A new retrospective study from the Harvey L Neiman Health Policy Institute in Reston, USA, has highlighted rising attrition rates across radiology, to a varying degree among subspecialties. The analysis, published in the American Journal of Roentgenology, was based on Medicare-enrolled radiologists from 2014–2022.
Led by Eric Christensen, he and his colleagues investigated attrition among radiology subspecialists using a subset of radiologists from an earlier study of a national sample of Medicare-enrolled radiologists. This prior study determined the association between radiologist and practice characteristics and radiologist attrition. “Examining attrition patterns among the radiology subspecialties was an important next step to better understand attrition so that it can be better managed”, said Christensen. Attrition was defined as a clinically active radiologist’s workforce exit based on lack of subsequent claims in a Medicare fee-for-service-dataset or a commercial, Medicare Advantage and Medicaid dataset.
The research team assigned radiologists to one of seven subspecialties, including: abdominal imaging, breast imaging, cardiothoracic imaging, musculoskeletal imaging, neuroradiology, nuclear medicine, and vascular and interventional radiology.
The analysis included 159,490 radiologist-years for 29,770 subspecialist radiologists. Between 2014 and 2022, the attrition rate was 2.2%, varying between subspecialties, ranging from 1% in vascular and interventional radiology to 4.3% in cardiothoracic imaging. Christensen and colleagues state that, year by year, attrition rates increased from 1.4% in 2014 to 2.7% in 2022 and increased over time for each subspecialty.
Adjusted odds of attrition, compared with abdominal imaging, were significantly higher for breast imaging (odds ratio [OR]=1.31) and cardiothoracic imaging (OR=1.81), but significantly lower for vascular and interventional radiology (OR=0.78), and not significantly different for other subspecialties. Mean estimated career length was 1.1 years and 1.5 years greater for men than for women among academic and non-academic radiologists, respectively; but these gender differences were smaller within individual subspecialties (academic: 0.4–0.6 years; non-academic: 0.2–0.5 years) as the choice of radiologic subspecialty differs between women and men.
“Our previous study found a larger gender difference in career length for subspecialists collectively—about 3.5 years,” said Jay Parikh (University of Texas MD Anderson Cancer Center, Houston, USA), study co-author. “The findings of this study show that much of the previous estimated gender difference can be explained by differences in subspecialty chosen by gender. For example, we found 63.7% of breast radiologists are women compared with 9.5% for vascular and interventional radiology.”
“Recruitment and retention initiatives are needed broadly across the workforce to avoid departure cycles that potentially exacerbate individual subspecialty shortages. Our study provides an important foundation for needed efforts to understand why attrition rates differ among the subspecialties. The persistent radiology workforce shortage is a potential driver worth exploring, as the associated workload burden may be disproportional across subspecialties,” said Parikh.
