Around the turn of the century in the U.S., an aging demographic and an increase in imaging utilization led some healthcare economists to raise alarms of an upcoming shortage of radiologists. However, according to study data from an American College of Radiology (ACR) survey of U.S. radiologists, there may be a balance between the supply and demand of these clinical professionals.
The study, published last month in Radiology (September 2005, Vol. 236:3, pp. 932-938), was based on 2003 survey data from 1,924 interventional radiologists, osteopathic radiologists, nuclear medicine specialists of interest, and other radiologists in the U.S. Study authors Cristian Meghea, Ph.D., and Jonathan Sunshine, Ph.D., from the ACR in Reston, VA, utilized the survey to query respondents as to how their workload compares with the one they desire.
"We assume that the desire for less work indicates a shortage of radiologists, while the desire for more work suggests a surplus," Meghea and Sunshine wrote.
Responses were classified as to age range (younger than 35, 35-44, 45-54, 55-64, and 65 and older), sex, type of practice (academic, part-time, nonacademic and academic private, government, solo, and multispecialty), and census region (Northeast, Midwest, South, and West). The authors noted that there were differences in radiologists' desired workload by six, age, and type and location of practice.
Meghea and Sunshine stated that similar percentages (17%) of all radiologists reported that they wanted less work and more work (16%).
"Radiologists who wanted to work less wished for a 21% decrease in workload, on average, while those who wanted more work wished for a 26% increase," they wrote. "Translating these percentages into physician hours, the desired changes in hours worked weekly were 12 hours (decrease) and 13 hours (increase)."
Those radiologists who wanted less work averaged a 54-hour work week, while those seeking more work averaged a 49-hour work week. The baseline hourly work week for those radiologists who stated that they were working about the right amount was 47 hours.
Approximately two-thirds of the survey respondents subspecialized to some extent, according to Meghea and Sunshine. As in the overall radiology population, they found almost equivalent percentages of those who desired less work (16%) and those who wanted more work (17%).
Two subspecialty areas stood out in the survey as wanting a decreased workload: musculoskeletal (MSK) and pediatric radiologists. The MSK radiologists sought a decrease in work by nearly four times the amount (14%) of their colleagues who sought a greater caseload (4%). Almost three times the amount of pediatric radiologists (18%) wanted a workload reduction, compared with their colleagues who wanted more (8%). Meghea and Sunshine noted that the desired workload reduction in both subspecialties was statistically insignificant (70 hours less a year for MSK, and 11 hours less for pediatric) and that the dataset was fairly small (42 MSK and 38 pediatric).
The type of practice a radiologist worked provided the greatest imbalances in the survey data. About a third of solo practitioners wanted an increased workload (30%) and about a fifth of academic practitioners (18%) sought more cases, while 11% sought less.
"No radiologists working in nonacademic government practices sought less work, while 31% wanted more work," Meghea and Sunshine wrote. "The situation was reversed in private nonacademic radiology practices: 23% of the radiologists wanted less work and only 14% sought more work, for an overall desired decrease of 52 hours per year, which was also a significant change."
When stratified by sex, the data showed males (83% of the total respondents) equivalent in their desire to work more (17%) and less (17%), with a net desired change in workload of two hours per year. Female radiologists exhibited a slight variation between those desiring less work (15%) with those wanting more (10%). However, the net desired overall change in workload on an annual basis was one hour per year, statistically not different than zero, the authors noted.
"There was little variation across locations with the exception of radiologists working in nonmetropolitan practices," the researchers wrote. "On average, radiologists working in nonmetropolitan practices sought a significant decrease in annual workload of 58 hours."
The age of a radiologist in practice also has a bearing on the desired workload of the practitioner, according to Meghea and Sunshine.
"When other factors were held constant -- including number of hours worked -- radiologists less than 35 years old sought a workload change of 166 hours more than the change sought by 45- to 54-year-old radiologists, the reference category," they wrote. "Radiologists 55-64 years of age wanted a workload change of 60 hours a year less than the change sought by the reference category."
Meghea and Sunshine found that, overall, there were similar percentages of radiologists seeking more and less work in 2003, while two-thirds of the respondents were content with their caseload.
"Our analysis suggests there was an overall balance between the demand and the supply of radiologists in 2003, but within this overall balance, private practice radiologists reported themselves overworked by 2%, while radiologists in academic and government-owned practices sought 4% and 12% more work, respectively," they wrote.
By Jonathan S. Batchelor
AuntMinnie.com staff writer
October 7, 2005
Related Reading
Rad workload shows double-digit increase, September 22, 2005
Technology, technique help ease radiologist shortage, November 2, 2004
Making RVU-based productivity assessment work for you, October 29, 2004
On getting a job in radiology: a primer for residents and fellows, October 18, 2004
Survey says rads are working harder for less, April 15, 2004
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