Verification and Modification of the Japanese College of Radiology Recommendation: Proper Evaluation of the Job of a Radiologist

Abstract

The recommendation, Proper Evaluation of the Job of a Radiologist, has been announced by the Japanese College of Radiology. The recommendation was that the clinical fee for diagnostic imaging and radiation therapy should be used for evaluating the job of a radiologist. The purpose of this paper was to confirm whether the recommendation reflects the medical practices in radiology, and if not, to present an alternative method. First, the healthcare insurance system in Japan was analyzed, and a costing system for healthcare was developed. Second, using the costing system, the income and expenditure of Toyama Prefectural Central Hospital were calculated, and departmental cost accounting in July 2020 was performed. Finally, the marginal profit of each medical department was obtained. In the healthcare insurance system, the medical fee is different from the clinical fee in that the former consists of the clinical practice fee and the reimbursement fee for drugs and medical material. Furthermore, the clinical fee in diagnostic imaging does not include, the first visit, revisit, or treatment fee. Therefore, the medical fee was used for evaluation of the medical practices of a radiologist. Clinical free in diagnostic imaging and radiation oncology cannot correspond to the job of a radiologist. The newly developed healthcare insurance system overcame this shortcoming. Marginal profit calculated from the medical fee of each medical department of Toyama Prefectural Central Hospital in July 2020 was calculated using the system. Marginal profit were 59,005,605 yen for diagnostic radiology and 21,822,523 yen for radiation oncology. Marginal profit in radiology compares favorably with that of other medical departments.