A new study has found a sharp drop-off in the number of radiologists still practicing 30 years after completing residency. But older radiologists are still productive, and by continuing to practice they could help address the field's ever-increasing workload, according to a study published May 8 in Academic Radiology.
That's why it's important to keep late-career radiologists working, wrote a team led by Dr. Andrew Rosenkrantz of NYU Langone Medical Center in New York City. Almost one-third of radiologists are older than 56, and 7% are older than 65, the team noted. So this group's practice patterns have the potential to significantly impact the practice patterns of radiologists of all career stages.
"Strategies to retain later-career radiologists in the workforce could help the specialty meet growing clinical demands, mitigate burnout in earlier career colleagues, and expand robust patient access to both basic and advanced imaging services," the researchers wrote.
The study included information from 28,463 radiologists from the 2016 Medicare Physician and Other Supplier Public Use File. The authors tracked radiologists' billed clinical work using relative value units; they found medical school graduation year information from Medicare Physician Compare and summarized practice patterns by decades after residency.
The 28,463 radiologists fell into the following postresidency practice duration groups (with a sharp drop-off after 30 years):
- 32.7% ≤ 10 years
- 29.3% 11 to 20 years
- 25% 21 to 30 years
- 10.5% 31 to 40 years
- 2.4% 41 to 50 years
- 0.1% ≥ 51 years
To a mean of 1.00, Rosenkrantz and colleagues found that billable clinical work was highest among radiologists with one to 40 years of practice postresidency, at 0.92. For those with 41 to 50 years, the mean was 0.64, and for those with 51 years or more, the mean was 0.43.
Types of imaging performed changed over a radiologist's career. For example, x-ray interpretation was highest among radiologists with more than 50 years of practice, while CT was highest among those with 10 or fewer years of practice.
| Billed work by modality, categorized by years postresidency | ||||||
| Modality | ≤ 10 | 11-20 | 21-30 | 31-40 | 41-50 | ≥ 51 |
| X-ray and fluoroscopy | 15.6% | 15.1% | 15.7% | 20.4% | 29.8% | 65.9% |
| Ultrasound | 6.2% | 7.4% | 8.3% | 10.6% | 11.6% | 6.9% |
| CT | 38.6% | 37.8% | 34.7% | 31.5% | 23.2% | 14.7% |
| MRI | 13.9% | 14.7% | 14.3% | 11.2% | 9.5% | 6.1% |
| Nuclear medicine | 1.7% | 2.4% | 3.3% | 4.4% | 7% | 0.1% |
| Mammography | 11.1% | 9.9% | 12.3% | 12.9% | 12.9% | 3.7% |
The study results have implications for the radiology workforce at large: Not only could the abrupt retirement of later-stage radiologists affect patient access to imaging services but it could also represent a loss of knowledge and experience earlier career radiologists don't yet have, Rosenkrantz and colleagues noted.
So how can this group of radiologists be retained? Add incentives such as flexible hours and modified workloads, according to the authors.
"Individual radiology practices will need to carefully consider all such alternatives when defining the role of later-career radiologists in their practices," they concluded.
