A series of factors, including low insurance reimbursement rates, high risk of getting sued, an aging roster of practitioners and a high demand for services, have converged to make radiologists a highly sought commodity in Pennsylvania.
"There are probably 40 jobs for every applicant," Robert Pyatt, MD, radiologist, told the Pittsburgh Post-Gazette. This for a career that can pay $500,000 a year, does not require the physician to be on call and may exclude working nights or weekends, he said.
According to Paul Kiproff, MD, chairman of the radiology department at Allegheny General Hospital in Pittsburgh, residents tend to go where they will make more money.
He said that in his current class of 70, no one has indicated an intention to stay in Pennsylvania once training is complete. Two already have announced they will leave, one for Alaska and another to Minnesota, "to make as much money as I do as an attending [physician]."
The Pittsburgh Post-Gazette reported that recruiting and retaining radiologists appears to be a statewide problem, rather than an issue for any one center or practice. While Pennsylvania does attract radiologists from other states, resident physicians who train here seldom stay here.
Bob Powell, executive director of the Pennsylvania Radiological Society, estimated the state's 16 residency programs have graduated about 500 radiologists the past five years.
Part of the reason is that Pennsylvania is among the top three states for residency programs, he said. Many out-of-state physicians come to the state to train, then return home when they're done.
However, only a decade ago, Pennsylvania retained half the radiologists who trained here, Pyatt said. One issue is that reimbursements, particularly from Medicare, may barely cover the expense of necessary staff and equipment.
Another is that mammography is the single largest radiology subspecialty for getting sued. Given the thousands of mammograms performed and reviewed annually, the chance of a missed diagnosis is real.
Younger radiologists don't want to do mammography, said Pyatt, adding that they prefer to do MRIs, or CAT scans, specialty procedures and 3D imaging. "In the next 10 years, there are roughly 1,000 radiologists who will turn 65 and retire, and that's the main group that's doing mammography."