Emergency Department Doctor Appreciates Nighthawking

Can be of value especially in rural areas...good articles on how teleradiology is growing..BD

As a practicing emergency department physician with "nighthawk" services after-hours, my emergency department group knows all too well the pros and cons of nighthawk readings. While they are clearly perceived as an economic threat to the staff radiologist, they can't have it both ways, i.e., sleep and get paid. Nighthawk readings are all reviewed by our staff radiologist after the fact, doing the patient or treating physicians no good in the contemporaneous timeframe. I find the nighthawk readings (always typed as opposed to handwritten "wet" readings) faster, more complete and upstanding against the biased scrutiny of an "overread." Who is to say which is more accurate, the nighthawk or staff second read?

The use of nighthawking services has grown in the past decade into a $3 billion to $5 billion industry, as technology improves and makes reading images from remote locations easier and more efficient. About half of all U.S. hospitals use teleradiologists, who are trained and credentialed in this country before moving to overseas offices, from which they e-mail, fax or phone results. Hospitals pay the outsourced radiologists directly, typically between $50 and $70 for each read; in-house staff bill patients and insurers according to coded rates.
Some radiologists view the lower costs of nighthawking services as devaluing the field of radiology. Outsourcing the expertise turns radiology into a commodity and gives the impression that anyone can do it, said Michael Brant-Zawadzki, medical director of radiology at 353-bed Hoag Memorial Hospital Presbyterian, Newport Beach, Calif., during the RSNA session. Besides competitive pricing, teleradiologists offer something else: the ability for radiologists to sleep through the night without being called in after-hours to read emergency scans.