Does career stage affect radiology practice patterns?

Researchers found an “abrupt and substantial” decline in the national radiologist workforce 30 years after residency, according to a new study published in Academic Radiology.

Those radiologists who continue working, however, produce similar billed clinical work compared to early-career readers, wrote first author Andrew B. Rosenkrantz, MD, MPA, of NYU Langone Medical Center’s Department of Radiology in New York, and colleagues.

According to a 2017 national workforce survey, 28% of practicing radiologists at the time of survey were older than 56 and 7% were older than 65, the authors noted.

“The practice patterns of this cohort, in terms of both the volume and distribution of rendered services, stand to greatly impact the practice patterns of radiologists of all career stages,” Rosenkrantz et al. wrote. “However, there is limited objective data comparing the practices of early-, mid-, and later-career radiologists.”

To get a better picture of the situation, the researchers gathered the billed services of more than 28,000 Medicare-participating radiologists taken from the 2016 Medicare Physician and Other Supplier Public Use File. Billed clinical work was weighted using work relative value units, and normalized to a mean of 1.00 among all radiologists.

Broken down, there was an “abrupt and substantial” decrease from 7,000 radiologists 21-30 years post-residency to about 3,000 radiologists 31-40 years post-residency.

Additional results included the following:

  • A total of 32.7% of radiologists were 10 years or less post-residency, 29.3% were 11-20 years removed and 2.4% were 41-50 years post-residency.
  • Billed clinical work remained steady regardless of career stage, ranging from 0.92-1.07 from 1 to 40 years and decreased to 0.64 for 41 to 50 years and finally dropped to 0.43 for 51 years or more.
  • CT imaging made up a majority of orders, representing up to 38.6% of billed work in the 1 to 30 year group, falling to 3.5% for 31-40 years. In comparison, MRI accounted for up to 14.3% of billed work in the 1 to 30 year cohort, decreasing to 11.2% in the 31 to 40 year radiologists.
  • Nuclear medicine billing increased with age, jumping from 1.7% for those 10 years or less post-residency to 7% in the 41-50 cohort.

“The findings indicate that despite an abrupt and dramatic decline in the number of radiologists in the workforce beyond 30 years following residency, those who do continue to work provide substantial contributions that can be of great value in the current workforce constrained environment," the authors wrote. "Strategies to retain later-career radiologists in the workforce could help the specialty meet growing clinical demands, mitigate burnout in earlier career colleagues, and expand robust patient access to both basic and advanced imaging services.”