We were very surprised when our survey showed an overall balance between the demand and supply of radiologists.

— Cristian I. Meghea, Ph.D.

Radiologist Shortage Over? Survey Says Yes

The severe shortage of radiologists experienced only a few years ago has alleviated considerably, according to a study appearing in the September issue of Radiology by Cristian I. Meghea, Ph.D., and Jonathan H. Sunshine, Ph.D., from the American College of Radiology (ACR).

In fact, some indicators suggest the disappearance of a shortage altogether. “We were very surprised when our survey showed an overall balance between the demand and supply of radiologists, given that a few years ago there were many indications of an acute shortage,” said Dr. Meghea.

Within this overall balance, an unforeseen surplus of radiologists was reported in academic and government-owned practices, while private practices and practices in non-metropolitan locations faced shortages.

In their study, Drs. Meghea and Sunshine analyzed data collected for the ACR 2003 Survey of Radiologists. This nationwide, random sampling of radiologists in the United States was conducted by mail between March and July 2003. A total of 1,346 responses were collected from professionally active radiologists, for an overall response rate of 63 percent.

The analysis excluded data from trainees, retirees and others not working in radiology. Responses were classified according to age group (ranging from less than 35 years old to 65 years and older), geographic region and practice type (solo, academic, nonacademic private, etc.). Physicians were queried about their main subspecialty, their weekly hours, number of separate locations at which they work, whether they are an owner of their main practice and whether they work full or part time.

Results indicated that the supply and demand of radiologists was generally balanced in 2003, based on the following radiologist responses:

• 67 percent were content with their workloads
• 17 percent wanted less work
• 16 percent wanted more work

This is in stark contrast to the severe shortage experienced in 2000, only three years prior. At that time, 51 percent of radiologists reported that they were overworked, and only five percent said that they wanted to work more. However, Dr. Meghea said the 2000 ACR survey did not clearly point out that reduction in workload may also mean less income.

Some Look for an Increased Workload

The survey also revealed that additional work was sought by solo practitioners (30 percent), those in government practice (31 percent) and those in academic practice (18 percent), while 23 percent of private practitioners desired less work. The authors speculate that this may result from a workload in private practice.

Among the subspecialties, the workloads were generally balanced, with a slight shortage (less than four percent) in pediatric and musculoskeletal radiology and a small surplus in body imaging. “Given anecdotal evidence regarding shortages in various subspecialties, we were pleased to find an overall balance,” said Dr. Meghea.

One-third of radiologists surveyed said that they do not subspecialize, even to a small extent.

The authors did find a slight residual shortage in nonmetropolitan areas. Twenty-five percent of radiologists working in these areas wanted less work, which was significantly greater than any other group surveyed. In contrast, there seems to be no relative shortage or surplus according to any particular geographic region surveyed.

RSNA Past-President C. Douglas Maynard, M.D., is a former co-chair of the ACR Task Force on Human Resources. When queried about factors that may have contributed to the apparent easing of the shortage, he indicated that the increased number of people completing radiology residency programs have made a substantial impact.

“In 2001, at the height of the shortage, 785 individuals took their oral board exams for the first time. In 2005, 1,057 individuals took their exams. This constitutes an increase of 34 percent—a significant influx of radiologists into the workforce,” Dr. Maynard stated.

He also added that the number of fellowships has gone down in recent years, which has led to higher numbers of radiologists entering the workforce more quickly. “The number of radiology procedures performed each year has been steadily increasing by six percent annually. This increase in staffing has aided enormously in keeping up with the workload,” he commented.

Both Drs. Meghea and Maynard agree that technology and better organization has made a considerable difference in productivity levels, which has in turn aided in abating the shortage. Other possible factors for the easing of the deficit, outlined by Dr. Sunshine and colleagues in the February 2004 issue of the American Journal of Roentgenology, include delayed retirement of radiologists, longer working hours combined with less vacation, an increase in on-call productivity due to the use of nighthawks and teleradiology and the erosion of radiology “turf” to other specialties.

Despite the apparent good news, Dr. Maynard warns, “There still appears to be subspecialty areas that are shorthanded in the academic programs, such as pediatric radiology, vascular/interventional radiology, women’s imaging and chest imaging.”

Declining Shortage in Other Specialties

In a similar staffing assessment, the American Society of Radiologic Technologists (ASRT) reported that the vacancy rate for radiologic technologists performing radiation therapy decreased from a national average of 7.9 percent in January 2004 to 6.2 percent in April 2005.

Comments from survey respondents indicated that rural areas may be more likely to experience shortages of (R.T.'s) performing radiation therapy, which is consistent with findings of the ACR radiologist survey. The situation was reversed for urban and metropolitan areas.

The ASRT survey also reported vacancy rates for other members of the radiation oncology team. The vacancy rate for medical dosimetrists declined from a national average of 8 percent in 2004 to 5.8 percent in 2005; the vacancy rate for medical physicists dropped from 9.6 percent to 7.6 percent; and the vacancy rate for oncology nurses fell from 6.2 percent to 4.8 percent. Only radiation oncologists experienced an increase in average vacancy rates, from 6.2 percent in 2004 to 6.4 percent in 2005.

The decline in vacancy rates among R.T.s performing radiation therapy is being attributed to increasing numbers of individuals becoming certified in radiation therapy. According to the American Registry of Radiologic Technologists, 941 people took the certification examination in radiation therapy in 2004, up from 830 people in 2003 and 652 in 2002.

These statistics and the results of the study of Drs. Meghea and Sunshine are a welcome sigh of relief, considering that only a few years ago, the shortage was projected to worsen in coming years. However, many physicians still have long-term concerns.

In response to this, Dr. Meghea asserted: “We at ACR are carefully monitoring the workforce situation on behalf of the entire radiology community. For now, practices should concentrate on their operations and technology in order to keep productivity high. ACR will soon publish research that will help practices focus on the factors that increase productivity the most.”

RSNA members and Radiology subscribers can access the full-text of the article, “Who's Overworked and Who's Underworked among Radiologists? An Update on the Radiologist Shortage, ” at radiology.rsnajnls.org/cgi/content/full/236/3/932.

Descriptive Statistics by Preferences about Workload

© RSNA, 2005. All rights reserved. Printed with permission.

Annual Hours Worked and Vacation Days of Full-Time Radiologists by Practice Type

© RSNA, 2005. All rights reserved. Printed with permission.