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  • Teleradiology experience

    To all the rads on here, I am wondering if any have had good experiences doing telerad and if so, with which company?  Most what I have heard is negative.  High volumes, low pay/case, bad night hours, etc.  I am thinking of telerad potentially in the near future to transition to part time work.

  • #2
    I’m not a radiologist, but our hospital recently started using telerads from 11p-7a. My radiology friends (who are in private practice) say they can pay the telerads to read their night studies less than what they can bill the patient’s insurance for. They make money off the reads while they’re home asleep.

    Seems to me if the private radiologists can pay telerads company a fraction of what they get reimbursed, the telerads company can pay you a fraction of a fraction of what you would make reading in private practice.

    On the other hand, working at home with minimal overhead and getting to set your own hours is very appealing. If the pay and hours seem acceptable to you, give it a shot!

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    • #3




      I’m not a radiologist, but our hospital recently started using telerads from 11p-7a. My radiology friends (who are in private practice) say they can pay the telerads to read their night studies less than what they can bill the patient’s insurance for. They make money off the reads while they’re home asleep.

      Seems to me if the private radiologists can pay telerads company a fraction of what they get reimbursed, the telerads company can pay you a fraction of a fraction of what you would make reading in private practice.

      On the other hand, working at home with minimal overhead and getting to set your own hours is very appealing. If the pay and hours seem acceptable to you, give it a shot!
      Click to expand...


      Some of that is not true.

      On average, we probably pay the telerad company 80-90% of Medicare reimbursement for preliminary reads, AND we have to do the final read in the AM. Plus, middle-of-the night is when a disproportionate fraction of our uninsured work comes through the ED, and our collection rate on that is very low. We pay the per-click rate, whether or not we collect. Plus, we pay about 7% of next revenue toward the cost of collections. It is break-even at best, all-in a small net loser, financially (and we still have to spend the time reading the cases). It certainly not a profit center!

      I know some people who work telerad, and you don’t get to “set your own hours”. Most people start off working a week on and a week off from 11p-7a, a schedule that may or may not suit the OP. It’s not like you can sign in at your leisure to bang out cases for extra money, let alone a livelihood.

      And, yes, you will get paid “a fraction of a fraction”, but it might be more like 80% of 80% of Medicare. So if a Head CT is $43 paid by Medicare, the Rad Group might pay $33, and the teleradiogist might pocket $27. It is an eat-what-you-kill model, and the more successful firms will provide a steady case flow and state-of-the-art workstations and support. Your efficiency will likely be optimized.

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      • #4
        There’s probably telerad docs on this forum. Probably sleeping now

        I don’t do it but have friends and colleagues that do and our group has used telerad for overnight (or golf league night) prelims for years. For us, like most groups, the cost of using telerad at nights is less than the cost of an FTE, and it would be difficult to manage overnight call without having the post call day off. So financially it makes sense.

        Non radiologists never seem to understand this. But our call can really be a grind.

        I haven’t analyzed it in a while but i don’t think we make any money on studies that go to nighthawk. I figure we do that work for free the next day, just the cost of being able to sleep at night.

        The telerad docs I know work 8 or 12 hr shifts from home, and lots of them work a 7 on / 7 off schedule. I know folks that work days and others that work nights.

        Knowing what we pay for the service, I don’t see how employed telerad docs make a lot of money. Often times it’s an hourly base rate with a per hour study minimum, with extra pay if you read above the base volume. So it pays to be fast and be good with templates and voice recognition.

        Doesn’t seem like much fun to me. Sure it’d be nice not to have all the interruptions I get, but I prefer the variability and comraderie of a hospital based practice.

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        • #5
          I am waiting for tele-obstetrics.  Ha

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          • #6
            Teleradiology is a necessary evil for groups that don't have the volume at night to justify the expense of 2 FTEs covering that work. I wouldn't want to do it, but I'm glad we have it. After hours work is very challenging for a radiology group to do right. My sense it that the referring docs don't like it.

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            • #7
              I’m a resident so no real experience with this. Though I’m curious, for private groups that cover their own nights, is 2 FTEs sustainable? I’ve heard it can be hard to retain good docs if they are working 7on 7 off - easy to get burned out that way. And I’ve seen job postings for 1 week on, 2 weeks off.


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              • #8
                Some groups that cover their own nights basically have their own internal nighthawks. And yeah working nights isn’t desirable for most people. Larger groups might just cover nights themselves where maybe everyone does one or two nights a month and a few weekends a year, with post call day off.

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                • #9
                  I am a form of teleradiologist - I do "on site" teleradiology for a large academic center, where we cover the AMC itself and provide after hours coverage for a large number of hospitals in our region, which are staffed by small radiology groups and are not equipped to use 3 FTE to cover overnights. I also do some at home teleradiology for other local and regional private practice groups.

                   

                  The OPs question is a hard one to answer, and the answer would depend a lot on what you are planning to do. Do you want to work days, evenings, or nights? How much do you want to work when you transition to part time? Where in the country are you located?

                   

                  The vast majority of "full time" teleradiology gigs consist of predominantly overnight work (10pm-7am) providing either preliminary or final interpretations for teleradiology clients. These usually run 1 week on, 2 weeks off, or the equivalent (1 week on, 1 week off is toxic and hiring for these types of jobs is not possible in this market). As has been stated above, if you work for a teleradiology company you will almost always work on a "per click" or "per RVU" basis and get paid for the number of studies you read, and will get paid less than what you would for the same work at a private practice. If you provide in house teleradiology coverage for a private practice group (which would, in my opinion, be far preferable to working for a large telerad company) you will generally (ideally) be treated as an equal member of the group and get paid a salary similar to other group members. I would not recommend attempting to do overnight teleradiology work in a transition to part time, unless you already have a lot of experience working overnight hours and are certain it fits your physiology. There are a very small minority of folks who thrive with overnight work (very, very, very small); for the rest of us, it is a constant struggle and often feels like fighting against nature.

                   

                  Part time teleradiology work is far more broad and can consist of a ton of different things. For example, I provide part time work for a regional private practice group for 2 evenings a month, remotely from home (the group is about 200 miles from me), and am paid hourly. I was able to get this job through personal contacts, and in my opinion something like this arrangement - if you can find one that is stable - is a great way to transition to part time work. I have a colleague who lives across the country from me and provides remote teleradiology work for 2 weekends/month for a large local group, and is otherwise retired from medicine. These types of arrangements are possible and can provide great work/life balance.

                   

                  Feel free to PM me if there is anything I can do to help. Specific recommendations I would have:

                  - consider if anyone you know personally in private practice or academia (or, better yet, your current employer) could use a part time remote reader, and brainstorm a way to make it happen

                  - if this isn't possible, you can contact the major teleradiology companies and discuss with them what type of work you are interested in doing, and see if there is something that would work. Make sure you have an exact sense of what hours you want to work, #days/hours per week, and roughly how many cases you can read.

                   

                  Good luck!

                   

                  - ER Rad

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                  • #10
                    how good are the reads generally?  there are some days where we get a bunch of calls in the morning changing the read and other times where it appears seamless.  sometimes the overreads are not able to completed in as timely a fashion.  I hate getting a call few days later from radiology for a study ordered by someone else in the ED patient discharged, will be coming to see me in few days but I've never met them.  no one wants to be the owner.

                     

                     

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                    • #11
                      Just like non telerad docs, some are exceptional, some are good, some can be subpar. Your hospital and or the Radiology group with the contract should have a QA process for prelims and finals. If there are outliers on the bad side, it should be addressed. I’ve has to do this before.

                      And discrepancies with the prelim should never come to attention days later, that’s unacceptable. It should be a doc to doc phone call immediately when the study is over read (next morning). I’d go talk to a radiologist and tell them your concerns.

                      In my practice, clinically significant discrepancies are rare, but they can and do happen. By contrast, there’s times the nighthawk caught something I didn’t. (I look at the study before I read the prelim report.) We all miss stuff sometimes.

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                      • #12




                        Just like non telerad docs, some are exceptional, some are good, some can be subpar. Your hospital and or the Radiology group with the contract should have a QA process for prelims and finals. If there are outliers on the bad side, it should be addressed. I’ve has to do this before.

                        And discrepancies with the prelim should never come to attention days later, that’s unacceptable. It should be a doc to doc phone call immediately when the study is over read (next morning). I’d go talk to a radiologist and tell them your concerns.

                        In my practice, clinically significant discrepancies are rare, but they can and do happen. By contrast, there’s times the nighthawk caught something I didn’t. (I look at the study before I read the prelim report.) We all miss stuff sometimes.
                        Click to expand...


                        agreed about the shoulds but sometimes there are sick physicians, or we are perpetually understaffed in many specialties.   as we move towards more and more subspecialized practices, I think night time and weekend readers/physicians/ are more apt to be rusty in some of the specialized parts.  I think the difference is when people are regularly working together, quality issues are more easily discovered.  when they are using the telerads, doing only nighttime reads and perhaps working inconsistently, it is harder to observe some of the issues.

                        jmo.

                        we have the same issues clinically.

                         

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                        • #13







                          Just like non telerad docs, some are exceptional, some are good, some can be subpar. Your hospital and or the Radiology group with the contract should have a QA process for prelims and finals. If there are outliers on the bad side, it should be addressed. I’ve has to do this before.

                          And discrepancies with the prelim should never come to attention days later, that’s unacceptable. It should be a doc to doc phone call immediately when the study is over read (next morning). I’d go talk to a radiologist and tell them your concerns.

                          In my practice, clinically significant discrepancies are rare, but they can and do happen. By contrast, there’s times the nighthawk caught something I didn’t. (I look at the study before I read the prelim report.) We all miss stuff sometimes.
                          Click to expand…


                          agreed about the shoulds but sometimes there are sick physicians, or we are perpetually understaffed in many specialties.   as we move towards more and more subspecialized practices, I think night time and weekend readers/physicians/ are more apt to be rusty in some of the specialized parts.  I think the difference is when people are regularly working together, quality issues are more easily discovered.  when they are using the telerads, doing only nighttime reads and perhaps working inconsistently, it is harder to observe some of the issues.

                          jmo.

                          we have the same issues clinically.

                           
                          Click to expand...


                          My experience is that the teleradiologists (we use the largest national firm) are very good. Sometimes I do not like an individual’s style, but I can say that about my own partners. We have been doing QA for over ten years and the major disagreement rate is in the .2% to .4% range. That is comparable to that within our own group.

                          Radiologists who provide regular overnight service essentially specialize in “Overnight Radiology”: fractures, acute abdomens, brain hemorrhage’s, and such. They should be as expert as anyone in your group/Hospital in these areas. I would not expect them to be especially skilled at mammo, prostate MRI, or interstitial lung disease (as examples), as these are almost always non-urgent daytime exams.

                           

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