Trend in radiologist workload compared to number of admissions in the emergency department

Introduction: Recent years have shown an increase in radiologists' workload, both during regular working hours and during on-call. We aimed to quantify the 8-year trend in on-call workload in a large tertiary academic medical center, and to compare the workload growth rate to emergency department (ED) visits growth rate during the same period.

Methods: The number of computed tomography (CT) studies during on-call hours (weekdays between 3.00 p.m. and 8.00 a.m., and weekends) between 2012 and 2019 was extracted from our hospital's Radiologic Information System. To estimate the on-call workload, all studies were converted to relative value units (RVUs) using the US Medicare physician reimbursement tables. The Kendall's tau b test was used to assess the temporal trend.

Results: Overall, on-call CT RVUs increased by 52% (Kendall's tau b = 0.776, p = 0.001) while ED visit rate grew by 23% with a weaker correlation coefficient (Kendall's tau b = 0.323, p = 0.009). RVUs of brain CT, the most prevalent examination type, increased by 33%, while abdominal CT, the second most prevalent examination, increased by 70%. Thoracic-lumbar spine CT examinations increased by 1375% and head and neck CT angiography examinations (stroke protocol and CT-Venography) grew by 287%.

Conclusions: Radiologists' on-call workload more than doubled the growth rate of ED visits over an 8-year period. Radiologists, radiographers and on-call ED workforce should be adjusted to accommodate these evolving changes to enhance quality and safety of patient care and to avoid caregivers' burnout.