Date of Award


Document Type

Open Access Thesis

Degree Name

Medical Doctor (MD)

First Advisor

Kevin M Johnson MD

Second Advisor

Jonathan Sunshine MD

Third Advisor

Howard Forman MD


Purpose To identify the characteristics of and the motives behind radiologists use, or lack thereof, of after-hours services. Methods From August 2005 to June 2006, 300 non-specialty hospitals randomly selected from the 2005 American Hospital Association Directory of Hospitals were contacted by phone, email, and mail, with an attempt made to speak to the chief of radiology. We obtained 115 responses, a 38.3% response rate, including 64 from practices that used an external after-hours service. Responses were analyzed using descriptive statistical analyses. Results Practices gave convenience as the most important reason they use an after-hours services, with value for recruiting ranked second and shortage of radiologists for off-hours coverage third. Three-fourths of practices said they receive 5% or fewer of their reads from these services. Two-thirds of practices paid the service about as much as they collected or more. Approximately 40% of respondents utilized an after-hours service located internationally. Of these, 56% said that the radiologists reading internationally were either all Americans or mostly Americans and 40% did not know the proportion of foreigners. Regardless, in-state licensure of all interpreting teleradiologists is essentially universal. Conclusions Most radiology groups using after-hours services do so for convenience rather than shortage of staff to provide coverage. Most practices send a very small percentage of their studies to the services. While overseas-located services are commonly used, there is little evidence of other than American radiologists or American-trained radiologists at these services.