It’s easy to measure radiologist productivity in terms of RVUs per hour.
What’s harder to assess is how efficiently a radiologist reaches that production number—both cognitively and psychologically.
I’ve written a lot about the biomechanical side of reducing friction in the radiology workflow: better input devices like programmable mice, off-hand keypads, and simple AutoHotkey scripts. But there’s another important piece—minimizing distractions and maintaining momentum from case to case.
On the macro shift level, you can have so-called bunker shifts free of technologist and clinician phone calls and other external distractions. Literature has shown, big surprise, that on the whole, people read more if you don’t interrupt them. But there are two issues with that:
- Talking to people is part of the job, at least some of the time.
- You can still distract yourself.
Auto Advance
One simple but powerful tool is AutoNext or equivalent automatic case-loading function in your worklist manager. When you sign a case, the next one opens automatically.
This reduces the liminal space between cases—those tiny gaps where your monkey mind looks for distraction, dopamine, or the occasional excuse to manipulate a shared worklist to avoid difficult or low-RVU studies.
(We can however acknowledge that automatic case selection/loading can increase the feeling of being on an endless hamster wheel, but overall I still believe it’s ultimately effective in removing some useless clicks and unnecessary decisions.)
Enough with the Email
Another low-effort win: don’t keep your email open in a browser tab. Just closing the tab dramatically reduces the urge to check email every five seconds between cases, especially when you can see the unread message counter climbing.
We are always looking for an excuse to disengage when a task gets hard. Your phone may be in your pocket, and you may need to be reachable, but it’s still better to batch-check email sporadically than to leave it constantly accessible.
Phone Just Out of Arm’s Reach
I need to be able to answer the phone. Anyone who needs me generally is going to call my cell or text, and I also forward the hospital phones to my cell phone when covering from home. This is one reason why I often keep an AirPod or two in my ears most of the time when I’m working alone: I can hear and answer the demand without needing to have my phone on my person. Just a little friction can go a long way.
Creating vs Editing
One feature I’ve come to really appreciate in my practice is access to a team of human editors (the imaging center pays)—someone who helps input clinical histories, contrast details, catch template mismatches, and fix obvious transcription errors. They’re not perfect, and they certainly don’t always make big changes, but the value isn’t just in the edits themselves.
What the editor allows me to do (only when I’m on an outpatient list) is separate the diagnostic report creation task from the editing task. I can read multiple cases in a row, focusing on interpretation and moving efficiently down the list—then switch into editor mode to proofread and finalize my reports. I catch more of my own mistakes with those few minutes of temporal distance.
This separation is key. Constantly switching back and forth between different cognitive modes creates attention residue (not to mention editing fresh words is always a challenge as your mind often sees what you meant to say and not what’s actually there).
While avoiding distractions like email, phones, and messages is intuitive but challenging, task batching is an overlooked opportunity (obviously only when working on non-time-sensitive cases). Diagnostic, then editorial. Not both at once. It’s a subtle shift, but I’ve found that when practical it makes a real difference in my focus, efficiency, and effectiveness.