Attrition is not a primary driver of the current national radiologist workforce shortage

Attrition is not a primary driver of the current national radiologist workforce shortage, according to new research published Tuesday.

Between 2015 and 2019, nearly 364,000 providers practiced in the U.S., 23,000 of whom were members of the specialty, experts detailed in Radiology [1]. Attrition—or the natural gradual reduction in workforce numbers over time—impacted about 13% of radiologists during this timeframe, similar to medicine subspecialists (13%) and anesthesiologists (16%). Other professions such as nonphysician practitioner (23%) and emergency medicine physician (27%) saw much greater turnover, researchers found.

“Radiologists had low attrition nationally in comparison with other provider groups,” Andrew B. Rosenkrantz, MD, and Ryan W. Cummings, MD, both with the Department of Radiology at the NYU Grossman School of Medicine, wrote July 23. “A small fraction of radiologists are expected to exit the workforce over time, and comparison with other groups may provide a useful reference for assessing whether the rate of exit for radiologists was unusually high.”

For the study, NYU experts analyzed Centers for Medicare & Medicaid Services data, detailing which physicians enrolled in federal payment programs or submitted a claim in the past six months. Radiologists were defined as individuals with a primary specialty code of diagnostic or interventional radiology or nuclear medicine. Other specialty attrition tallies included 18% for primary care docs, 17% for surgeons and 20% for pathologists.

In radiology, attrition was nearly 14% for male members of the specialty and 12% among women. The attrition rate was higher for radiologists age 65 or younger (6%) versus those 45 or younger (3%). Across all genders and age groups, radiologists consistently had lower attrition relative to other specialties, Rosenkrantz et al. reported. By geography, attrition was highest in Montana (25%) and lowest in New Jersey (10%).

Much has been reported about the radiologist shortage. As of May 2023, there were 1,788 job openings on the American College of Radiology job board. Possible ramifications of this ongoing challenge include care delays, potential errors and radiologist burnout, the study’s authors wrote. Some have surmised that attrition, with rads exiting the workforce prematurely to pursue a career elsewhere, is a cause. But Rosenkrantz and Cummings believe their study puts this theory to rest.

“The findings suggest that attrition is not a primary driver of the current national radiologist workforce shortage, and that other potential drivers should be explored,” the authors concluded. “For example, another potential driver is insufficient annual influx of new radiologists; the Accreditation Council for Graduate Medical Education reported a total of 5,541 diagnostic and interventional radiology residents (across all training years) in 2022–2023.”

Potential limitations included the study’s sole reliance on Medicare claims, focus on a single time interval and lack of information on why radiologists exited the workforce.

The American College of Radiology and other specialty societies have pressed lawmakers to address this issue in recent months. ACR called for “swift congressional action” to address the shortage in May, presenting the Resident Physician Shortage Reduction Act as a possible solution. Reintroduced in April 2023, S.1302 would lift the cap on the number of Medicare-funded graduate medical education positions and gradually raise the total tally by 14,000 over the next seven years.