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AJR Am J Roentgenol. 2010 Nov;195(5):1159-63. doi: 10.2214/AJR.10.4359.

The performance of outside readings by radiology practices.

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Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA.



The purpose of our study was to determine how many radiology practices perform outside readings, what characteristics affect the prevalence and volume of outside readings, and how practices are paid for outside readings.


We analyzed data from the American College of Radiology's 2007 Survey of Radiologists, a stratified random sample e-mail and telephone survey. A total of 480 survey responses were evaluated; responses were weighted to make them representative of all U.S. radiology practices. We provide descriptive statistics and multivariable regression analysis results.


Overall, 40% of radiology practices in the United States performed outside readings in 2007. Outside readings constituted an average of 11% of the workload of these practices and 4% of the total workload of radiologists in the United States. Other practice characteristics being equal, academic practices, government practices, radiology units of multispecialty groups, and small practices had particularly low odds of performing outside readings. If they did perform outside readings, then, other practice characteristics being equal, small practices, solo practices, radiology units of multispecialty groups, practices in the main cities of large metropolitan areas, and those in nonmetropolitan areas had, on average, a relatively large portion of their workload consisting of outside readings. By far, the most common methods of payment were directly billing for the professional component or receiving a flat fee per study.


Outside readings were a common activity among radiology practices in 2007. There was substantial variability among practice types, sizes, and locations in whether practices performed outside readings and, if so, how much outside reading they did.

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