America sees ‘concerning’ drop in pediatric radiology workforce, despite rising imaging volumes
The United States has seen a “concerning” drop in pediatric radiologists, despite rising imaging volumes, according to new Neiman Health Policy Institute research.
Between 2016 and 2023, the number of diagnostic specialists focused on children fell by more than 7%, down to 2,032. Same for the proportion of pediatric rads as a percentage of all radiologists, dropping from about 6.4% down to 4.6%, experts detailed Monday in JACR.
The findings come amid reports of a “major” workforce shortage in pediatric radiology, driven by decreased trainee interest in related fellowships, rising clinical volumes and a competitive job market.
“Our findings show that, while the overall radiology workforce has grown, the number of pediatric-focused radiologists has declined, which raises concerns about access to specialized care for children,” co-author Casey Pelzl, MPH, principal economics and health services analyst at the Neiman Institute, said in a statement Sept. 9.
For the study, researchers utilized a private payer claims database from Inovalon Insights. The tally included over 52 million radiology claims and spanned Medicaid, Medicare Advantage and commercial payers. The authors defined pediatric radiologists as those who dedicated 50% or more of their work relative value units (wRVUs) toward children. Among more than 109,000 unique radiologists practicing between 2016–2023, about 8.4% (or 9,198) met the criteria as pediatric radiologists over the entire period. Annual unique pediatric radiologist headcount fell from 2,190 down to 2,032 seven years later.
When dropping the study’s threshold to rads who dedicated 25% of wRVUs to children, the number of unique pediatric rads across the entire period rose to 13,532 (or 12.4%). At 75%, the headcount totaled 7,456 (or 6.8% of all unique rads between 2016–2023). Researchers cautioned many radiologists are delivering pediatric imaging services without formal subspecialty certification, potentially impacting their findings.
“This suggests that traditional self-reported estimates, which were last collected through the ACR’s 2003 Survey of Radiologists, may significantly undercount the true pediatric radiology workforce,” study co-author Hansel J. Otero, MD, vice chair for clinical research at Children’s Hospital of Philadelphia, said in a statement.
Otero and colleagues noted their figures are significantly higher than the 2003 survey, which estimated there are between 800–900 practicing pediatric radiologists in the country. This discrepancy may be due to a small but notable number of rads devoting their work effort to caring for children, but without formal fellowship in pediatric radiology. These individuals may not know they qualify for the added American Board of Radiology certification or are not interested in obtaining it. Such subspecialty certification is not required for clinical practice, the authors noted, and involves a fee of nearly $2,000.
“Hence, increased financial and administrative burden or perceived low value of formally certifying may contribute to some radiologists forgoing certification,” according to the study. “Regardless of the reason, this group is likely poorly accounted for in traditional self-reported estimates of the total number of pediatric radiologists and could be useful for accurately estimating the subspecialties of the radiology workforce.”
This past March, ABR approved a new pathway to becoming a certified pediatric rad. It involves a total of 15 months of experience in pediatric radiology during a 48-month radiology residency at an accredited program, along with ABR approval before graduation.
“We hypothesize that an increase in the number of certified pediatric radiologists might ease the demand for such specialists and even stabilize wages and job offerings,” the authors noted, “although not necessarily impacting the actual number of professionals devoting most of their time to interpreting pediatric imaging, as our methodology primarily quantifies demand rather than the supply side of the physician shortage equation.”
Read more, including potential study limitations, in the Journal of the American College of Radiology.
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.