July 20, 2022

Remote radiology option expands coverage, enhances care

A new initiative within Vanderbilt’s Department of Radiology and Radiological Sciences allows some physicians to work remotely, thereby increasing the number of specialists available to enhance care.


by Emily Stembridge

Maintaining a healthy work-life balance helps reduce stress and prevent burnout in employees, and working from home is a common way to help employees feel a stronger sense of flexibility and overall well-being. Traditionally, the medical field has not been able to provide work-from-home options to physicians due to the high-touch nature of the job.

Melissa Picard, MD

The Department of Radiology and Radiological Sciences is working to change that. Melissa Picard, MD, associate professor of Radiology, like most radiology faculty, teaches residents, responds to the questions of referring physicians and analyzes images to triage patients. The only difference between Picard and most other VUMC radiologists is that Picard works entirely remotely from her home office in Charleston, South Carolina.

Picard and her husband both completed their medical training in Louisiana and Ohio before relocating to Charleston for her residency at the Medical University of South Carolina (MUSC). When her husband found a job at a local medical practice in Charleston, Picard decided to stay on as faculty at MUSC, working part time so she could also be more involved in caring for their three children.

Picard remained in this role until a former resident connected her with Reed Omary, MD, MS, Carol D. and Henry P. Pendergrass Professor and chair of Radiology, who was recruiting new faculty to VUMC. When Omary was not only open to the idea of Picard working remotely, but excited about it, Picard jumped at the chance to try something new.

“During COVID-19, we were all forced to do things differently than the traditional way,” Picard said. “And a lot of us realized the opportunities that came alongside that.”

Picard completed all her interviews for the job via Zoom and accepted the position in April 2021 without having met any of her colleagues in person, officially starting in September 2021. Although Picard is out of sight from VUMC Radiology faculty, she works hard to ensure she is not out of mind.

While maintaining work-life balance is important to Picard, it is equally as important to her that she be an integral member of the radiology team in both the clinical and educational realms. She has made two trips to Nashville to meet her co-workers in efforts to foster the personal relationships that come with in-person interactions.

Similarly, to her colleagues, Picard regularly participates in tumor boards, which are mostly a remote format. This has allowed her opportunities to contribute directly to patient care as well as meet and interact with other clinicians face to face.

Picard values resident education and did not want to miss an opportunity to teach while working remotely. She stays connected with residents by hosting virtual lectures, even bringing her previous experience with simulation education to VUMC. She created a new simulation lab for VUMC radiology residents, which she facilitated in person during one of her trips to Nashville. Picard is intentional about being present and involved, especially when it comes to interacting with radiology residents. Picard is so involved in education and responding to questions that often other faculty and clinicians do not realize she is not located in Nashville.

“We’re so used to feeling like we need to be sitting right next to our residents to teach them, but now we’re seeing that with the right setup, people and resources, we can still teach them effectively and be involved in their academics,” she said. “We’re still figuring it all out, but I think we’re off to a really strong start.”

Being in the Eastern time zone allows Picard to get an early start reading overnight studies and helping facilitate patient care before her family is up and out the door to school. She resumes reading images for most of the morning, pausing in the afternoons to pick her daughter up from school and drop her off at swim practice. Then, she returns home and reads images until she’s caught up to a typical day’s workload. She then spends the evening with her family and preparing for the next day.

“The biggest key is communication,” Picard said. “It’s vital to let the residents know when I’m around and when I’m not. It’s such a privilege to be flexible with my day and contribute to both my family and my job in a way that works for everyone.”

This approach is an innovative way to help address the national shortage of radiologists while also greatly benefiting the remote radiologists, says Omary. So far, there are four remote radiologists working for VUMC — a cardiothoracic radiologist in Houston, an emergency radiologist in Seattle who will start in September, a pediatric neuroradiologist from Cleveland and Picard.

“Dr. Picard is an incredible asset to our department, the Medical Center and our patients,” Omary says. “During the tornado that tore through Tennessee and Kentucky this past winter, Dr. Picard jumped in remotely to conduct vitally important patient imaging triage. We are lucky to have her expertise, and in the future, that of additional remote radiologists who are available to bolster care during regular hours, pandemics or climate disasters.”