The healthcare industry is facing a critical shortage of skilled nuclear radiologists, threatening timely cancer treatment and care. With only 53% of training programs at full enrollment, innovative solutions are needed to address the staffing crisis.

Teleradiology can help, as it enables nuclear radiologists to interpret scans remotely, increase flexibility in their work schedules and expand access to specialized expertise, said Dr. Mark Crockett, chief medical officer at TeleDaaS, a vendor of dosimetry-as-a-service, which is very similar to teleradiology.

Crockett believes this technology-driven approach will alleviate the current staffing challenges and drive progress in radiopharmaceuticals – ultimately leading to better patient care.

We interviewed Crockett to discuss the staffing crisis for nuclear radiologists, how teleradiology can help combat the crisis, how teleradiology can drive progress in radiopharmaceuticals, and the medical isotope market's projected surge driven by growth in targeted cancer treatment and imaging.

Q. Please talk about the staffing crisis for nuclear radiologists. What do things look like at hospitals and health systems? What are the consequences of the crisis?

A. One reason for the staffing crisis is that demand has been rapidly increasing with new treatments becoming available, and the supply of doctors has not been keeping pace. Nuclear medicine is a field that requires highly specialized and difficult training. Many doctors choose other related specialties such as diagnostic radiology; they can cover some nuclear medicine, but also provide a wide range of services.

The few physicians that train tend to be concentrated in academic centers, and rural health systems struggle to find qualified nuclear medicine doctors to cover all their needs, which then leads to disparities in access to care.

In some geographic areas, patients struggle to access nuclear medicine experts, which complicates their ability to receive specialized treatments and diagnostic imaging. This could mean patients have to travel long distances or receive care without optimal dosing and monitoring.

This staffing shortage is a significant problem that limits patients' ability to access the nuclear medicine services they need, especially for new targeted radiopharmaceutical therapies.

Q. How exactly can teleradiology help combat the staffing crisis? Obviously, it can expand access to skilled professionals many miles away. But what can technology do to strengthen the field?

A. Teleradiology allows nuclear medicine experts to read scans more efficiently and provide guidance remotely, enabling them to serve a wider geographic area beyond a single hospital.

Teleradiology enables smaller hospitals without dedicated nuclear medicine staff to access this specialized expertise. Radiologists can provide oversight and dosing guidance remotely. Additionally, teleradiology allows nuclear medicine doctors to work more efficiently – they can evaluate remote patients when time becomes available, providing a consistent level of care across a wide area.

Teleradiology can make nuclear medicine doctors more efficient and expand their reach, which is crucial given the shortage of these specialized professionals.

By allowing remote review of scans and dosimetry, teleradiology helps ensure patients receive ideal monitoring and guidance from nuclear medicine experts, even at hospitals that lack an on-site nuclear medicine physician. This helps strengthen the nuclear radiology field by expanding access to quality care.

Q. You believe teleradiology can drive progress in radiopharmaceuticals. Please describe radiopharmaceuticals and explain the kind of progress you see occurring with teleradiology.

A. Radiopharmaceuticals deliver radiation directly to cancer cells by binding to specific proteins on their surface, allowing for targeted treatment. Many of the treatments that work like this are extremely new, and excitement about their impact is growing as new studies are released.

Using dosimetry with these agents is controversial. Many of them have a standard dose they are approved for, and officially that's how they are dosed. But there is significant research that shows that individual patients can get more doses safely, and that some patients are already at risk with the standard dose.

This has led scientific organizations to propose all patients get dosimetry with their care. For these new agents to be used in that way, a new way of extending nuclear medicine physicians will be required if we are to treat patients across the U.S. with personalized care, to say nothing of the rest of the world.

Teleradiology can also drive progress in radiopharmaceuticals by creating a new level of data that describes dose and patient outcomes. By allowing nuclear medicine experts to remotely review scans and facilitate dosimetry, more data is generated and we may be able to see more clearly which patients benefit from a given dosing approach. This expanded data is essential for improving health outcomes, ensuring more patients benefit from treatment.

Q. You also point to the medical isotope market's projected surge, driven by growth in targeted cancer treatment and imaging. You say there is a significant opportunity for teleradiology to address workforce gaps here. Please elaborate.

A. The projected multibillion-dollar market surge for medical isotopes is driven by the growth in targeted radiopharmaceutical cancer treatments and new indications. Currently, the approach is limited to a few cancers and agents, but many more are being studied and will no doubt gain approval.

This will no doubt create significant workforce challenges that teleradiology can help address. Currently, there are not enough nuclear medicine doctors to provide the level of service needed to administer these new therapies across the country. Teleradiology allows the existing specialists to expand their reach, therefore providing care for more patients.

Many smaller hospitals may lack this kind of nuclear medicine expertise; teleradiology allows them to treat with the new agents already here, to say nothing of the ones coming.

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Email him: bsiwicki@himss.org
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