Attracting and Retaining Radiology Staff
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Radiology administrators at AHRA share their strategies.
What is the biggest challenge currently facing radiology administrators? The answer from radiology administrators attending AHRA 2023 was unanimous: attracting and retaining radiology staff. Read on to learn their strategies for addressing this critical and persistent issue.
The lasting impact of COVID
Attendees are painfully aware that healthcare has been the second largest sector affected by the “Great Resignation” during and following the COVID pandemic, according to the U.S. Bureau of Labor Statistics. The enduring shortage is affecting staffing for radiographers and radiologists; and all imaging modalities.
Marion Anderson, CRA, Diagnostic Imaging Manager at Karmanos Cancer Center in Detroit, Michigan reports that her facility is down two-thirds of staff for CT and mammography exams.
Aiysha Lewis, CRA, Director of Operations and Business Development for Adventist Healthcare Imaging in Monrovia, MD, is struggling with staffing of radiologists. “We simply can’t find more radiologists to fill our open positions. We need to providing imaging 24/7 for outpatient and inpatient facilities; it’s becoming critical,” she said.
Increasing the workload – along with compensation – for existing radiologists does not solve the problem either. “How do you ask them to do more without overtaxing them? Is not just about compensation. It’s also about the impact of the workload on them,” Ms. Lewis added.
With demand for imaging on the rise (along with the aging population), the competition is fierce. Travel positions offer better pay while the increasing number of urgent care and free-standing emergency centers offer an environment that is more attractive and less stressful to many candidates than a hospital.
The consequences of short staffing are significant. The increased workload on existing staff adds to their stress and burnout; patients need to wait a longer period of time to get in for exams which delays diagnosis and treatment; and providers are unhappy.
Strategies for attracting and retaining radiology staff
How are radiology administrators addressing the issue? Creativity and flexibility were the resounding answers.
Karmanos Cancer Center in Detroit is posting positions for traveling staff. Meanwhile, the University of Cincinnati Medical Center has extended its efforts to fill the pipeline down to the high school level. “We are offering full college tuition with an understanding that the graduates will work for us for five years. That’s how creative we’re getting,” said Becky Allen, CRA, MS, Vice President of Operations at UC Medical Center and Enterprise Director of Radiology. Ms. Allen is also the AHRA president elect 2022-2023.
Flexibility and creativity are also essential to managing the current workload with a smaller staff. For example, a closer review of CT exam volumes led CarolinaEast Health System to reduce the number of days that CT exams are available, explained Donna Russell, RTRM, Radiology Manager. “By limiting the number of days for CT exams, we can redeploy those staff members to other modalities on other days.”
Increasing the amount of cross training also adds to flexibility for supporting multiple imaging modalities.
Retaining existing staff – who now have more options for better pay and work in less-intensive environments – is equally critical. University Hospitals of Cleveland in Ohio undertook a thorough review of their compensation model to make sure they are competitive. “We made sure everyone is compensated according to the current market,” said Michelle Dossa, CRA, Radiology Director, West Market, University Hospitals of Cleveland. “That is important to retaining the staff we do have.”
University Hospitals in Mentor Ohio is actively increasing employee engagement and employees’ connections with the hospitals’ mission and values, said Michelle Nocera, CRA, Director of Radiology, University Hospitals in Mentor Ohio.
“Employees’ relationships and attitudes with work are very different since pre-COVID,” said Ms. Nocera. “We are having lots of ‘stay’ interviews to ask them what they want from work. They tell us they want a better work/life balance, flexible hours, and they do not want to be on call.”
Executive leadership also plays an essential role in retention of radiology staff, emphasized Keith Aldahondo, MHA, RT (CT) (MR) CRA, CT/MRI, Manager at Tampa General Hospital in Florida. “We are very fortunate to have a phenomenal leadership team. Their leadership makes the hospital a great place to work. Staff want to follow them and work for them,” he said.
Fewer funds for capital investment
Finances – and the lack of them – was the second challenge cited often by AHRA attendees.
“We have an aging equipment fleet that needs replacement,” said Ms. Nocera. “The problem is compounded by the fact that we could not address the need during COVID, and now we have less funds for everything.”
The need for prior authorization for more studies plus decreased reimbursement adds to the challenge, said Ms. Russell. Indeed just this week, the U.S. Centers for Medicare and Medicaid Services (CMS) has once again included radiology reimbursement cuts in its Medicare Physician Fee Schedule (MPFS) Proposed Rule.
“Eighty-six percent of academic healthcare centers are operating in the red,” said Ms. Allen whose budget has decreased from $120M to $20M. “It doesn’t matter how much revenue we generate when radiology only generates a 2 to 3 percent profit.”
And that number one issue of staffing shortages adds to the competition for limited funds. “Our hourly cost for a tech (including benefits) used to be about $45 an hour. Now because of the competitive environment, it has increased to $100 an hour. It’s simply not sustainable,” explained Ms. Allen.
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Katie Kilfoyle Remis is the editor of Everything Rad.
Reach her at Katie.Remis@Carestream.com