When outpatient imaging centers are opened, a key decision that hospitals and radiology groups have to make is how to staff them with radiologists. Will the radiology group rotate all its doctors though the outpatient center, or will a few radiologists be designated as outpatient care providers?

At the Advanced Imaging Center, Virginia Beach General Hospital and Hampton Roads Radiology chose to designate radiologists to work specifically and exclusively with outpatients.

"We wanted to make this a physician-driven center for physicians," says Danilo Espinola, MD, president of Hampton Roads Radiology and AIC's manager. "We wanted to send the message to clinicians that we were the best."

AIC is staffed by four radiologists, of which Espinola is one. "Our physicians are customer friendly, happy to talk to doctors, willing to talk to patients, and at the same time could meet the requirements to do high-end CTs and general radiology."

Only one radiologist is in the center at any one time. "The reason we did this is that we wanted to provide a continuity to the relationships with the referring physicians so they wouldn't see 17 or 20 names coming out of there and not know who to talk to," Espinola says.

Having one doctor in the center does not mean that the single doctor does all the reading for the center. CT and MRI studies are distributed electronically to appropriate subspecialists within Hampton Roads. Other subspecialists may read appropriate cases. One important role the on-duty radiologist at AIC does fulfill is consulting with referring physicians. AIC has established a hotline to let referrers

consult not only about ongoing exams but to query the radiologist about what exams might be most appropriate for a symptom or suspected diagnosis.

"We wanted to provide customer service to the clinicians that went beyond helping them reinterpret what we said in our reports or clarifying for him or her the result of an exam," says Espinola. "We wanted to tell them If you don't know what to do with a patient, you call us and we'll tell you what is the right exam for that clinical circumstance.'"