Mindfulness, seven or more hours sleep a night, and spending less time on social media can all be effective ways to cope better with stress at work and avoid cynicism for radiologists, who are in the top ten clinician groups to suffer from burnout, according to Prof. Bruce B. Forster, head of radiology at UBC Faculty of Medicine, Vancouver, Canada.

Forster, who himself has experienced burnout, knows only too well the toll it takes on the individual and on patient care. He explains how he manages in his job, which has a major administrative component to it.

Excessive and unsupported non-clinical work is a recognised cause of radiologist burnout, says Prof. Bruce B. Forster, head of radiology at UBC Faculty of Medicine, Vancouver, Canada.

“Awareness of the risks and symptoms of burnout and how to access help and support are vital if radiologists are to continue in the job they love,” he told ECR Today. “Also, feedback about the positive impact of our work on patient outcomes helps us better appreciate the value of our contributions to patient care.”

Some of the symptoms to be aware of are insomnia, impaired concentration, drop-off in performance, and increased negative thinking, which Forster claims is especially prevalent. Although physician association support is often available, he believes it is almost always under-utilised.

Along with being aware of human factors that may indicate burnout, Forster advises ECR 2020 delegates to be aware of the structural components that may contribute to it. He suggests that excessive and unsupported non-clinical work is a recognised major cause of radiologist burnout, and has a number of clear and simple ideas that in his opinion would help eliminate some of this unnecessary strain and alleviate the burden of administrative tasks:

  • Hire reading room co-ordinators
  • Seek assistance in triaging phone calls
  • Get help in forwarding urgent reports
  • Request patient records such as previous imaging exams if not readily available from the lab, pathology, etc.
  • Ask for clerical support to cope with correspondence
  • Look for support to deliver patient-centred care, ‘welcome to the department’, information for patients regarding tests, etc.
  • Aim for workplace optimisation, including ergonomics and support for informatics

Forster notes that radiologists may also benefit from leadership and business training, to more efficiently navigate the complex environment in which they work. This is already happening in Canada, where the Canadian Association of Radiologists and Canadian Radiological Foundation have partnered with the University of British Columbia Sauder School of Business in Vancouver to provide guidance for radiologists on operations management and negotiation. The partnership has so far produced two executive education courses targeted at radiologists, helping to effectively bridge the once large divide between business and medicine.

Another workforce challenge facing the profession today is the need to embrace the technologies of tomorrow, including artificial intelligence (AI).

According to fellow speaker Dr. Neelam Dugar, consultant radiologist at the Doncaster and Bassetlaw Hospitals NHS Trust, U.K., and informatics adviser to the Royal College of Radiologists (RCR), “There are professional challenges to interdisciplinary collaboration if radiologists do not open their minds to it and start listening.”

One of her main concerns is that if radiologists see AI as a threat, then this will delay implementation.

“AI takes away the time-consuming jobs that make up much of our daily working life but which actually often do not require human intelligence,” explained Dugar, who believes there is a misconception that AI, teleradiology and delegation to radiographers present a serious threat to radiology. “AI in particular should be seen as über transformative to technology, and its proper application will absolutely help to improve our practice.”

The proper application of artificial intelligence will help to improve radiologists’ practice, according to Dr. Neelam Dugar, consultant radiologist at the Doncaster and Bassetlaw Hospitals NHS Trust, U.K.

She considers there are various levels of delegation where radiographer colleagues can support radiologists, enabling smooth running of departments and streamlining patient care. This is particularly the case in those European countries where there is a shortage of radiologists. She thinks sonography is a very good example of how radiographers who are well advanced in their field can add value and relieve pressure on radiologists.

“Plain film reporting from the accident and emergency unit in cases requiring a simple yes or no response – for instance, plain film reporting of hip and ankle fractures – are examples where good collaboration is vital to help streamline patient care,” said Dugar, adding that another area where radiographers have helped streamline practice is in double reporting of CT colon exams and mammograms. “Preliminary reporting of findings from radiographers, plus medical opinion from a radiologist – for example, when it requires more in-depth lateral thinking and reviewing blood results, histopathology reports – is also proving to be a useful area of collaboration with radiographers.”

She provided a note of caution, however.

“There is anxiety amongst some radiologists that this is simply a cost-cutting exercise, but it should present no fear for radiologists because when delegation is safely implemented, it will not compromise patient care,” said Dugar, who encourages interdisciplinary and inter-professional cooperation by making it part of the job and setting aside time for it. It is important there are good professional standards set nationally, prior to implementing radiographer delegation (see RCR’s Standards for interpretation and reporting of imaging investigations, Second edition, 2018). Standards of patient care should not be compromised by delegation, she said.

“Interprofessional collaboration and collaboration with AI should be a culture within our profession. Additionally, guidance and direction from our colleges are essential to us in these exciting times,” Dugar concluded.

LIVE
Professional Challenges Session,
Tuesday, November 10, 17:00–18:00
PC 17 Challenges facing the radiology workforce

  • Chairperson’s introduction
    Sergey Morozov; Moscow/RU
  • Strategies to overcome radiologists shortage including ‘turf battles – a friend or a foe?’, teleradiology, artificial technology, delegation to radiographers
    Neelam Dugar; Doncaster/UK
  • Education and training challenges
    Carlo Catalano; Rome/IT
  • Challenges and opportunities with subspecialisation in radiology
    Christoph D. Becker; Geneva/CH
  • Radiologists’ workload and risks for burnout
    Bruce B. Forster; Vancouver, BC/CA
  • Live Q&A: Is radiology at risk due to shortages, subspecialisation and other challenges?

FURTHER READING

Morozov S, Guseva E, Ledikhova N, Vladzymyrskyy A, Safronov D (2018) Telemedicine-based system for quality management and peer review in radiology. Insights Imaging. 9(3):337-341: i3-journal.org/629

Diaz FN, Ulla M (2019) Validation of an informatics tool to assess resident’s progress in developing reporting skills. Insights Imaging. 10(1):96: i3-journal.org/772

European Society of Radiology (ESR) (2016) Summary of the proceedings of the International Summit 2015: General and subspecialty radiology. Insights Imaging. 7(1):1-5: i3-journal.org/453

Jindal T, Shah Y, Dickerson E (2018) An electronic system for submitting and reviewing resident schedule requests increases resident satisfaction and residency program administrative efficiency. ECR 2018 / C-2352: myESR.org/182352

Nitrosi A, Del Prato A, Bertolini M et al (2018) Use of a RIS-integrated software to balance the workload of radiology specialists during night shifts in a multicenter Diagnostic Imaging Department. ECR 2018 / C-1286: myESR.org/181286