Technology is making it possible for radiologists to do more work in the same number of hours, according to Mythreyi Bhargavan, Ph.D., of the American College of Radiology (ACR) in Reston, VA.
"The use of PACS really cuts down on reading time," Bhargavan told AuntMinnie.com. "A radiologist can sit down and look at a lot of images pretty quickly and come up with a diagnosis."
Bhargavan and colleagues from Johns Hopkins University in Baltimore and Yale University in New Haven, CT, determined radiologists' productivity and workload in 2006-2007, as measured by both procedures per full-time equivalent (FTE) radiologist and relative value units (RVUs) per FTE, and compared them to productivity and workload in 1991-1992.
On the productivity side, radiologists' annual output per FTE radiologist increased 70% as measured by RVUs and 49% as measured in time-adjusted RVUs from 1992 to 2007. This productivity growth is significantly higher than that reported by the U.S. Bureau of Labor Statistics, which estimates that hourly output per worker in businesses increased 38% during the same time frame.
Growth in radiologist workload was significant but not as dramatic. The mean number of procedures per FTE radiologist increased from 13,900 in 2002-2003 to 14,900 in 2006-2007, an increase of 7%. Compared to 1991-1992, however, radiologist workload increased by 34%.
The study, performed under auspices of the ACR, used data taken from the society's 2007 Survey of Radiologists between May and June 2007. Response rate was 20%, with 487 responses. Data from previous years were taken from the 1990, 1995, 2000, and 2003 ACR Surveys of Radiologists.
The researchers calculated RVU data using the Medicare Physician Fee Schedule and the Medicare Physician/Supplier Procedure Summary data. They did not use surveys from radiologists who reported that the number of procedures per FTE radiologist was less than one-third or more than three times the median; this eliminated responses that reported fewer than 4,500 or more than 40,500 annual procedures per FTE radiologist in radiology practice.
In 2006, the average number of procedures per FTE radiologist was 14,900 annually. One-quarter of radiologists were in practices that performed 11,100 or fewer procedures per FTE radiologist annually, while another quarter were in practices that performed 18,300 or more procedures annually per FTE radiologist.
Radiologists in the top quartile were performing at least 65% more procedures than those in the bottom quartile. For primarily academic practices, private multispecialty practices, and private radiology practices, this difference was also 65% or more; however, annual hours worked by FTE radiologists in the 75th percentile were only 22% greater than those worked by FTE radiologists in the 25th percentile.
Radiologists in exclusively private radiology practices performed on average 16,400 procedures each year per FTE radiologist, much more than the average for all radiologists. Academic radiologists performed an average of 9,800 procedures annually per FTE radiologist, 34% less than the average for all radiologists.
Physician work RVUs per procedure in 2007 averaged 0.68, with CT making up 20% of all procedures, MR contributing 5.5%, and radiography, including mammography, making up 61%.
The study also found that imaging is growing at approximately a 4% rate per year, Bhargavan said. And even though nonradiologists are getting traction in imaging, they're not necessarily decreasing radiologists' workloads.
"One of the common concerns radiologists have is that nonradiologists are performing more imaging than they used to, encroaching on radiologists' territory," Bhargavan said. "But in fact, work done by radiologists is still increasing at a fairly steady rate, about 2%. The remaining 2% is going to the nonrads."
By Kate Madden Yee
AuntMinnie.com staff writer
June 18, 2009
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