Navigating the crucial challenges in radiology practice management


The landscape of radiology practice management is undergoing a significant transformation, as leaders contend with industrywide challenges such as staff shortages and reimbursement issues. Radiology Business Management Association (RBMA) President-Elect Pete Moffatt, senior vice president of business development at Advocate Radiology, shed light on the pressing issues plaguing radiology in a video interview with Radiology Business at the Radiological Society of North America 2023 meeting.

Radiologist recruitment woes and physician shortages

Moffatt highlighted the biggest struggle radiology practices face in recruiting physicians. With an impending wave of retiring practitioners and a shortage of incoming talent, the burden on existing radiologists has intensified. This shortage was punctuated at RSNA this year, with a large number of new healthcare systems on the show floor attempting to recruit physicians. Moffatt underscored the resultant strain on the workforce, leading to burnout and overwork among the remaining physicians. He noted that this challenge extends across the nation, emphasizing the urgent need for strategic solutions to bridge this gap.

"I speak with radiology practices, administrators, physicians, all across the United States. One of the more frequent topics of conversation over the last year or so has been the fact that recruiting physicians is extremely difficult right now. It's definitely a market that suits being a radiologist, but a lot of the pressures that the groups face with retiring physicians, things like that, trying to fill those spots has taken up a lot of time on the administrative side," Moffatt explained.

He spoke at RSNA with a recruiter who set up a booth for the first time just to recruit radiologists because they have some retiring in the near future. Like others, the leaders at the organization are afraid they will not be able to fill the position through conventional job postings. 

"If they don't fill those holes, it creates a tremendous amount of pressure on the group. The existing physician base tends to be overworked. Everybody's hearing the phrase burnout, things like that. And I think it's really associated with the fact that you have fewer physicians carrying the workload for some of those that obviously, as I mentioned, are retiring. So it just continues to be an issue all around the us," Moffatt said.

Moffatt pointed out that post-pandemic, some practitioners opted for early retirement or transitioned to nonmedical roles such as positions in industry, exacerbating the scarcity of radiologists. Also, the insufficient number of radiologists graduating medical schools to meet the demand exacerbates the recruitment crisis. He emphasized the need to promote radiology as a career choice among medical students and outlined RBMA initiatives aimed at attracting younger generations to the field.

Financial pressures are contributing to the attrition in radiology

Radiology has witnessed either cuts or stagnation in Medicare reimbursements rates for the past 15 years. Physicians also have are not given inflationary increases, so those pressures help magnify the continued reimbursement cuts. This has started to raise the question: At which point do radiologists or health systems stop accepting Medicare patients because the costs begin to be higher than what CMS is willing to pay?

Moffatt believes that is a difficult question. While out-right denial of service is not a major issue yet, patients are already seeing the impact of those lower reimbursements in the form of no longer having enough radiologists to serve patients in some regions of the country. With the shortage of radiologists growing, this problem will just be compounded year after year.  

"We see this already at a lot of rural hospitals that stop providing services if they don't have physicians to staff those accounts. Sometimes those problems could be generated because of the fact that a physician in a rural area may be recruited by another practice that's able to have more financial incentive for them to come work for them. So it pulls that doctor out of the smaller hospital and, yes, it has a negative influence on ultimately the patient base," Moffatt explained. 

In the face of the Centers for Medicare and Medicaid Services reimbursement cut and the challenges they are posing, Moffatt highlighted the pivotal role of RBMA in advocating for its members. He cited initiatives like the creation of the Radiology Patient Action Network as pivotal in giving Medicare patients a platform to voice concerns regarding declining reimbursements from CMS and combating the ripple effects of inflation. This effort includes patient surveys that can be used to show Congress the sentiments of those who face losing services.

When asked about potential remedies, Moffatt stressed the importance of continuous advocacy efforts and outreach to younger medical students, aiming to cultivate interest in radiology as a career path. He expressed optimism that these proactive measures, if sustained, could gradually alleviate the existing gaps in the radiology workforce.

Dave Fornell is a digital editor with Cardiovascular Business and Radiology Business magazines. He has been covering healthcare for more than 16 years.

Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail:

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