Radiology Access in Rural Germany: A Nationwide Survey on Outpatient Imaging and Teleradiology

Background/Objectives: This study examines the role of teleradiology and outpatient imaging in addressing gaps in rural radiology, analyzing the perspectives of referring physicians and radiologists. Methods: An online survey was conducted with a primary focus on evaluating the perspectives of referring physicians, including practicing surgeons, internists, and general practitioners. Their responses were then compared with those of radiologists. The survey consisted of multiple sections covering demographics, attitudes toward teleradiology, and outpatient imaging. It employed Likert scales, semantic differential scales, multiple-choice questions, and weighted ranking systems. Results: A total of 171 participants were included in the survey, consisting of 50 internists, 40 surgeons, 48 general practitioners, and 33 radiologists. A total of 79.2% of referring physicians rated teleradiology positively (at least 4 out of 5 stars), although its adoption in Germany remains limited, with 80.4% of referring physicians and 55.6% of radiologists reporting minimal to no use in their regions. Key concerns among referring physicians included the "lack of communication of teleradiologists with requesting physicians" (50%) and "lack of diagnostic consultations of radiologists with patients" (26.7%). In contrast, radiologists expressed significantly greater concern about technical failures (28.6% vs. 3.3%, p < 0.05). Additionally, 59.5% of referring physicians identified teleradiology as a crucial factor for improving access to radiology in rural areas. With regard to outpatient imaging, referring physicians valued continuity of care most highly, while radiologists prioritized minimizing wait times. Conclusions: Referring physicians view teleradiology and outpatient imaging as promising solutions for bridging the gap in radiology access between urban and rural areas. Addressing concerns like communication barriers and ensuring technical reliability are critical to its broader adoption and implementation.