Imaging volumes continue rising, but not all radiologists shouldering the same burden
Imaging volumes have continued to rise since the COVID-19 pandemic, but only a smaller portion of radiologists are picking up the added slack, according to new research.
Between 2018 and early last year, radiology exam case loads leapt roughly 31%, an annual growth rate of almost 5%. Most members of the specialty handled similar shares of the burden both before and after the onset of the public health crisis, researchers detail in the Journal of the American College of Radiology. However, the top 25% of busiest radiologists have read about 31% more studies since 2018 and work nearly 20% more clinical shifts per quarter, compared to seven years ago.
When combined with national radiologist labor shortages, workload imbalances have the potential to create significant operational and professional stress for imaging groups, experts charge.
“This creates a differential experience in that some radiologists are experiencing the rising volume more keenly than others by shouldering a larger portion of the load,” Matthew S. Davenport, MD, MBA, a radiologist with Michigan Medicine, Ann Arbor, and co-authors wrote Dec. 26.
The analysis incorporated over 46 million imaging exams handled by nearly 1,600 unique radiologists at about 170 U.S. practice sites. Study subjects spanned 19 states and included academic providers, community hospitals, multispecialty clinics, and freestanding imaging centers. Of the radiologists included, about 43% (or 671) were full-time and read more than 100 exams per quarter throughout the baseline and final study periods.
Average aggregate change in exams handled per day, per radiologist was modest, the study found, at about +0.6%, climbing from 49.1 to 49.4. However, the top quartile of radiologists (measured by exam volumes) experienced “meaningful” increases, jumping from 56.6 per day in 2018 up to 73.9 in early 2024 (or 30.6%). Same for clinical days worked per quarter, rising from 38.6 days up to 46.2 (a 19.7% increase). Conversely, radiologists in the bottom quartile saw their case load fall from nearly 79 exams per day down to 54.
“This indicates that some radiologists have substantially slowed their effort, while others have substantially increased it,” the authors noted. “Those who are experiencing this will feel it keenly, even if the average productivity overall is stable.”
Meanwhile, the number of working radiologists increased by nearly 24% over six years (up to almost 1,100) with “substantial turnover.” Days worked per radiologist, per quarter remained relatively stable, falling by almost 5%, down to 39.1 days. Sharp exam declines during the pandemic were not associated with large reductions in the radiologist workforce, the study found.
“It is well known that labor is a sticky cost in the face of sharp demand fluctuations (i.e., labor cost does not decrease as rapidly or as much as demand declines),” the authors wrote. “But this also provides evidence that the radiologist labor market did not experience a large bout of unexpected retirements during this period. The strong rebound in imaging volumes in the year following the pandemic likely contributed to the perception of substantial volume growth, but it normalized within 12 months and once again mirrored the pre-pandemic growth rate.”
Read more in JACR, including potential study limitations.
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.