Invasive Procedural Versus Diagnostic Imaging and Clinical Services Rendered by Radiology Trainees Over Two Decades |
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Authors: | Andrew B. Rosenkrantz C. Matthew Hawkins Lori A. Deitte Jennifer Hemingway Danny R. Hughes Richard Duszak |
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Affiliation: | 1. Department of Radiology, NYU Langone Medical Center, New York, New York;2. Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia;3. Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee;4. Harvey L. Neiman Health Policy Institute, Reston, Virginia;5. School of Economics, Georgia Institute of Technology, Atlanta, Georgia |
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Abstract: | PurposeTo characterize evolving radiology trainee exposure to invasive procedures.MethodsUsing Physician/Supplier Procedure Summary Master Files from 1997 to 2016, we identified Medicare services performed by radiology trainees in approved programs by extracting information on services billed by diagnostic and interventional radiologists reported with “GC” modifiers. Services were categorized as (1) invasive procedures, (2) noninvasive diagnostic imaging services, or (3) clinical evaluation and management (E&M) services. Relative category trainee work effort was estimated using service-level work relative value units.ResultsNationally from 1997 to 2016, invasive procedures declined from 34.2% to 14.3% of relative work effort for all Medicare-billed radiology trainee services. Radiology trainees’ noninvasive diagnostic imaging services increased from 65.1% to 85.4%. Clinical E&M services remained uniformly low (0.7%-0.3%). Diagnostic radiology (DR) and interventional radiology (IR) faculty supervised 81.0% and 19.0%, respectively, of all trainee invasive procedures in 1997, versus 68.3% and 31.7%, respectively, in 2016. Despite declining relative procedural work, trainees were exposed to a wide range of both basic and complex invasive procedures in both 1997 and 2016. Over this period, trainee noninvasive diagnostic imaging services shifted away from radiography to CT and MRI.ConclusionRadiology trainees’ relative invasive procedural work effort has declined over time as their work increasingly focuses on CT and MRI. As DR and IR-DR residency curricula begin to diverge, it is critical that both DR and IR residents receive robust training in basic image-guided procedures to ensure broad patient access to these services. |
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Keywords: | Corresponding author and reprints: Andrew B. Rosenkrantz NYU Langone Health Department of Radiology 660 First Avenue New York NY 10016. |
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