Retrospective and prospective chart review was conducted to study patient callbacks to the emergency department (ED) based on plain radiograph interpretation discrepancies between radiologists and emergency physicians before and after a continuous quality improvement (CQI) intervention. Patients who were called back to the ED because of radiograph interpretation discrepancies were retrospectively studied. These results were reviewed by a CQI team, which recommended greater communication and consultation. A prospective study was then performed. Before quality intervention, 0.7% of the patients were recalled; 0.4% required recall after quality assurance, a reduction of 42.9% (P = .0001). Emergency physicians in this study had a low percentage of patient recall due to discrepancies in radiologic interpretation. CQI further reduced this percentage. The proficiency of emergency physicians interpreting radiographs validates the current practice of emergency physicians rendering treatment based on their interpretations and supports the notion of emergency physicians billing for this service.