Interventional radiology (IR) work has grown increasingly concentrated among a smaller share of the radiologist workforce over the past 15 years, according to a study published June 17 in the Journal of Vascular and Interventional Radiology.
The finding comes from a retrospective analysis of Medicare claims covering 476,688 radiologist-years representing 46,533 unique radiologists between 2008 and 2023, noted a team led by Eric Christensen, PhD, of the Harvey L. Neiman Health Policy Institute in Reston, VA.
"The percentage of those with a super-majority (>90%) of IR-related work more than doubled between 2008 and 2023," the group wrote.
Since IR's formal recognition as a specialty in 2012, the optimal practice model for interventional radiologists has been a matter of debate, centering on whether IR should function as an independent specialty or remain integrated within general radiology departments, the authors explained. Moreover, heterogeneity in how IR practices are structured implies that complete separation from diagnostic radiology may not be optimal or attainable across all practice settings, they added.
A clearer understanding of how IR work is distributed across radiologists is needed, the group wrote, and to that end, they analyzed Medicare claims data to track IR-related work volume across radiologist cohorts, stratifying by age, practice type, academic affiliation, urbanicity, and practice size over the 15-year period.
According to the results, radiologists who were male, aged between 35 and 44 years old, and in practices that are metropolitan, multispecialty, and with one to nine radiologists were the most likely to perform a majority of IR work (>50%). Meanwhile, the proportion of radiologists performing some (>0%) IR-related work declined from 66.9% in 2008 to 49.6% in 2023.
Further, among those with IR-related work, the proportion with a majority (>50-100%) of IR-related work increased from 12.6% to 18.5%, and the proportion with supermajority workloads (>90-100%) increased from 4.1% to 8.8%. Lastly, for the 2020-2023 period, radiologists had higher odds of supermajority IR workloads versus the 2008-2011 period (odds ratio, 1.65), the researchers reported.
“This national claims-based analysis demonstrates that IR-related work in the United States is becoming increasingly concentrated among fewer radiologists,” the group wrote.
Ultimately, the findings may help contextualize ongoing debates regarding departmental structure, workforce planning, compensation, procedural coverage, and the integration of IR within radiology, according to the researchers.
“As IR continues to evolve as a primary clinical specialty, understanding the heterogeneous practice patterns of radiologists performing IR-related work will be essential for designing sustainable, flexible, and patient-centered practice models,” the group concluded.
The full study is available here.
