“Welcome to Wherever You Are”?Jon Bon Jovi, 2005
What do all rock stars and many imaging technologists have in common? They both take their talents on the road. Whether it’s a band’s world tour or an individual technologist’s temporary tour of duty in a hospital, imaging center, or mobile unit, both groups have found that travel is part of the job description.
As technologist shortages strain radiology departments, the export of technological expertise to areas of need has become not just an option but a necessity for some?albeit a more expensive one?to help meet increasing imaging demands. And as technology students face wait lists to enter radiology programs, and hospitals prepare for the onslaught of the aging population with its growing healthcare needs, facilities also grapple with the loss of its Baby Boomers’ retirement. Meanwhile, increasing vacancies have to be filled.
A solution beyond extending permanent staff’s hours could be the traveling technologist, a trained and certified imaging professional who signs a contract for, typically, a 3-month period to work at a hospital or imaging center. For example, On Assignment (Calabasas, Calif) is a healthcare specialty company that works with large and small acute-care facilities, providing imaging technologists nationally as one facet of its business. Who are some of the other players, including placement companies and technologists? Read on to find out the details.
AN ITINERANT IMAGER HITS THE ROAD?AGAIN
Traveling technologists who work in mobile units regularly relate to this postal adage: “Neither snow, nor rain, nor heat, nor gloom of night stays these couriers from the swift completion of their appointed rounds.” In this case, it’s much-needed imaging services. Whether in remote or metropolitan areas, modalities are on the move, navigated by what many consider the best of the best.
It requires a special kind of technologist to deliver knowledge and skills in new places every day, adapting to constant change. Those who dislike challenging themselves, who insist on regular hours, and who prefer predictability need not apply. Extensive imaging experience, confidence in your well-honed skills, and true dedication can seal the deal. Willingness to ride in a semi or a coach is a must.
For imaging road warrior Kris Nornes, RT(CT)(MR), of DMS Health Group (Fargo, ND), the challenges, diverse assignments, and self-reliance needed as a mobile-unit tech suit her just fine. Nornes’ territory covers northwest Minnesota up to the Canadian border, North Dakota to mid-Minnesota, and occasionally northeastern Minnesota.
Awake and on the go before daybreak, Nornes?who has been a technologist for more than 20 years?braves the winter cold, snow, and ice and drives to meet the mobile unit that will transport her to an imaging site where she performs MRI scans. Workdays can last 15 or 16 hours, and that includes driving time.
“The most MRIs I’ve done in a day is 21 or so, but that gets to be a lot of hours,” Nornes says. “We try to be really flexible [and not turn people away]?whereas in a normal hospital, the patient would be told [to come back] in a week or something like that. In smaller hospitals, we try to let them make the most use of us while we’re there.”
On average, Nornes and the coach driver log approximately 3,000 miles per month. Some days, they will ride 200 to 300 miles; other days, a mere 40 to 50 miles. The weather presents challenges, but it’s all in a day’s work. “You can’t be a road wimp,” she says.
Nornes’ mobile unit goes to smaller, more remote sites. On the days that are truly hazardous driving, the coach is forced to forego its schedule, but everyone tries to keep the weather-related cancellations to a minimum, realizing that a no-show translates to missed scans for people who might be elderly and who cannot drive themselves out of their area to be imaged. Cancellation could mean postponing patients’ scans for another week or two.
Some days are a guessing game when it comes to the weather. Northern Minnesota can sometimes have 10 inches of snow, and a 5 am departure time frequently precludes the luxury of highway reports. “Maybe the travel in my area is OK, but until I get up to my site that’s a hundred miles [away], they’re having worse weather, so that’s always a struggle,” Nornes explains. “We don’t want to have to cancel our patients. On the other hand, our company is pretty mindful of not wanting to endanger our equipment or staff by sending them into blizzards.”
Access to a radiologist varies. Sometimes, one is on-site and available to the unit for questions. Frequently, though, Nornes contacts a radiologist by phone. One radiologist might serve two or three hospitals. And different places can have different expectations.
“So, I guess we always do make the comparison that it is a more difficult job, because we need to respond to maybe 10 different radiology groups who have different sets of routines and [specifics in] what they want,” Nornes says.
The time pressure to complete scheduled exams is constant, because the mobile unit does not have the option of next-day availability. “We have to be fairly quick,” Nornes says. Results are also faster because of the PACS factor.
The changing venues offer mobile-unit technologists variety, independence, and the opportunity to test their knowledge and experience. “We’re never playing radiologist at all, but we’re trying to decide what the radiologist would want us to do in this case,” she adds, “and I find that challenging.”
“When we come across someone who has one of the more specialized modalities, such as interventional radiology, we actually create a sales approach for him or her, where we’re marketing the person to facilities,” says Christine Poleon, On Assignment’s VP of health information management and allied travel. “If we have a person who wants to go to [a particular area], then we’ll contact facilities within [that area] and candidate-market them.”
Kevin Stands is a traveling interventional radiologic technologist who currently is working at 580-bed Memorial Hospital (Colorado Springs, Colo) for On Assignment. He trained in the US Air Force and has worked as a traveler for the past 1? years. While employees are out on health-related leave, Stands fills in the gaps. He performs special procedures in his technologist capacity, including diagnostic contrast studies and the placement of temporary lines. He currently performs five to 10 procedures per day.
Travel appeals to this former airman. “I am able to see places that I probably wouldn’t get to see otherwise,” Stands says. “And it’s kind of paid for. Every place is different, and I learn different techniques and how other people do things. So I’m getting better, and I’ve been fortunate to meet a lot of great people. The drawback is that I’m away from my family.”
Flexibility helps any traveling tech on assignment. “You get to a new place, and you don’t know how they do things, so you have to be receptive,” Stands advises. Procedures, equipment, and preferred products can vary from one institution to the next.
The Existing Need
Peninsula Regional Medical Center (Salisbury, Md), a 400-bed hospital, has tapped travelers for angiography, general radiography, and ultrasound procedures. When the department lost some staff to relocation, it required immediate coverage.
“Some of the [technology] students are graduating, so they’ll be filling some of the spots,” explains Mario Todorov, MD, a radiologist at Peninsula Regional. “But some are moving to subspecialize in additional fields of radiology, so our needs are not going to be met by the graduating students. [Traveling technologists] provide coverage when we need it and when we cannot find someone to cover permanently.”
The experience and skills of traveling technologists have won the respect of radiologists at many facilities. The level of expertise can exceed that of techs who work in a permanent setting and who are not exposed to different methods and approaches that the travelers learn.
“[Travelers] bring ideas and new ways of doing things that might not be done here,” Todorov says. “Whenever there is a complicated case, we try to scan the patients here, but oftentimes they go to Johns Hopkins or the University of Maryland for a second opinion. Sometimes, the technologists have experience in doing tests that might have been done at big university hospitals and that could facilitate diagnosing the patients here as well as there.”
Peninsula Regional is using approximately 10 travelers at its facility. The stay varies, but typically, a traveler will contract for 3 months at a time. “Some in nuclear medicine stay for six months,” Todorov explains. “Some travelers finish their rotations here, go for a few months somewhere else, and then come back to us.” He notes that the facility plans to continue using traveling technologists to meet its radiology needs.
Although many facilities recognize the travelers’ skills, some choose not to take advantage of the staffing option because of the additional cost involved. “The bottom line is that we hire travelers when we cannot recruit otherwise,” says Geoffrey Smith, MD, an interventional radiologist at Wyoming Medical Center (Casper, Wyo) and its affiliated outpatient radiology center as well as chair of the Small & Rural Practices Commission of the American College of Radiology (ACR of Reston, Va). “They are usually well qualified but extremely expensive, and thus [the hospital and imaging center] does everything it can to retain staff and avoid hiring travelers.”
Smith adds that every place he has worked has sought to avoid traveling staff whenever possible because of the “high financial impacts.” Wyoming Medical recently used traveling or temporary sonographers, general radiology techs, and CT techs.
Med Travelers (Irving, Tex), a national firm that specializes in the temporary placement of medical-imaging professionals, says its business responds to needs brought about frequently by growth and attrition. Permanent staff members migrate to outpatient centers, where they can dispose of the on-call hours and extended shifts. That’s where Med Travelers steps in.
The firm’s VP, John Moberly, says that Med Travelers has experienced approximately a 32% growth in 2005 over 2004. “I have to believe that other companies within this industry are experiencing similar growth,” he says.
The impact of society’s aging population and the problem of obesity will increase the demand for modalities in the cardiovascular and interventional specialties, according to Moberly. “It is estimated that right now, about 100,000 people in the United States are over the age of 100,” Moberly says. “The US Census Report said that by the year 2020, there will be more than 400,000 people in the United States over the age of 100. So we know this is sparking demand in cardiovascular specialties.”
The obvious benefit of traveling technologists to the patient is the opportunity to be evaluated near home. For the hospital, it translates to providing a vital resource to the community and an uninterrupted revenue stream.
Placement firms acknowledge the increased cost of traveling versus permanent technologists. And travelers could face some resentment from full-time staff members who realize that the temporary tech is making more money than they are. However, agencies point out that traveling techs have the inconvenience of living away from family and experiencing the associated stress.
Firms also note that the added expense of a traveler is offset by the elimination of expenses that the client isn’t paying for, such as health insurance and other benefits. “The most important thing is to realize that when it comes to expenses, the revenue isn’t lost,” Moberly advises.
Traveling technologists are considered full-time employees by Med Travelers and receive health insurance, 401(k) participation, and other benefits. In most cases, traveling technologists are considered employed by the agency that sends them to a site.
The highest demand for travelers is directly proportional to population. For the past 3 years, California, Texas, Florida, and Pennsylvania have created the most demand for techs from Radworking.com (Denton, Tex), followed by Missouri, Massachusetts, and Georgia. One segment of the company provides an online job board that facilitates the exchange of information for clients and technologists.
Hospitals typically find help through a traveling-tech firm or agency that acts as a contact for the hospital. Technologists can come in on a per diem or longer-term basis, reducing extended shifts that take their toll on permanent staff.
“Most of the hospitals will do that, and there are a number of agencies that use us and facilitate the employment of technologists who want to travel,” says Radworking.com CEO Kenneth Gould. “I have seen a kind of hybrid over the years that’s come into popularity: A [healthcare] system that might have four or five or more hospitals will try to begin to pull their own resources together to develop a database of per diem techs that they can count on to pull in and fill in as needed. That’s certainly not the norm, but I’ve seen it on occasion.”
Approximately 900 radiologic technologist programs?many with 2-year wait lists?exist nationally. A 2004 survey 1 by the American Society of Radiologic Technologists (ASRT of Albuquerque, NM) placed vacancy rates nationally at 7.7% for radiographers, 5.7% for CT, 6.9% for MR, 5.6% for mammography, 6.9% for nuclear medicine, and 9.5% for sonographers.
For traveling technologists, the road appears to be paved with opportunities.
- American Society of Radiologic Technologists News Release. RT vacancies decline, ASRT survey shows. December 2, 2004. Available at: www.asrt.org. Accessed April 19, 2006.
FAST FACTS ABOUT TRAVELING TECHNOLOGISTS
In 2005, Med Travelers (Irving, Tex) conducted telephone interviews with the firm’s temporary technologists as well as users and/or purchasers of temporary technologist services. The results of the survey were compiled into a report, 2005 Survey on Temporary Imaging Technologist Staffing Trends Based on 2004 Data. This report marks the fourth survey of its kind, and the findings from each year’s survey are included.
To read the report in full, visit www.med-travelers.com. However, we have pulled out a few interesting findings here:
|* Question posed to users and/or purchasers of temporary technologist services.
? Question posed to temporary technologists.
Lin Muschlitz is a contributing writer for Medical Imaging.