Night Time Radiology

Sydney, Zurich,Tel Aviv and Idaho. What do these places have in common?

Let’s take a walk, or in this case a drive, into your local hospital (after 9 p.m.). You arrive having just fallen on ice, your ankle now sufficiently doubled in size. There is a strong likelihood that your “films” are being read, remotely, via an internet connection by a Radiologist in one of these locations. What’s that? There is no actual Radiologist in the hospital looking at the study and making a preliminary interpretation? Exactly.

In addition to one of the larger corporate radiology groups (which oddly shares its name with a bird of prey) there are a number of “remote” radiology services being provided around the country and, literally, around the globe. Typically these services cover the 8 p.m. to 8 a.m. shift.

Now before you luddites storm your local hospital with torches and pitchforks, bear in mind that imaging technology is far superior than the early days of film x-rays. Most imaging today is performed, and in some cases interpreted, with the direct aid of computers (CT, CAT, MRI, etc.). And blazing internet connection speeds combined with HD monitors can make the virtual experience no different from the actual. The majority of these remote radiology services advertise that their Radiologists are eminently qualified and certified and that their reading is subject to quality assurances. Do I know?

Presumably, the Radiologist in Jakarta isn’t simultaneously looking at internet porn while reviewing your ankle images. Presumably. As an added measure of Peer Review, the majority of hospitals require that a staff Radiologist review the night time remote interpretation to see if they concur with their opinions. . .the following morning.

In theory, this is wonderful. However, consider whether a simple mistake in interpretation could mean the difference between sending you home in the middle of the night or immediately admitting you to the hospital. Oh, and instead of a broken ankle, let’s say you came in with a ruptured appendix?

posted by David Marc Schwadron, Esq.