Teleradiology: A Remedy for Physician Burnout? Exploring the Link Between Work-Life Balance, Doctor Wellbeing, and Patient Care

“Burnout hits record high”(1) “Physician burnout: a global crisis”(2) “Physician burnout undermines safe healthcare”(3).

Reports such as those above paint a gloomy picture of the effects of the current workforce crisis. It raises the questions: What is burnout? How does it affect radiologists and their patients? And what role could teleradiology play as a solution?

The ICD-11 defines burnout as: “[…] a syndrome conceptualised as resulting from chronic workplace stress that has not been successfully managed. It is characterised by three dimensions:

1. feelings of energy depletion or exhaustion;
2. increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and
3. reduced professional efficacy.

Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life.”(4)

Burnout is thus a reaction in the social dimension of the bio-psycho-social model of disease. Whether or not burnout in itself causes clinical psychopathology is still heavily debated(5,6). 

Nevertheless, burnout comes with negative consequences for physicians, the work force, and patient safety. 

Systematic reviews have revealed that burnout causes significantly lower productivity, and that low levels of professionalism were twice as likely to occur. Turnover intention also increased by more than threefold compared with retention. The most worrisome findings were that physician burnout doubled patient safety incidents and significantly decreased patient satisfaction(3)(8).

Even radiology, which is considered one of the “ROAD to happiness” specialties, carries a serious risk of burnout. In the burnout ranking in the UK it ranks 8th and 9th for trainees and consultants, respectively(9). In the USA, it’s even ranked 6th(10). This risk, with the current 30% shortfall of consultant radiologists and the ever-increasing demand for imaging reports, will only worsen over the coming years(11).

How could teleradiology reduce burnout rates? By improving the work-life balance of the radiologist.

“Teleradiology is the transmission of radiological patient images […] from one location to another for the purposes of sharing studies with other radiologists.”(13)

Teleradiology comes with a lot of advantages: Teleradiologists can plan their work-schedule around their personal commitments, instead of the other way around. Substantive radiologists can outsource their nightshifts, thereby reducing fatigue-induced reading inaccuracy(14).

Rural radiologists can easily obtain specialist opinions in areas outside of their expertise. Managers welcome the speed and safety element it brings by having several radiologists simultaneously available at the click of a button during times of increased demand(14). In relation to burnout, it tackles two of the most common causes, which are “too many hours at work” and “lack of autonomy over one’s life”(12).

Despite all the advantages, one must not forget to mention its shadow sides. Teleradiologists might feel even more isolated and disconnected to their patients, which is another cause of physician burn out. Other concerns include issues surrounding data breaches, reimbursement, quality assurance, and credentialing.(15)

Taking all arguments into account, the advantages of teleradiology, specifically in relation to radiologist burnout, outweigh the negatives. 91% of all trusts already utilise it, and the demand will only increase(16). We should embrace this tool for the benefit of physicians and their patients, and ensure the concerns are addressed in an adequate manner.

Teleradiology is for doctors and patients. It is one of the oldest and most successful, clinical telemedicine specialties.[1] It is multifaceted, and may provide a solution to the increasing demands on radiologists.

Burnout can be identified as overwhelming exhaustion, depersonalisation, and decreased sense of  accomplishment.[2] In 2024 the European Radiology Journal found 77% of radiologists identified to be  burnt out.[3] In addition, The Royal College of Radiologists (RCR) in 2023 found that 100% of radiology  clinical directors in the UK are concerned about workforce burnout, with 43% of these departments  relying on the goodwill of their radiologists to manage excess demand.[4]  

In the traditional hospital radiology setting, high workloads are combined with the need for a physical presence. At its core, by allowing remote reporting, teleradiologists get the flexibility in work location and schedule that they desire, for example, enjoying breakfast with family instead of commuting to work.[5] However, this is just the tip of the iceberg. Where teleradiology thrives is its ability to better distribute workload, particularly benefiting underserved or rural areas whose access to in-house radiologists is limited, allowing for consistent on-time reporting. Large tertiary centres also benefit by supporting the increasing workload of emergency reporting, which can keep stress levels down, and reporting quality high.[6,7]  

Despite being remote work, teleradiology allows for social collaboration with colleagues from around  the world, providing constant learning opportunities and a sense of community, both of which are vital  for keeping morale high, and ensuring a high accuracy of reporting.[8] Teleradiology implementations of  artificial intelligence help to reduce the cognitive load associated with routine tasks, allowing the  reporter to focus more where their experience and expertise is vital, boosting job satisfaction.[9,10] 

The RCR have reported a 30% deficit in the workforce in 2023, and a growth rate of just 6.3%.[4] With the average age of a consultant radiologist leaving the workforce being just 54, teleradiology can offer a solution to reduce the deficit. By offering more part-time flexible work, senior radiologists can maintain professional integrity, whilst reducing their workload and managing good work-life balance. And this is needed, MRI and CT scanning rates are increasing at 11%, almost double the rate of workforce growth.[4] 

But is teleradiology the correct solution to increasing reporting demand and ultimately workforce burnout? The NHS spent 276 million in 2023 on managing this excess demand, a large proportion of which was towards private teleradiology services. This is the equivalent to 2690 yearly consultant salaries.[4] If we only use private teleradiology services to manage this demand, without sufficiently growing the NHS workforce, they may also become saturated, creating a downward cycle of more overworking.  

Remote working, distributing workload, collaboration, AI integration and maintaining workforce numbers are all benefits of teleradiology which put doctor wellbeing at the priority, whilst not sacrificing on the quality of patient care.