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The mission of the Harvey L. Neiman Health Policy Institute® is to establish foundational evidence for health policy and radiology practice that promotes the effective and efficient use of health care resources and improves patient care.

May 8, 2018

Ultrasound Complexity of Radiologists vs. Non-radiologists

Radiologists interpret a disproportionately larger share of lower extremity venous duplex ultrasound (LEVDU) examinations on weekends and on the sickest patients, according to a new Harvey L. Neiman Health Policy Institute study published online in the Journal of American College of Radiology (JACR).

Prabhakar, Gottumukkala and their colleagues used a 5% national sample of Medicare beneficiaries from 2011 to 2015 to examine the differences in LEVDU services billed to Medicare by radiologists vs. non-radiologists by day of week, site of service, and patient complexity.

“While previous reports have explored interspecialty differences in the total volume of specific imaging services, little is known regarding the variation in the timing and sites of services, as well as the complexity of patients served by those different specialty groups,” said Anand Prabhakar, MD, MBA, emergency radiology staff at Massachusetts General Hospital. “Our analysis thus uncovers new insights into previously described interspecialty market share differences.”

Of 760,433 LEVDU examinations for which provider specialty could be determined, 439,964 (58%) were interpreted by radiologists and 320,469 (42%) by non-radiologists. On weekends, radiologists interpreted 75% and non-radiologists 25%. Compared to non-radiologists, radiologists disproportionately interpret LEVDU on weekends (vs. weekdays), in higher acuity settings, and on more complex patients.

“To optimize around-the-clock patient access to necessary imaging, emerging quality payment programs should consider timing and sites of service, as well as patient complexity,” said Ravi Gottumukkala, MD, third year radiology resident at Massachusetts General Hospital.

To obtain a copy of the JACR study or to arrange an interview with a Neiman Institute spokesperson, contact Nichole Gay at (703) 648-1665 or


About the Harvey L. Neiman Health Policy Institute

The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care. Visit us at and follow us on TwitterLinkedIn and Facebook.


Nichole Gay
Harvey L. Neiman Health Policy Institute