Teleradiology is an ideal choice for retirees, moms, and those seeking to escape the rat race. And for the industry, it’s a chance to hang on to a cache of knowledge.

There is little doubt that teleradiology services have been a boon to overburdened, understaffed radiology practices. They are efficient, affordable, and available at a moment’s notice.

But teleradiology has been a benefit in another way. It is helping to preserve an important cache of knowledge and experience that traditionally was lost to retirement, family, and geography. And it is needed. As Frank Seidelmann, DO, cofounder of Franklin & Seidelmann, Beachwood, Ohio, explained during a presentation at the summer conference of the American Healthcare Radiology Administrators (AHRA), citing statistics from the American Journal of Radiology, the 5% deficit of radiologists in 2001 will increase to 20% by 2020. A Merrill Lynch study put this percentage in real numbers—there will be 15,000 too few radiologists working by 2020.

The shortage in personnel is inversely proportional to the number of hours worked. In the 8-year period between 1995 and 2003, radiologists’ hours increased—on average—from 50 hours to 53 hours. This may not seem like a large increase, but Seidelmann noted that this capability will reach its limit in the not-too-distant future, and patients will suffer.

But there is an answer to the shortage, and it is technology. Over the last few years, systems pioneered by teleradiology companies have extended the reach of radiology departments to US-trained and certified experts all over the world. The result has been transformative for health care, patients, and, especially, radiologists. Retirement no longer has to be an option.

Not Ready to Retire

When Fred Van Natta, MD, tried to retire in 2002, he found that after 3 months he was ready to read films again. "I was not intellectually ready to retire," he said, so he became an independent contractor for Imaging on Call, Pough-keepsie, NY, reading films for hospitals in Pennsylvania and California.

The payoff has been exactly what he needed, an intellectually challenging and rewarding extension to his career. "I’m working with different hospitals and equipment," he said. "One may be very high [tech] and some not so [advanced]." He is always shifting gears, working out the diagnosis and how the case should be handled based on both the films and the hospital’s culture, how the patient was admitted, and what sort of equipment was being used.

Van Natta does all of his work from the comfort of his rural Pennsylvania home where he has two monitors set up—a high-resolution PACs-capable one, the other, a standard workstation. All the information comes through a T1 line and is encrypted and protected. He uses a Microsoft Notepad program to dictate his findings and then sends his results back to the hospital. Technology is a reliable tool for Van Natta. The only thing limiting him are the types of cases—the number of images and the complexity of the diagnosis.

Currently, Van Natta, 65, is full-time, working 2 weeks on and 2 weeks off, for an equivalent of 48 weeks a year. Though his primary motivation is intellectual stimulation, he does admit that, for him, teleradiology has one major disadvantage. "The only downside is that because I work evenings, my social life suffers a little," he said.

As Van Natta enters the second half of his sixth decade, he says that he expects to move to half-time. Several of his teleradiology colleagues—including a female radiologist in Spain who is caring for her aged parents, and another one in Switzerland with small children—already are working half-time.

Teleradiology is, in fact, proving to be an ideal option for the stay-at-home mom radiologist.

Stay-at-Home Mom

Julie Shaffrey, MD, has been a night owl for her entire career. When she finished her training at Johns Hopkins, she joined an 80-radiologist group in Baltimore. But being a new mom, she found that the daytime hours were not very conducive to caring for a child. So, she opted for night work, which allowed her to work 1 week on and 2 weeks off—the best of both worlds.

After 5 years, Shaffrey left the group and went to work for Virtual Radiologic, Minneapolis. Now, the mother of three continues her 1-week-on, 2-week-off schedule from home.

"The best thing is to be home and in a high-powered position while having access to my kids. I’m never [really] gone," she said. "I always say that I won the job lottery. If I had to ever go back to a [traditional group], I probably wouldn’t." She is also part of the executive management group for Virtual Radiologic, working mostly on administrative issues during her "off" weeks.

Shaffrey is licensed in 35 states and works with more than 200 hospitals. One of the advantages of working at night is that the types of cases she gets are typically emergent and more interesting than what is seen in the day. "I like emergency cases," said Shaffrey. "If you develop these relationships with the referring doctors, even though they are remote and developed through telephone conversations, the physicians come to trust you and have the same confidence in your ability and diagnosis as if you worked down the hall from them in a conventional hospital setting."

Intellectual stimulation and being able to raise a family are only two of the reasons why teleradiology is an ideal path. For others, it’s more fundamental and profound—it’s a way to reconnect with the work they love.

Staying in the Game

Kerry Ford, MD, thought he was taking a year-long sabbatical to go to France and brush up on the language. That was 2 years ago. He’s still there, living with his wife in a small village in the Vendee and reading studies as a teleradiologist for Nighthawk Pros, Royersford, Pa.

He made the change because he was getting burned out working at a hospital in Waco, Tex. Now, he has fallen in love again with his vocation. "For me, this wasn’t a segue into retiring—I was getting burned out. I was thinking of quitting. But teleradiology is like pure radiology," Ford said. "You get to do one case at a time with no interruptions. I always wondered why someone would continue working when they were 68, 69, 70. It’s because you love what you do."

Ford is able to work in France thanks to telephony and Internet solutions from TeleRAD IT, the provider of all of Nighthawk Pros’ communications needs. The clarity and reliability of the lines of communication allow Ford to receive and send information from hospitals and colleagues all over the world.

Ford’s renewed love of radiology after it nearly burned to a cinder is one end of the professional spectrum. Romantic love is another reason teleradiology can be ideal.

Whisked Away

For Laura Novell, MD, the trip to Alaska was just a brief respite before beginning her work as an interventional radiologist in Virginia. However, the trip was life-altering. Novell met the man of her dreams and soon found herself married and whisked off to Hawaii.

This change in plans did not mean she was giving up her goal of being an interventional radiologist. However, she found that the single group on the Big Island of Hawaii had no need for one. She turned to Nighthawk Pros and became a teleradiologist instead. That was 4 years ago. "I’m kind of spoiled now," she joked.

Her enjoyment of teleradiology echoes her Nighthawk Pros’ colleague Ford. "It’s pure radiology. I read cases, talk on the phone, have no commute—I like that a lot."

And while this wasn’t her original career path, Novell plans to keep on doing this sort of work. While most teleradiologists—like Novell—can’t specialize, that may be changing.

Specialty Radiology

Seidelmann, a neuroradiologist, likes being a specialist. But he wanted to get out of the day-in, day-out grind. With Boston radiologist Peter Franklin, he started Franklin & Seidel-mann specialty radiology services. "Our concept was that there weren’t enough specialists in every hospital, so we’d move the images to where the experts were," he said.

The more than 100 radiologists working for Franklin & Seidelmann are all experts in a particular area, and many are from academic centers. Some are full-time, some part-time, but for Seidelmann, 62, the importance is that his company will help fight the radiologic brain drain that is a result of retirement. "I think there is an ability to extend a radiologist’s career," he said.

He sees that the day of the general-ist teleradiologist is ending. "It’s now body-specific imaging. This is a result of the 1990s when radiology grew up. You now have radiology at the microscopic level."

Seidelmann, who still works full-time (a consequence of Franklin & Seidelmann’s success), expects to be reading neurology studies for the next 10 to 13 years. "You don’t spend a lifetime getting skills just to give them up," he said. "My ideal position is a phased-in semiretirement where I might work a half day, 4 days a week." Like the other teleradiologists, Seidelmann lives in a fairly remote area—off the shore of the Carolinas—and stays in touch with colleagues and hospitals through a proprietary software system.

While not every radiologist in the company is full-time, Seidelmann said he expects a level of commitment. That level of commitment has been easier to accommodate as Franklin & Seidelmann has continued to grow.

No matter the original motivation, all of the teleradiolo-gists have one thing in common—they have come to love the lifestyle.

Attractive Lifestyle

"Pure radiology" are the buzzwords of the teleradiologists. For radiologists like Van Natta, Ford, Shaffrey, Novell, and Seidelmann, that means that the image is everything. There are no interruptions, no demands from administrators or other colleagues. "When you see someone sitting at home reading an image, you will see how much more focused they are," said Van Natta, adding that these focused readings are more accurate and have a faster turnaround time.

Shaffrey also likes the camaraderie. She has developed close relationships with her online colleagues and hospital staff. "I’ve built good relationships with the emergency department doctors. When these doctors see my name and I call, they say, ‘Hey, Julie…,’" she said. Many of Shaffrey’s colleagues have become good friends, and their regular interactions are not limited just to consulting on a case, but in catching up.

The lifestyle is attractive because of the flexibility and being able to focus at the job at hand, but Shaffrey notes that the potential teleradiologist has to have the right kind of personality for this career path. "You have to be more outgoing, willing to engage people," she said. "If you’re just a name on a piece of paper, then the emergency department doctors won’t e forgiving. To them, you’ll just be a service."

As the Internet becomes more sophisticated and the radiology shortage becomes more acute, there is little doubt that teleradiology will increasingly become the path of choice for a widening range of radiologists looking for a fulfilling, "pure" career.

C.A. Wolski is a contributing writer for Axis Imaging News. For more information, contact .