Physician extenders in Radiology
Radiology Practitioner Assistant / Radiologist Assistant

Some of you may have heard about the newest professions in Radiology, the Radiology Practitioner Assistant (RPA) or Radiologist Assistant (RA).  These highly trained and experienced Radiologic Technologists are physician extenders, similar to other allied health physician extenders.  Both the RPA and RA go through extensive academic and clinical training after their Radiologic Technologist training and several years of experience working as a technologist, and work under the supervision of an ABR certified radiologist to improve patient care in the Radiology department.

Because this role is so new, there are still issues to be resolved as word gets out about these valuable employees.  Here at Partners, we are lucky enough to have several technologists that have continued their training to this next level.

One of the issues that need to be resolved at this time is payment for services.  At this time, CMS (Center for Medicare and Medicaid Services) does not recognize these individuals as independent practitioners; therefore no payment system is in place.  CMS, the ACR (American College of Radiology), the ARRT (American Registry of Radiologic Technologists) and others are working together at this time to resolve this issue.  We hope to hear of some resolution by the end of this calendar year.

Another interesting component of this is that there are currently two designations for these similar roles. The ACR, ARRT, ASRT (American Society of Radiologic Technologists) and CBRPA (Certification Board for Radiology Practitioner Assistants) are currently working together to merge the two and hope to have this also resolved by the end of the calendar year.  Issues under current discussion are degree requirements and scope of practice.

Finally, because the role is so new, a formal licensing process has not yet been implemented.  The MA DPH (Massachusetts Department of Public Health) is working on the process at this time, and is granting temporary license waivers to qualified candidates.  They too hope to have this worked out by the end of this year.  Several other states already have legislation and/or regulations in place for licensing. 

As you can see, this is an exciting time for these new roles in Radiology.  We are excited here at Partners to employ some of these dedicated personnel, and are working with several facilities to develop a practice model on which each can base a job description according to their needs.

These physician extenders must be licensed as an RT in MA, have current registration and be in good standing with state and affiliation statutes.  They must maintain their RTR license and credentials and fulfill all continuing education requirements.  They must abide by the ARRT code of ethics and any additional regulations as stated by their affiliation.  These highly motivated individuals are able to expand their knowledge and usefulness to the patient and the hospital.

Some of the benefits of this new role are:

• Increased employee satisfaction in an extended role.
• Increased patient satisfaction
• Less time waiting for exams to be performed
• Increased patient throughput
• Frees up radiologists time to concentrate on
• Reading/interpreting images
• Consulting with physicians regarding pending cases
• Allows better access, as patients do not have to wait for a radiologist to be available for certain exams
• Adds career opportunities to RT(R) position

At this time, there is a well-documented shortage of radiologists nationwide.  In 2003, an ACR study showed the number of radiology residencies to be increasing by 2% yearly.  Workload in radiology departments however, is conservatively estimated at a 6% increase annually.  As departments strive to do more with fewer resources, these skilled practitioners can help us to insure that patients receive high quality care in a timely fashion.

While there is still much to be determined with regards to payment and the exact designation, we are looking forward to working with these individuals and will keep everyone posted with any new information we receive.

For additional information:
www.arrt.org
www.asrt.org
www.acr.org
www.cbrpa.org

Authors:
Jason Barrett RT(R), CBRPA
Rick Dahl RT(R), RRA, CBRPA
Lisa Ewing, RT(R), BSM
Mark Girard, MD
Richard Guarino                                                         
Steven Miller, MD
John Patti, MD
Robert Sheridan, RT(R)

Partners Healthcare Systems - RRA/RPA Job Description

Partners Radiology RRA/RPA
Information regarding Federal Regulatory Requirements for Radiology Assistants and Radiology Practitioner Assistant as of September 2007