Tina Rosenbaum, MD, has been an emergency room physician at MedStar Washington Hospital Center for 12 years – and for much of that time, there was a gap in medical imaging as part of patient care in the middle of the night. “[But] now, we get our answers immediately,” Dr. Rosenbaum says.
The reason? Our overnight radiologists who provide immediate coverage at the Hospital Center, as well as several other MedStar facilities.
Radiology chairman James Jelinek, MD, says the program was the idea of Arnold Raizon, MD. Prior to instituting dedicated teams to cover the overnight hours, radiologists would generally work their normal daytime schedules and then trade off night-time shifts. In addition, MedStar hospitals were previously covered by five different groups, all using different computer systems.
This approach didn’t make for the best patient care experience.
The Rising Need for Overnight Radiology Coverage
Laurie Abrams, MD, notes, however, that the need for dedicated overnight coverage wasn’t always necessary. Smaller radiology practices – which were the norm 20 years ago – didn’t lend themselves to dedicated teams to work the overnight hours. But as practices consolidated and grew larger, small teams of overnight radiologists became a more practical solution.
Also, the technology changed. “Reliance on imaging technology is much greater than it used be,” Dr. Abrams says.
Imaging tests can be used to diagnose an ever-increasing number of conditions. For example, head scans were previously considered to be a rare event, but now a busy hospital might find it necessary to conduct four or five head scans in a single hour. So having an overnight radiologist on-hand to offer advice, and interpret scans and films, can make a huge difference.
Bridging Gaps, Provide Better Patient Care
Thanks to the institutionalizing of the overnight radiologists at MedStar Washington Hospital Center and other facilities, many patients can be sent home quickly and safely. And when they need to be sent to the operating room, that too happens more efficiently.
That’s not to say there aren’t challenges to working overnight.
From the moment they log into the Radiology platform, they have a worklist that generally keeps them busy for the entire shift – and that’s on a normal night. On nights when there are multiple trauma cases, the need for both speed and accuracy becomes enormous.
“Your brain is always on. There is no downtime,” Gabe Schneider, MD, points out.
But that is one of the very reasons why this group takes such pleasure in their work. All radiologists are integral to patient care, says Dr. Taner, but overnight, “you are often the decision point. You can make the most difference.”
For instance, Dr. Rosenbaum says it’s not uncommon for the radiologist to take the initiative and inform the surgical teams when it is apparent that surgery will be necessary: “They will link together all the different teams and keep the lines of communication open. That helps everyone.”
For Dr. Raizon, that type of teamwork is the entire key to what they do. “The technical staff has always had dedicated people who work at night. It makes sense that the physicians do, too. This way, we all get to know each other, which leads to better patient care.”
It’s About People
Even with spending their evenings and late nights intimately involved with some of the technologically sophisticated aspects of medicine, all four overnight radiologists stress that the personal relationships they have developed are the single best part of the job.
Dr. Raizon, who has been there from the beginning, intends to work in this capacity for the remainder of his career. “I really like the people I work with at night,” he says. “It’s not just about reading X-rays. So much of medicine is about the people."