Rate of Growth of Radiologist Workload in the Emergency Department Compared to Change in Number of Admissions

Background: Recent years have shown a constant 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) admission growth rate during the same period.

Methods: Data regarding 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 were extracted from our hospital’s Radiologic Information System. To estimate the on-call workload, all studies were converted into 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: The total CT RVUs during on-call hours increased by 52% between 2012 and 2019 (Kendall’s tau b= 0.776, p = 0.001) while ED admission rate grew by 23% percent with a weaker correlation coefficient (Kendall’s tau b= 0.323, p = 0.009). RVU of Brain CT, the most prevalent CT examination type, increased by 33%, while abdomen CT, the second most prevalent examination, increased by 70%. Thoracic-lumbar spine CT examinations increased by 1375% between 2012 and 2019 and head and neck CT angiography examinations (stroke protocol and CT-Venography) grew by 287%.

Conclusions: The workload for radiologists during on-call hours increased dramatically in the past 8 years and more than doubled the growth rate of ED admissions. Radiologist, 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.