Radiologist credits RPAs for improved patient care

Radiologists find RPAs to be vital link

From a radiologist’s perspective, the RPA position has successfully bridged the gap between radiologist and technologist. As exam volumes increase, reimbursement dwindles, and well-trained radiologists remain scarce, the RPA becomes a viable and cost-effective means of increasing efficiency. But that’s not all. Our experience has been one of enhanced income opportunities, improved patient satisfaction, and streamlined workflow; all the result of a single RPA.

As indicated in the main story, there are four main benefits of RPAs to radiologists:

1. As an interventional radiologist working in a community hospital, the ability to defer nearly all of the relatively routine procedures to an RPA allows me to concentrate on the more complicated cases and also assist in a significant amount of the routine film reading.

With the addition of our RPA, I am able to do the work of at least 1½ radiologists each day. In essence, an RPA can successfully perform a significant portion of the duties traditionally requiring a physician, allowing the radiologist to perform more of the duties absolutely requiring a physician. We cover eight small community hospitals with all images sent to our central community hospital via PACS. We plan on adding two more RPAs in the next year to obviate the need of a radiologist performing GI procedures and arthrograms at our outlying facilities. This will result in significant timesavings to us in both travel time and time performing the procedures.

2. There is a cost savings to the system. Despite RPA salaries being higher than RT salaries, every minute saved by the radiologist can be translated into more productive activities like reading film or conducting procedures. The cost benefit is significant. One need only ask any radiologist how much it is worth to be 50% more productive. Who reaps the benefits of this cost savings is dependent on the type of practice. In our private-practice setting, the radiologists are the main financial beneficiaries.
3. Patient satisfaction is improved. Most radiologists would agree that quality time with patients has declined as the constraints on our time have grown. Having a well-trained individual contacting patients before and after procedures, thoroughly discussing their cases, and obtaining consent has improved the patients’ experiences in our institution. While a well-trained nurse can also fulfill this function (particularly in the setting of a special procedures lab), I believe having an RPA spending time with the patient before, during, and after the procedure is superior because fully half our exams or more are performed nearly autonomously by the RPA. The much-vaunted continuity of care has been achieved, and, quite simply, the patients are happier.
4. Finally, RPAs help improve workflow. Physicians are notorious for making patients, technologists, and other ancillary staff wait. This is not due to a lack of caring, but rather occurs because our attention is being stretched in several different directions at once. It is not uncommon to have four call reports, two physicians waiting for consults, a nurse from the floor on hold, and an emergency in the ER awaiting your attention all at once. An RPA keeping the workflow going while the radiologist puts out fires is a breath of fresh air in an otherwise congested work environment.

The success of any physician extender venture is dependent on the relationship. Trust based on quality performance of procedures by the RPA must be developed. This necessitates that the RPA aspire to a level of excellence. On a personal note, James Abraham (see feature article) is our RPA and my right-hand man. A testament to his importance in our practice is clearly apparent when he is on vacation. Many procedures are put on hold and the schedule is kept as light as possible. Upon his return, we sigh with relief and vow to never allow him to take another vacation.

In summary, the RPA is a welcome wave of the future in radiology. Certainly, its success will be gauged on its practitioners; in our experience, the position’s future is assured. We have found the RPA to be a colleague to the radiologist, a mentor to the radiologic technologist, a facilitator to the nurse; and an expeditor to the scheduler; but most of all, a comforter to the patient.

Radiologist credits RPAs for improved patient care

RPAs are fast becoming a reality in the current radiology practice environment. To date, our experience has been positive with regards to improvement in daily workload and efficiency.

In our practice the improvement has been achieved in the special procedures area, where Mr. Abraham has been a high-end technologist for many years. The RPA training program has given him the opportunity to expand his skills and perform various procedures, many of which were previously considered outside his scope of practice as a technologist.

As noted in the article, the amount of work required both prior to, and following, an interventional procedure is significant and affects patient care. In our case, the use of an RPA has been like adding half a radiologist position. This addition has greatly improved the general level of patient care where, in an understaffed, busy practice, inefficiencies waste valuable time.

Furthermore, in today’s age of remote interpretation, an RPA may provide benefits through the performance of limited procedures remotely such as upper GIs, barium enemas, and arthrograms.

As regards the potential negative impact of RPAs on a radiology practice, we have found none. The scope of practice being instituted at the state level and the exclusion of interpretation privileges has made James an important ally as opposed to a competitor.

Overall, the RPA is welcomed in our practice and will have a positive impact on radiology in the future.