Radiology practices’ use of nurse practitioners, physician assistants has swelled in recent years

Radiology practices’ use of nurse practitioners and physician assistants has climbed considerably in recent years, according to new Neiman Health Policy Institute research released Friday.

During a time when the number of U.S. imaging groups fell by nearly 37%, their employment of such nonphysician practitioners leapt by 11%. Radiology practices more likely to utilize NPPs are in urban areas, larger in size, and had a higher percentage of interventional specialists, experts wrote in JACR.

Meanwhile, provider groups with fewer nonphysicians employed a higher number of veteran radiologists, with less focus on interventional subspecialization.

As radiology practice and professional society leaders seek to better understand and react to the expanding number and scope of NPPs, such information about their evolving use within the specialty could inform these efforts,” first author Stefan Santavicca, senior data analyst in the Department of Radiology and Imaging Sciences at Emory University School of Medicine in Atlanta, and co-authors wrote March 4.

To reach their conclusions, Neiman Health Policy Institute experts utilized Medicare data spanning 2017 through 2019. They mapped out all NP and PA use, tying it to physician practices that only operate in radiology. They found that the number of radiologists in practices using nonphysician practitioners climbed 10.4% while the number of rad-employed NPPs increased almost 18%.

Both medium- and large-sized practices were more likely to use nurse practitioners and physician assistants. And with each 1% increase in IR specialists as a share of all radiologists in a practice, there was a 453% uptick in the odds that it would employ one or more nonphysician practitioner. Study authors noted this finding was no surprise, given the subspecialty’s call for more longitudinal care and use of NPPs to support such activities.

However, Santavicca et al. did not expect to find that practices with higher numbers of nonphysicians also had a greater share of early-career radiologists. This comes after a recent American College of Radiology survey found that such physicians have strong concerns about the growing use of NPPs.

“Although our methods do not permit us to assert a definitive explanation for this apparent discordance, we believe it is possible that the strong opinions expressed by younger radiologists might be informed by actual exposure to NPPs in their day-to-day work,” the study authors noted.

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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