Radiologist shortage will persist into 2055 without counteraction

Today’s imbalance between radiologist supply and medical imaging demand in the U.S. will persist into 2055 without counteraction, according to Neiman Health Policy Institute research published Wednesday. 

In the next 30 years, the supply of radiologists is expected to grow by nearly 26%, assuming no increases in the number of radiology residents. Meanwhile, imaging utilization will climb between 17% to 27% during the same time, depending on modality, experts detailed in the Journal of the American College of Radiology. 

The findings are based on various inputs including population growth, aging, and radiologist attrition rates. JACR published the two studies days after the college encouraged Congress to prioritize radiology in adding more federally supported medical residency positions. 

“…The present radiologist shortage is projected to persist unless steps are taken to grow the workforce and/or decrease per person imaging utilization,” lead author Eric Christensen, PhD, research director at the Neiman Institute, said in a statement shared Feb. 12. “In other words, the shortage is not projected to get worse, nor will it likely improve in the next three decades, without effective action.”

To forecast future radiologist workforce numbers for the first study, Neiman experts utilized Centers for Medicare & Medicaid Data spanning 2014 to 2023. They modeled future new entrants into the profession based on National Residency Matching Program information from 2005 to 2025. 

As of 2023, there were 37,482 radiologists enrolled to treat Medicare beneficiaries. If the number of radiology residency positions does not grow at a greater trajectory in 2025 and beyond, the projected number of specialists will climb to 47,119 by 2055. However, if radiology records an increase in residency slots, Christensen and colleagues expect the profession to reach 52,591 physicians in three decades, a more than 40% increase. Male radiologists practice for about 35.7 years on average and females 34.2, based on 2014-2023 career data. Radiologists left the workforce at a 50% higher rate beginning in 2020 amid the pandemic. If attrition remained at these levels, the radiologist workforce will grow 21% by 2022, resulting in 3,116 fewer physicians versus the pre-pandemic trajectory.

“These pre-COVID and post-COVID attrition differences are substantial,” study co-author Elizabeth Rula, PhD, executive director of the Neiman Institute, said in the announcement. “Hence, monitoring attrition patterns and implementing effective programs to improve workplace well-being, is crucial,” she added later. 

Imaging demand trends

For the second study on imaging demand, Christensen and co-authors used a 5% sample of Medicare fee-for-service claims spanning 2018-2022. They combined this with data from Inovalon Insights, incorporating claims from commercial insurance, Medicare Advantage and Medicaid. Future utilization was modeled based on U.S. Census Bureau population projections and recent imaging trends by modality. 

The final sample included over 348.2 million insured individuals. Assuming no continuation of current trends, imaging utilization would grow 16.9% to 26.9% by 2055. However, if healthcare consumption continued on its current path through 2030, the range would be between a 5.6% decrease and 45.2% increase. CT utilization would be 45% higher in 2055, for example, if current trends continue through 2030, or 59% if they persist through 2035. Conversely, nuclear medicine use would fall 6% if current trends continued for five years and decrease 21% if they persist into 2035. Applying 2022 imaging utilization rates to the projected future population, imaging studies would increase 25% for CT, 17% for MR, 27% for nuclear medicine, 17% in ultrasound, 18% for X-ray and 23% for interventional procedures by 2055. 

Population growth accounted for between 73% to 88% of utilization increases and aging another 12% to 27%. Imaging consumption varied by insurance type, the authors noted. For instance, average CT use for men was about 0.7 per fee-for-service Medicare beneficiary compared to 0.4 for those with Advantage plans. 

Neiman Institute experts emphasized the importance of curbing inappropriate imaging use—alongside increasing radiologist residency numbers—to address the supply-demand imbalance. Researchers plan to conduct follow-up studies to assess possible solutions, including AI to improve radiologist efficiency and clinical decision support to reduce unnecessary imaging requests. 

“Given the strong influence of population demographics on future utilization, we must consider solutions to bend these curves and ensure that outcomes do not deteriorate due to patients not having imaging access, or experiencing long delays,” Rula said in the announcement. 

The studies have several limitations, such as their reliance on potentially flawed population growth projections and imaging utilization trends that are subject to change.