How radiologists feel about productivity trackers in their departments

The prevalence of remote work has come with a rise in worker productivity trackers—intended to make sure employees are actually working rather than, say, making balloon animals with their surgical gloves—and healthcare is no exception. Scoreboards that track various metrics tied to productivity are commonplace in healthcare. In radiology, scoreboards are commonly used to make sure radiologists are keeping up with a slew of metrics, like financial performance, customer satisfaction, and regulatory compliance.

Worker productivity trackers across industries have proven to be controversial, with some employers arguing they help ensure workers are getting their jobs done and that a business is meeting its goals, while others argue trackers hurt morale and are a way for companies to overly micromanage employees. Within the radiology world, there are also differing views on whether scoreboards are helpful or harmful.

An ‘imperfect’ way to track productivity

Eric Rubin, a radiologist in Pennsylvania and chair of the Human Resources Commission for the American College of Radiology—a trade group that represents tens of thousands of radiologists—said he hasn’t heard industry-wide complaints about the use of the scoreboards. But his group, Southeast Radiology, made the decision not to use them, he said, because they have the potential to slow down workers and negatively affect morale.

“A radiologist may decide that they don’t want to continue to work in our groups if they feel that our main focus is to track our workers’ productivity rather than to do the work as needed to take care of our patients,” Rubin said.

Kurt Schoppe, a radiologist at Radiology Associates of North Texas, said his practice uses software that tracks radiologists’ RVUs, or relative value units. RVUs are used in what’s called the resource-based relative value scale, which is what Centers for Medicare & Medicaid Services (CMS) and other payers use to figure out reimbursement rates. The idea is that RVUs show how much value a physician provides to patients.

Many argue that RVUs are an imperfect way to measure productivity, since they don’t account for a lot of things a radiologist does each day to bring value to their practice, such as talking on the phone to hospital administrators, Rubin said.

At Schoppe’s practice, radiologists see how many RVUs they accumulate in a day and where they stack up compared to others on the same shift, though their coworkers’ names are kept anonymous. Schoppe said he didn’t want to include RVUs in the software, but was outvoted by the other radiologists in the group.

“I don’t want people to get on a treadmill and race to be productive, because we know from both peer-reviewed research and our own internal research that volume doesn’t correlate well with quality or service,” Schoppe said.

Paul Chang, a radiologist at the University of Chicago, said the problem with real-time productivity dashboards is that they can lack context. For instance, a dashboard may show that one radiologist isn’t reading as many scans as the others, but that could be because they’re looking at more complex, time-consuming scans.

“I’m not a fan of real-time productivity dashboards with knowledge workers and healthcare providers because the way they tend to be used, the way they tend to be displayed, tends to be—in my mind—dehumanizing,” Chang said.

Raking in the cash?

On the other hand, Dawn Harris-McClain, president of consulting firm Accountable Physician Advisors, said that monitoring efficiency and effectiveness can improve medical practices’ profit margins, make sure they’re holding themselves accountable, and benchmark against industry standards.

“If you don’t know what’s broken, it’s hard to change,” Harris-McClain said. “And we change behavior by really understanding how to motivate people, and most people are motivated by some sort of competition, ability to increase their compensation, [and] get time off.”

Another incentive for the scoreboards is CMS reimbursements. CMS has certain standards that practices have to meet to continue being a participating Medicare provider, so they may choose to scoreboard metrics to ensure everyone is working toward those goals.

“When you keep getting your reimbursement from the government and other payers cut, you have to find ways to be more efficient with your resources,” Harris-McClain said. “But at the end of the day, if you’re in healthcare, you should have your ultimate goal be taking great care of patients and providing great outcomes. That should be your standard.”