Carol Schweitzer-Schilling has been a radiologic technologist since 1977. She decided to look into the profession after hearing a radiology instructor speak at her high school. She shadowed a technologist, and knew she had found the right path.
"I can vividly remember seeing gallstones on an x-ray, and I was hooked," Schweitzer-Schilling said. "Life in x-ray was much simpler then. No CT, no MRI -- we were it as far as diagnostics were concerned."
Over the next 23 years, Schweitzer-Schilling saw the advent of new imaging modalities and witnessed fluctuations in her chosen profession -- not all for the better: hospitals struggling under managed care demands, layoffs, and an increasing workload.
"I have witnessed many changes, most for the better, but many that make our jobs much harder," she said. "We work longer hours and do more outside our job description than ever before."
Clearly, the job that Schweitzer-Schilling now performs at a community hospital in Middletown, CT, is not the same as when she first started. Like most professions, the RT job market has experienced its fair share of upheaval -- shortages in one decade, surpluses in the next, attempts to tighten accreditation rules, attempts to make the field more attractive. More than 20 years after Schweitzer-Schilling donned her RT uniform, the profession is in flux.
Radiologic technology: The past 20 years
In the early 1980s, expanding technology and increasing patient loads created healthy demand for radiology professionals. In response, various radiology organizations founded the Summit on Manpower in 1988 to boost recruitment efforts and encourage employment retention.
Six years later, the number of radiography and radiation therapy graduates had grown by more than 60%, from 7,000 in 1988 to 11,500 in 1994, according to the American Society of Radiologic Technologists (ASRT).
Enter managed care. Mergers, downsizing, and consolidation in the mid-1990s led to a decline in demand for several medical professions, including RTs. Suddenly, there was saturation.
In an attempt to curb high unemployment rates, several RT programs voluntarily began reducing enrollment. By 1997, the number of graduates dropped by nearly 20%, to 9,244. However, the effort was shortsighted: Several programs closed down because of the loss of tuition fees.
According to the Joint Review Committee on Education in Radiologic Technology (JRCERT), the number of radiation therapy programs has dropped 42%, from 125 programs in 1994 to 73 in 2000. There has been an overall drop in JRCERT-accredited programs of 16% between 1994 and October 1, 2000.
With fewer RTs earning certifications and degrees, recruiting efforts are once again on the rise.
"Recruitment efforts are intense," said Donna Olmstead, an ASRT spokesperson. "But competition for qualified candidates for radiologic careers is also stiff. Many people with technical interests opt for careers in computer technology or other medical fields."
CARE
The Consumer Assurance of Radiologic Excellence bill (CARE), introduced in the House of Representatives in September, could mean more changes are in store.
Currently, there is no nationwide standard for training RTs. At one hospital, an RT may only need a certificate; at another, a four-year degree may be the standard. And training times vary as well, all resulting in no official standard of care. The CARE act is designed to eliminate these inconsistencies.
"I strongly support the CARE act," said Roland Clements, RT, an instructor at Kapiolani Community College in Honolulu. "This will, in the long run, improve patient care and safety while providing a climate to practice in a professional manner. This is one answer to the shortage of qualified RTs that we experience about every five years or so."
There has been some prior movement toward standardization. In 1981, Congress passed the Consumer-Patient Radiation Health and Safety Act, creating minimum standards of education and credentialing for imaging professionals. Participation, however, was voluntary, and only 35 states have enacted licensure laws.
"Barbers in the 15 states without licensure are held to a higher standard than people taking x-rays," Olmstead said. "Advances in technology increase the demand for well-trained radiologic technologists who are skilled in a variety of areas."
Also this year, RTs taking advanced-level exams saw the start of specific clinical experience requirements for taking the exam. Previously, taking a test required practicing for a year, paying the test fee, taking the test, and then passing it. Now, performance records must be documented, either through on-the-job training or through the clinical portion of a training program, before one can take the exam.
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