparency, and patient portals all aim to achieve these goals. And while improvements like these are important to success in healthcare, they also change how medicine is delivered — and that, in turn, can have some collateral damage: professional burnout.

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The Road to Wellness

Radiologists and practice leaders are taking steps to stave off burnout and find joy in their work.

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Physician wellness is recognized as a critical component of enhancing the quality of healthcare. An epidemic of symptoms related to stress and burnout among medical professionals, including radiologists, is threatening not only healthcare providers at a personal level but also the entire healthcare system. According to the 2019 Medscape National Physician Burnout and Depression Report, 45 percent of radiologists reported feeling burned out. Radiology was also found to be the 12th highest of the 29 specialties surveyed for burnout.1 These statistics pose substantial threats to our patients, colleagues, institutions, and the profession. They are associated with high turnover, poor patient outcomes, errors and suicide risk.

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Before Burnout

Effective radiology leaders should seek out unspoken concerns to bolster staff wellness.

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While definitions of wellness and burnout vary, most agree the absence of one drives the prevalence of the other. As rates of burnout among radiologists continue to rise, radiology leaders responsible for safeguarding the performance of their team and the care of their patients must be proactive.

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Walk and Talk

Vanderbilt University's radiology chair champions walking meetings for stronger connections and increased exercise.

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Reed A. Omary, MD, and Courtney M. Tomblinson, MD, have gone on multiple walking meetings together. Tomblinson says the approach puts people at ease and allows recruits to envision themselves in the place where they will be working.

A lot has been said in recent years about the negative impact that sitting all day can have on the physical and mental health of workers who spend most of their time in front of a computer. Workers are encouraged to abandon their desks often to stretch their legs, rest their eyes, and clear their minds — and radiologists are no exception.

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The Struggle to Keep Up

Daily workload is an issue for radiologists — at any stage of their career.

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Not only is medicine one of the most intellectually challenging careers, it includes an incredibly demanding workload. Not to mention increasing responsibilities and pressure at work can have a huge impact on mental health. You’ve likely heard the alarming statistic: approximately 300–400 physicians die by suicide each year in the United States. That means the suicide rate among physicians is more than double that of the general population.1 “Every year we lose the equivalent of two medical school classes,” says Scott M. Truhlar, MD, MBA, MS, FACR, a radiologist at Radiologic Medical Services, P.C., in Coralville, Iowa.

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Finding a Balance

Radiologists want to have more time — and more control over their time.

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When a radiologist (who wishes to remain anonymous) joined a small private practice where she was the only woman, she found she didn’t have a workspace to make her own. Nor she did have any personal space. According to this radiologist, “Most of us who work in private practices sit in a different seat every day, by ourselves, and have no place that is our own — no place to put a coffee cup or a handbag or a picture of our kids.”

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