Attrition rising across all radiology subspecialties, with some leaving the workforce faster than others
Attrition is rising across all radiology subspecialties, with some leaving the workforce faster than others, according to new research published Wednesday.
The specialty’s staffing shortage has been driven by factors including clinically active radiologists leaving the profession, rising imaging volumes and an insufficient rate of new entrants. Neiman Health Policy Institute researchers recently examined how attrition rates differ among various types of radiologists, sharing their findings in the American Journal of Roentgenology.
Their study included nearly 30,000 subspecialized physicians, using Medicare data spanning 2014 to 2022. The overall attrition rate rose from about 1.4% at the beginning of the study period up to 2.7%, increasing over time for each subspecialty.
“Our study provides an important foundation for needed efforts to understand why attrition rates differ among the subspecialties,” study co-author Jay Parikh, MD, with the University of Texas MD Anderson Cancer Center, Houston, said in a statement March 4. “The persistent radiology workforce shortage is a potential driver worth exploring, as the associated workload burden may be disproportional across subspecialties.”
The attrition rate across the nine-year study period was 2.2% and varied by subspecialty, researchers found. For example, among vascular and interventional radiology, it was approximately 1%, or 4.3% for those in cardiothoracic imaging. Year-by-year attrition rates increased over time for each subspecialty. This included as little as 0.4% for musculoskeletal imaging up to 2.1% for cardiothoracic radiology.
Adjusted odds of leaving the profession were significantly higher for breast (odds ratio=1.31) and cardiothoracic imaging specialists (OR=1.81) compared to those in abdominal imaging. Conversely, attrition odds were significantly lower for vascular and interventional radiology subspecialists (OR=0.78) but not measurably different for other subspecialties.
Average estimated career length was about 1.1 years greater for male radiologists versus female colleagues and 1.5 years more for those in academia compared to other care settings. However, these gender differences were smaller within individual subspecialties (i.e., 0.4 to 0.6 years in academia, or 0.2 to 0.5 years in nonacademic settings).
The study comes after another recent analysis from the Neiman Health Policy Institute found that subspecialist radiologists are leaving the workforce at a higher rate than their generalist colleagues. It also discovered that female rads are exiting medicine more so than men. Parikh and colleagues believe findings from their new study prove that much of this gender difference can be explained by subspeciality. For instance, about 64% of breast radiologists are women compared to 10% or vascular/IR.
“Recruitment and retention initiatives are needed broadly across subspecialties and in general radiology to avoid potential workforce departure cycles that could exacerbate shortages in individual subspecialties,” the authors concluded.
Parikh et al. suggested that workforce attrition could potentially be counterbalanced by adding more entrants, potentially through expanding the trainee supply.
“However, inherent structural challenges have posed barriers to growing the radiology trainee pipeline,” the authors added. “There have also been longstanding recognized shortages of graduates entering available training positions within particular subspecialties including nuclear medicine and pediatric radiology. As a complementary approach, the presently observed across-the-board increases in subspecialty attrition rates could be partially mitigated by seeking an expanded supply of generalist radiologists, to be available to flexibly address gaps in their practices’ subspecialty coverage schemes.”
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.