I couldn't agree with you more. Why is it that the emerency physician
who is sitting on the firing line can't get paid for reading the films?
Afterall he is the one who has to make the call in the heat of battle.
After reads are an important QA issue and I am grateful for the times
when a radiologist does pick up on a missed finding. Most of the time
the issue is whether we read a film as peribronchial thickening and
they call it mild pneumonia or vice versa. Clinically that discrepancy
is a minor one as it would not change the patients therapy. When we
miss a finding like abdominal calcifications associated with
neuroblastoma, then everyone should be relieved that the radiologist
was on their toes. BUT>>> it shouldn't make a difference to the patient
if that call is made at 2AM in the ED or at 8AM, after radiologist has
had a nights sleep and his morning coffee.
In this era of capitation, I think we should be able to capture the fee
for reading the films when a radiologist is not present. If they
overread at a later time, there might need to be a diffferent fee or
reduced amount (only if they find a difference.??) Perhaps when they
find a significant discrepancy the fee should be forfitted to them...
but then where else in medicine is that applicable?
ONly my thoughts...
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