Radiologists losing share of overall physician workforce

The head count of radiology trainees in the U.S. blossomed 84.2 percent between 1997 and 2011, but the workforce expansion isn’t as heartening for the specialty as it initially sounds.

For one thing, the U.S. population grew at a rate placing the number of radiologists per 100,000 residents with only a 7.5 percent increase.

For another, radiologists’ share of the overall physician workforce declined nationally by 8.8 percent.

More telling still, just 2.7 percent of all first-year postgraduate trainees were enrolled in a diagnostic radiology training program in 2013.

That’s a drop from 3.7 percent in radiologist share of the overall physician workforce in two years prior—and it may suggest that the decline is accelerating.

The workforce analysis identifying the trends, lead-authored by Andrew Rosenkrantz, MD, MPA, of NYU Langone Medical Center, was published ahead of print in Radiology.

Gleaning data from federal area health resources files and Medicare 5 percent research identifiable files, the authors computed parameters related to the radiologist workforce and analyzed trends in geographic and temporal variation.

In state-by-state comparisons, the researchers found variations all over the proverbial map—ranging from a minimum of no trainees in at least one state each year to the maximum number in at least one state each year varying between 332 and 678.

They also found:

• Between 1997 and 2011, five states with between zero and two trainees either remained stable or decreased to zero trainees.
• The remaining 45 states showed an increase in the number of radiology trainees, and three states showed an increase of more than 200 percent (maximum increase, 266.7 percent in New Hampshire).
• Some 17 states showed an increase between 100 percent and 200 percent, while 25 states showed an increase of less than 100 percent.
• Unsurprisingly, the states with the most radiology trainees tended to be states with larger total populations (New York, California, Pennsylvania).

Citing a recent study showing a possible reversal of the decline in imaging utilization observed since 2006, Rosenkrantz and colleagues note in their study discussion that, if the one-year reversal proves the start of a trend—and imaging volumes again begin to rise—“then radiologists’ decreasing share of the overall physician workforce could likely adversely affect their ability to expand service capacity and result in regional, if not national, patient-access challenges.”

On the other hand, they point out, advances in digital imaging are increasing radiologists’ productivity, which may mitigate undesirable consequences of the profession’s falloff within the overall physician workforce.

“Because of strong geographic variation in the U.S. radiologist workforce, efforts toward sensible geographic redistribution may be as appropriate, if not more appropriate, than efforts to adjust the overall national workforce size,” the authors conclude.

Finally, because of long-standing geographic variation in radiology trainees, “new approaches may be needed to facilitate and incentivize such redistribution,” they write. “These factors should all be considered when shaping practices and policies at the local practice and national specialty level that affect—or potentially affect—the radiologist workforce.”