Radiologist Shortage: A challenging era for radiology

A number of factors, including a shortage of radiologists, increased procedure volume and shrinking reimbursements have created one of the specialty's most challenging eras.

The Radiologist Manpower Crisis - At a Glance Flat Supply Due to Resident Programs

The number of new radiologists is increasing by only 2% per year, according to Dr. Charles Williams, chair of the American College of Radiology's Commission on Human Resources. Since 1996, radiology programs have increased from 442 to 458. This growth is due to an increase in vascular/interventional programs. Without taking the significant increase in vascular/interventional programs into account, the number of radiology residency programs has actually decreased from 372 in 1996 to 356 in 2001. (JAMA, 9/4/02)

Subspecialty Training - A trend towards subspecialty training poses a supply and demand challenge with rural hospitals and facilities.

Recent surveys indicate that 70 percent of radiologists are generalists while the remaining 30 percent are sub-specialists. This trend is tough on smaller hospitals and those in rural settings where general diagnostic radiologists are typically required - not sub-specialists.

Imaging Services - Better Technology, More Demand

Radiology is a technology-driven field. New technologies (such as the development of ultrasound - CT, magnetic resonance scanning and nuclear medicine) coupled with an aging population are responsible for an increased demand for imaging services. According to a study by the Sr. Director of Research at the American College of Radiology, MRI, CT, and interventional radiology services have increased, on average 7.3 percent annually over the past 12 years. The number of new radiologists is increasing by only 2 percent per year, according to Dr. Charles Williams, chair of the American College of Radiology's Commission on Human Resources. Utilization data concludes that persons 65 years and older utilize imaging services three times more often than younger population.

According to the U.S. Census Bureau, by the year 2020, the national population is projected to be 325 million - a 16 percent increase. The percentage of the population projected to be 65 and older in the year 2020 is expected to be 53 million, a 50 percent increase - the huge leap in this age bracket is attributed to the aging baby boomer generation. And, the baby boomer generation is more preventive-medicine oriented than the generation before them. That trend will certainly continue.

Impact on Hospitals - Diagnostic imaging is a clinical necessity in every hospital.

RSNA News states that the average radiologist bills approximately $1.46 million a year in revenue. An interventional radiologist bills $1.58 million. With radiology services being such a strong financial contributor, many hospitals are realizing that they cannot afford to have a vacancy in the department, not even temporarily. How do they manage the workload and keep the revenue coming in?

Teleradiology - Technology paves the way for radiologists to read images from remote locations, 24/7.

A U.S. Radiology Partners survey of radiology practices found that 70 percent do at least some night call outsourcing. The use of teleradiology is being expanded to redistribute workloads. Initially, teleradiology services provided second and third shift, weekend, and vacation coverage only. But a new trend toward reading weekday shifts is emerging - especially in rural areas where PACS and teleradiology are letting radiologists in metro areas interpret studies from less populated regions.

Locum Tenens Coverage - Many facilities are finding that a temporary staff shortage is not necessarily short-term.

Reports estimate that it takes 11.9 months, on average, to fill a staff vacancy. As a result, many are considering locum tenens coverage to maintain the revenue base and relieve existing staff. As supply tightens and workloads increase, maintaining high morale is crucial.

Locum tenens coverage allows the facility to run at 100 percent. Having the extra staff also provides significant lifestyle benefits to existing staff by easing the heavy workload. With all of the challenges and changes in radiology, one thing that remains constant - radiology remains at the center of medical practice. In order for a patient to receive adequate medical care, the input of the radiologist, both in diagnosis and treatment is necessary. With current estimates for the shortage to continue for at least ten more years, facilities need to plan ahead and keep their staffing at 100 percent.