The importance of a second opinion for detecting and treating critical ailments like cancer is undeniable. Most patients go for a second opinion to be sure of their disease and its stage of advancement. Radiologists often play a critical role in second opinion readings.
Second Opinion Reads
Outside facilities send breast images for a second time reading when the first reading reveals signs of malignancy. These additional works increase the overall workload of the radiologists substantially. However, they do not receive a reimbursement matching the additional effort they put in for these readings.
Especially the centers designed by the National Comprehensive Cancer Network receive piles of such additional reading requests every day. After the second reading, almost 43% of these cases come out with a new insight or completely different diagnosis. The second reading results often stand in stark contrast with the initial readings.
For clinical considerations, the importance of second opinions is paramount. However, this also increases the workload of the radiologists by leaps and bounds.
The Research
Catherine M. Tuite works as an MD with the breast imaging department of ChristianaCare Helen F. Graham Cancer Center and Research Institute’s radiology section. Catherine and her colleagues further mentioned that breast radiologists take care of the second reading of any imaging much like the first stage reading.
They cannot leave any detail behind. They focus on the imaging as if they were looking for primary interpretations. In many cases, their revelations confirm that the level one interpretation was inadequate. Expert opinion can alter the management recommendations significantly or offer an entirely fresh cancer diagnosis as well.
Additionally, when expert radiologists interpret the imaging for the second time, their risk of being blamed for medical malpractices also increases. Taking all these aspects together, the radiologists involved in second opinion interpretations are now questioning the adequacy of the current reimbursement practices.
However, calculating the exact value for such efforts is not an easy task. No global parameters or yardsticks offer a perfect way to know the amount of reimbursement that would suffice such valuable and risky interpretations. This is why experts have dug deeper to cardinally compare the reimbursement received and the efforts involved.
The Result
The team of researchers took three years of data for the study. They also conducted a report analysis for ‘Outside Film review”. They interpreted 2126 studies together. The average calculated range of yearly work value for each CPT code came out to be between 3135 and 3804.
The credits the radiologists got for outside imaging reads fell considerably short when weighed against the number of requests.
Very second opinion interpretation involves the intellectual involvement of the concerned radiologists. The time it takes and the effort it demands always remain substantial. Radiologists often receive only the wRVUs the lowest-value interpretations.
Sometimes, the values remain extremely discounted. In both ways, the radiologists get way lesser than what they deserve. The authors mentioned that such practices undervalue intellectual contributions and more.
The team suggested crediting study-specific fees to the radiologists, performing second opinion interpretations. They further mentioned that the study and its findings will help validate this claim. However, the relevant authorities have to discuss the exact amount of reimbursement in the future.
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