title: Referring physicians' attitudes toward international interpretation of teleradiology images.
abstract: OBJECTIVE
  We evaluated referring physician attitudes toward the international interpretation of radiologic images.
  
  
  METHODS
  A five-question, scenario-based survey describing features of a hypothetic local radiology firm compared with those of its hypothetic overseas counterpart, international radiology, was sent by mail to 350 physicians from a broad range of medical and surgical specialties. One hundred nineteen physicians responded, for a response rate of 34%. Referring physicians were asked to indicate their preference for local versus international interpretation in each scenario using a 5-point Likert scale, with a score of -2 indicating a strong preference for international services, 0 indicating no preference, and 2 indicating a strong preference for local services.
  
  
  RESULTS
  When all variables are held to be equal, referring physicians strongly prefer local services (mean score, 1.77; SD, 0.77). When international teleradiology provides either a 2-day faster turnaround time for reports or a 30 dollars lower out-of-pocket cost to the patient, referring physicians still prefer local services, although less than they did with all variables held equal (mean score, 0.42-0.44; SD, 1.30-1.40). When international teleradiology provides both a 2-day faster turnaround time and a 30 dollars lower out-of-pocket cost to the patient, referring physicians preferred international teleradiology, albeit only slightly (mean, -0.25; SD, 1.50). Finally, when the credentials of the international radiologists are perceived to be less than those of the local radiologists, even in the face of faster turnaround time and 30 dollars lower cost to the patient, referring physicians overall strongly prefer local services (mean, 1.51; SD, 0.86).
  
  
  CONCLUSIONS
  Referring physicians prefer local interpretation of radiologic images to international interpretation when all things are equal. However, the timeliness of image interpretation and the cost to the patient are important factors in this decision.
authors.affiliation: Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT, USA. neil.lester@yale.edu
authors.forename: Neil
authors.initials: N
authors.lastname: Lester
authors.forename: Tyler
authors.initials: T
authors.lastname: Durazzo
authors.forename: Alan
authors.initials: A
authors.lastname: Kaye
authors.forename: Marilyn
authors.initials: M
authors.lastname: Ahl
authors.forename: Howard P
authors.initials: HP
authors.lastname: Forman
mesh_terms: D001291:Attitude of Health Personnel; D038622:Internationality; D010820:Physicians / Q000191:economics / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000191:economics* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D019112:Teleradiology / Q000191:economics* / Q000706:statistics & numerical data*; D014481:United States