Radiologist turnover rose by over 60% in the past decade, and women are more prone to leaving their imaging position than men, according to findings published February 23 in the Journal of the American College of Radiology.
Researchers led by Jay Parikh, MD, from the University of Texas MD Anderson Cancer Center in Houston identified several factors tied to higher turnover, including excessive workload, nonacademic practices, lower years of practicing, and practices being in a metropolitan setting.
“Practices should consider these factors as they design retention efforts,” Parikh and colleagues wrote.
Staffing challenges persist in radiology as imaging volume continues to increase. Turnover has both direct and indirect costs for imaging practices and departments, including higher costs to replace physicians and existing workforces being left to absorb the workload and call duties of the leaving radiologist.
The Parikh team estimated the radiologist turnover rate and its association with workload. They also evaluated radiologist- and practice-level characteristics and how they may contribute to the turnover rate.
Using data collected between 2013 and 2022 from the Centers for Medicare & Medicaid Services (CMS), the team examined practice turnover rates of radiologists by year (radiologist-years). Final analysis included 280,692 radiologist-years from 39,439 radiologists who met the study selection criteria.
Turnover increased during the study period from 5.3% to 8.5%, with adjusted turnover odds being higher in 2022 (odds ratio [OR], 1.96) compared with 2013 (OR, 1 [reference]).
The researchers also reported higher odds ratios for female radiologists (OR, 1.06) and radiologists working in a metropolitan-based practice (OR, 1.12), and lower odds ratios for radiologists working in an academic practice (OR, 0.91). Also, odds ratios increased among radiologists with fewer years of practice.
Turnover odds decreased with workload (OR, 0.82 per 1,000 work relative value units [wRVUs]) and increased with workload squared (OR, 1.01). Combined, these odds ratios represent a declining turnover rate until an inflection point is reached, after which turnover increases with workload and wRVUs.
Across all radiologists, this inflection point was reached at 12,940 wRVUs. Stratifying by academic status, the inflection point was 8,820 and 13,380 wRVUs for academic and nonacademic radiologists, respectively. By years of practice, the inflection point decreased as years of practice increased from 15,210 wRVUs for one to 10 years of practice to 10,130 wRVUs for 41 years or more of practice.
“The turnover curve by wRVUs becomes increasingly flat as years of practice increase,” the team wrote.
Finally, by metropolitan status, the inflection point was less for nonmetropolitan versus metropolitan radiologists (11,770 wRVUs vs. 13,020 wRVUs).
The study authors called for future research to study whether workload-associated turnover among academic radiologists results in transition to nonacademic positions with volume-driven compensation.
“Radiology practice leaders should monitor excessive workload and identify financial and nonfinancial benefits that may serve as a buffer to the negative effects of high workload and burnout,” they wrote. “Practices seeking to recruit and retain radiologists should contemplate increasing paid leave and allocating resources for professional development, wellness, and addressing burnout.”
Read the full study here.
