February 21, 2022

Emergency Radiology, Teleradiology and After-Hours Work

Tarek N. Hanna, MD

I am an emergency radiologist. I love the urgency, clinical impact and spectrum of acute imaging. Imaging in emergency departments (ED) throughout the United States continues to rise, and radiology has become central to the care of the acutely ill and injured patient. The diagnostic radiologist is fundamental to ED patient management, and I find it is constantly fulfilling to read cases that have immediate clinical impact.

I began my career in teleradiology. When I tell people this, sometimes they will pause and ask, “When did you switch from teleradiology to emergency radiology?”

The answer is that I was always an emergency radiologist. Teleradiology is not a subspecialty, but rather a type of practice. Neuroradiologists, abdominal imagers and musculoskeletal radiologists can all be teleradiologists.

Many teleradiologists classify themselves as emergency radiologists because the demand is greater for contemporaneous reads of emergent examinations that may exceed the capacity of on-site imagers. Indeed, this dynamic is particularly true during the evening and overnight periods.

I like to think of emergency radiology, teleradiology and after-hours imaging as three overlapping circles — a radiology Venn diagram. Some emergency radiologists are also teleradiologists while others work on-site shoulder-to-shoulder with trauma surgeons and ED providers. Similarly, many teleradiologists are emergency radiologists while others offer non-emergent, subspecialty interpretations in neuroradiology or MSK. While these radiologists may work the evening and overnight shifts, which involve high-volume ED time periods, some may work business hours as well.

Understanding this framework is crucial to recognizing the landscape of emergency radiology and teleradiology. Many young radiologists entering practice today will begin their careers doing some emergency radiology, some teleradiology or remote work, and some after-hours work. You will wear many hats, and how you choose to classify your practice is up to you!