Jay A. Harolds

Burnout of Radiologists: Frequency, Risk Factors, and Remedies: A Report of the ACR Commission on Human Resources

Burnout is a concern for radiologists. The burnout rate is greater among diagnostic radiologists than the mean for all physicians, while radiation oncologists have a slightly lower burnout rate. Burnout can result in unprofessional behavior, thoughts of suicide, premature retirement, and errors in patient care. Strategies to reduce burnout include addressing the sources of job dissatisfaction, instilling lifestyle balance, finding reasons to work other than money, improving money management, developing a support group, and seeking help when needed.

Retirement issues for radiologists and the radiology practice, part 1: a report of the ACR Commission on Human Resources, Subcommittee on Retirement.

Retirement and issues associated with the initiation of retirement have undergone extensive change in the past decade. Multiple factors, including economic conditions, have resulted in a delay in the initiation of retirement. Delayed retirement of senior radiologists is a factor contributing to a diminished job market for entering radiology graduates. These senior radiologists have extensive experience in operational issues and understanding complex relationships with other health professionals, hospitals, and often medical schools. In addition, although they may not be as facile with MRI or PET/CT, senior radiologists have a tremendous command of traditional imaging, which is lacking in recently trained radiologists. The authors examine many of the issues related to delayed retirement and propose some possible solutions.

Preventing Another Group From Displacing Your Practice: Perspectives From the 2010 AMCLC

Most hospital-based radiology practices have enjoyed stable long-term relationships with the institutions they serve. Recently, however, an increasing number of hospitals have replaced established radiologists. In some cases, the incoming group provides only a small number of on-site radiologists and uses long-distance teleradiology for the bulk of image interpretations. Such technology, along with changing market forces, places many practices at risk. A number of strategies to maintain and foster long-term service relationships were discussed by the ACR Council and are reviewed herein.

Are Nuclear Medicine Residents Prepared for Employment? A Survey-Informed Perspective

INTRODUCTION Nuclear medicine (NM) residency is a 3-year specialty program. However, previous accredited graduate medical education can satisfy up to 2 years of the 3-year requirement. There are 3NMresidency pathways available: (1) 3 years (after 1 year of graduate medical education), (2) 2 years (after 2 years of graduate medical education), and (3) 1 year (after completion of an accredited diagnostic radiology [DR] residency) [1]. The majority of NM residents are nonradiologists enrolled in 2-year or 3-year pathways; the 1-year pathway is populated by those already trained in DR. Thus, NM residents constitute a heterogeneous group. NM graduates from 2-year and 3-year programs are eligible for NM certification through the American Board of Nuclear Medicine (ABNM) only. Graduates from the 1-year program can pursue dual certification in DR and in NM through the ABR and the ABNM, respectively; these graduates are also eligible for ABR subspecialty certification in nuclear radiology. Radiology practices are experiencing an explosion in hybrid imaging (PET/CT, SPECT/CT). Coupled with manpower efficiencies forced by current economic constraints, there has been a clear demand for physicians with dual competency in radiology-based body imaging (especially CT) and NM. In recent years, many NM and DR educators have expressed their concerns regarding the employability of NM-only trainees who lack independent expertise in anatomic imaging. Relevant discussions have occurred within and among the

Retirement Issues for Radiologists, Part 2: Consensus Statement on Retirement and Preretirement Issues by the Commission on Human Resources of the ACR

There are many retirement and preretirement issues facing individual radiology groups and practices. The discussion of the numerous options available for radiologists contemplating retirement sometimes becomes contentious within a practice and may pit younger radiologists against the more senior members of the group. The potential exists for the process to degenerate into personality clashes. The purpose of this article is to offer some objective guidance on retirement issues.

The Disruptive Professional: Case Scenarios

This article examines certain critical aspects relating to the clinical competency of professionalism. A discussion is presented which is centered on an analysis of two fictional scenarios explored from the standpoint of a current and a former program director, an associate dean, a department chair, and a lawyer. These cases are followed by a series of questions and a legal discussion which can then be used for either individual study or group discussion.

Quality and Safety in Health Care, Part I: Five Pioneers in Quality.

Abstract Five pioneers had a huge impact on the quality movement in health care in the United States. Ernest Codman contributed in many ways, including his focus on outcome analysis. Avidis Donabedian is known for his focus on the 3 domains of structure, process, and outcome in health care. Walter Shewhart is known especially for the control chart and early work on what W. Edwards Deming made into the PDSA cycle. Deming is also known for other contributions, including his 14 points of management, correcting system problems rather than blaming the workers, and his System of Profound Knowledge. Juran is known for the Pareto principle and his emphasis on customer satisfaction and addressing the human, not just statistical side, of quality improvement.

Trends and different educational pathways for training physicians in nuclear medicine.

The introduction of positron emission tomography/computed tomography (CT), single photon-emission CT/CT, and software packages for multimodality imaging has accelerated the need for nuclear medicine physicians to obtain more training in cross-sectional imaging, especially in CT. In recent years, the Nuclear Regulatory Commission, the Accreditation Council for Graduate Medical Education, the American Board of Radiology, and the American Board of Nuclear Medicine have promulgated new rules and regulations. In addition, the Society of Nuclear Medicine, the American College of Radiology, and the American College of Cardiology Foundation have crafted new guidelines and training requirements. All these changes have consequences for the education of physicians in nuclear medicine. Self-referral and concerns about radiation exposure from nuclear medicine examinations and CT are also affecting the education of physicians practicing nuclear medicine. The authors examine the impact of these developments on training and certification in nuclear medicine and suggest another pathway to train some nuclear medicine physicians.

Program directors as conflict managers.

One possible reason for the reported 16.58% turnover in radiology program directors between July 1, 2001, and June 30, 2002 (1), is the numerous conflicts that the program director (PD) must handle. Conflicts occur between faculty and residents, residents and other residents or fellows, PDs and chairpersons, PDs and faculty, residents and technologists or other hospital employees, residents and nonradiology faculty, and PDs and administrators of the institution. At times, PDs may feel powerless to successfully manage these conflicts. This article reviews the types of conflicts that can occur in a radiology residency program and the ways in which PDs can intervene to prevent them or resolve the problems that result from them.

Career prospects for graduating nuclear medicine residents: survey of nuclear medicine program directors.

There has been much consternation in the nuclear medicine (NM) community in recent years regarding the difficulty many NM graduates experience in securing initial employment. A survey designed to determine the extent and root causes behind the paucity of career opportunities was sent to all 2010-2011 NM residency program directors. The results of that survey and its implications for NM trainees and the profession are presented and discussed in this article.