Attrition in the radiology workforce is higher in subspecialties and is most pronounced in specific subspecialties, according to research from the Harvey L. Neiman Health Policy Institute (HPI).
Loss of subspecialists can affect the ability of patients to access and receive care, wrote a team headed by Eric W. Christensen, PhD, in a study published March 4 in the American Journal of Roentgenology.
Higher attrition in subspecialties such as cardiothoracic and breast imaging raises concerns for the possibility of disproportionate shortages in those areas, and consequent higher workloads, leading to “a vicious cycle where a relatively pronounced shortage in a specific subspecialty abruptly heightens workload demands and call burden on that specialty’s remaining radiologists, further exacerbating workforce departures," the authors noted.
To investigate the attrition trend, Christensen and colleagues conducted an analysis using data from all Medicare radiologists who submitted claims between 2014 and 2022. This included 159,490 radiologist-year observations for 29,770 radiologists practicing as subspecialists. The group adjusted for differences in radiologist characteristics and practice setting, such as years of practice, gender, and academic status, in determining the attrition rates. Abdominal imaging was used as the reference subspecialty.
The team reported an overall higher attrition rate for subspecialists, varying from 1% for vascular/interventional radiologists (IR) to 4.3% for cardiothoracic radiologists, for example. Breast imaging attrition was also high, at 2.8%.
Attrition rates rose year-by-year from 1.4% (2014) to 2.7% (2022). They also increased over that period for each of the subspecialty fields (ranging from 0.4% for musculoskeletal imaging to 2.1% for cardiothoracic imaging). This growth in attrition rates for subspecialists was consistent with previously reported numbers for the radiology workforce on the whole.
The authors also reported that there were correlations between higher attrition rates among women practicing in subspecialties compared with men, among subspecialists in the Midwest compared with the Northeast, and among those in nonacademic practices compared with academic settings.
Past research has demonstrated a correlation between seniority and attrition in subspecialists, a factor that played a role in this analysis as well.
“Our previous studies have shown years of practice -- seniority -- to be the most important driver of attrition. We found that seniority varied widely among the subspecialties and was highest for cardiothoracic imaging and lowest for vascular/IR,” Christensen and colleagues noted. “Hence, some of the unadjusted attrition differences (ranging from 1% to 4.3%) are due to differences in seniority among the subspecialties.”
The study results underscore the need for strategies to recruit and retain radiologists not only in subspecialties but also in general radiology. Such initiatives could "mitigate the burdens that attrition creates" and avoid the “workforce departure cycles” that lead to subspecialty shortages, the authors concluded.
Read the study here.
