Pediatric Radiology in an Adult Community Hospital
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1 Pediatric Radiology in an Adult Community Hospital Kimberly A. Garver, MD Section Head, Pediatric Radiology Section Head, Ultrasound Huron Valley Radiology Ann Arbor, Michigan
2 Huron Valley Radiology Private practice radiology group 34 board certified subspecialized radiologists One CAQ pediatric radiologist Two hospital systems--st. Joseph Mercy and Promedica (Ohio) 5 hospitals and 4 outpatient sites 537 bed teaching hospital in Ann Arbor. 10 inpatient pediatric beds, 15 NICU beds, dedicated pediatric ER until 11pm 24/7 in house coverage for all sites with IR on call Very limited pediatric subspecialist referrals
3 My background Board certified in radiology in 1994 (University of Michigan) Fellowship trained in mammography and pediatric radiology (University of Michigan) Private practice since Primary specialty areas include ultrasound, mammography, pediatrics and general body CT on call HVR Board Member
4 How we do Pediatric Radiology RADIOGRAPHY Read by everyone 24/7. FLUOROSCOPY Performed only by me on pediatric Mondays for outpatients. NICU by me as needed. ULTRASOUND Outpatient subspecialty exams done on pediatric Mondays. NICU, inpatients, ER exams read by mostly dedicated US docs and on call as needed. MSK CT and MRI NEURO Read by subspecialists in MSK. Read by neuroradiologists 24/7. BODY CT Very limited outpatient work. ER cases read by body docs.
5 How We Cover Pediatric Radiology Call In house 24/7 Body and Neuro coverage since 2015 Radiology Assistants in house 24/7 for triage Voluntary Cell phone coverage by me to assist NICU, ER, radiologists, staff PACS on laptop at home If not at home, will have partners text pictures or video clips from PACS monitor without patient identifiers Do the best I can without 24/7 guarantee University of Michigan, C. S. Mott Children s Hospital is 3 miles away
6 Pediatric Anesthesia MRI Anesthesiology Interventional Radiology Radiology nurses/conscious sedation Anesthesiology Fluoro, CT, Ultrasound No sedation
7 Pediatric Ancillary Supports Child life (none) Performed by technologists and myself Catheterization Trained X-ray technologists or myself IV starts Radiology nursing/technologists/pediatric hospitalists/hospital IV team
8 Compensation Hourly compensation model allows for variable work schedules for everyone and easy to calculate single consistent fair formula Paid only for time you work Partners work from plus days per year with full benefits Benefits are paid for equally by all members Shift premiums for afternoons and weekends (1.5) and midnights (1.8) Administrative work paid for only in time, not additional salary No productivity or administrative bonuses No additional compensation for pediatric calls
9 Productivity Tracking RVUs reported to partners on a quarterly and yearly basis RVU reports include a list of all partners, with ** denoting similar skill set radiologists in your group Section RVUs are compared to benchmarks provided by Strategic Radiology data (large number of pooled private practices) Pediatric RVUs benchmarked at 5.99 RVUs per hour
10 Quality Metrics Radiology Physician Quality Officer. Radiology Staff Quality Officer. Pediatric metrics: MRI for appendicitis utilization and accuracy. ACR Quality Tracking (5 reviewed cases per day per partner for all modalities).
11 Conclusion Practicing as the sole pediatric radiologist in a large multispecialty private practice group is rewarding and possible Hospital demands for 24/7 on call dedicated pediatric imaging is not financially feasible for the group or hospital Pediatric radiology requires a lot of non-rvu based time and effort to practice well, which can be a challenge in a high volume private practice setting
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