By Melissa Silverberg
When Hemang Kotecha, DO, looks back on the beginning of his emergency radiology career, he remembers trying to do everything at once—covering high-volume evening shifts more than an hour from home, taking on multiple leadership roles, mentoring residents and reading hundreds of cases a day without backup.
“Early in my career, I said yes to every opportunity,” he said. “After the birth of my first daughter, I realized I was missing important time with her and placing a significant strain on my wife, who also works full time.”
Transitioning to night shifts, reducing some non-clinical commitments, and finding better balance allowed him to be more present at home and more recharged at work.
“That experience highlighted how scheduling, workload, compensation and competing responsibilities impact wellness,” he said.
It also shaped the direction of his Thursday morning session, which aimed to raise awareness of burnout among emergency radiologists and equip them with practical strategies to address it.
Emergency radiology is uniquely demanding. High acuity and high volume converge with rapid turnaround expectations. Frequent interruptions and the need for 24/7 coverage create conditions that when sustained, create fertile ground for burnout.
Burnout in emergency radiology often manifests as emotional exhaustion, depersonalization and a diminished sense of personal accomplishment, Dr. Kotecha explained.
“The main contributors are high workload, demanding schedules and staffing shortages,” said Dr. Kotecha, an emergency radiologist and assistant professor with UMass Memorial Health. “Limited time for teaching, research or professional development further adds to the strain, while feeling undervalued or disconnected can make burnout more likely.”
To reach individual radiologists who feel too busy to engage in wellness initiatives, Dr. Kotecha recommends simple, evidence-informed strategies like structured breaks, peer check-ins and clear communication. For individuals, he recommended gratitude journaling, exercise and finding peers with similar concerns.
But wellness needs to be prioritized in radiology departments from the top down. Dr. Kotecha suggested departments appoint a wellness officer to shift workplace culture and explore other organizational level reforms—such as matching staffing to peak volumes, improving leadership communication and streamlining workflows through IT or AI support—to reduce unnecessary strain.
“Burnout isn’t just an individual problem; it’s shaped by the environment and organizational structure,” he said. “Even small changes, such as better scheduling, workload distribution or clearer communication channels, can make a meaningful difference.”
Burnout often begins quietly. “The early signs can be subtle, like feeling more tired than usual, having trouble focusing, getting irritated easily or feeling less connected to the work,” Dr. Kotecha said.
He also noted “quiet quitting”—doing only what is required and withdrawing from non-clinical engagement—as a sign leaders should take seriously.
For emergency radiologists, whose schedules frequently include nights, weekends and constantly shifting rhythms, early recognition is especially critical.
“Sleep disruption, limited time with family and the feeling of always adjusting between work and home life all add up,” he said.
“Resilience should be seen as a shared effort,” Dr. Kotecha said. Leaders can help by normalizing boundary-setting, providing recovery time after demanding shifts and creating peer support structures that make it easier to speak openly about stress.
He hopes the field continues moving toward more transparency and more two-way communication between frontline radiologists and leadership.
“Burnout in emergency radiology is real, and it’s shaped by many factors we can identify and address. Recognizing those contributors is the first step toward making meaningful change.”
Access the presentation, “Resilience and Wellness: Tools for Emergency Radiologists,” (R1-CER14D) on demand at RSNA.org/MeetingCentral.
