A shortage of up to 42,000 radiologists is expected by 2033. Currently, the radiology technologist vacancy rates are up to 18.1%, compared to 6.2% three years ago. Further complicating the matter, the number of imaging studies has increased by up to 5% per year, but the number of radiology residency positions has increased by only 2%. If current imaging rates remain standard, there will be an estimated 16.9% to 26.9% increase in imaging utilization by 2055.
“We (the industry) waited too long to start discussing the shortage,” leaders from Evanston, Ill.-based Endeavor Health told Becker’s. “Had we been proactive in understanding this phenomenon, we could have avoided some of the deficit. Now we are in reaction mode and trying to catch up.”
With America’s aging population, many radiologists are also going to be retiring in coming years, with fewer radiologists coming up to replace them.
And the challenges for health systems do not end there.
“The relatively higher fixed costs smaller private groups bear for billing services, malpractice insurance, benefits, etc. make it increasingly difficult to offer competitive wages, so recruitment and retention in a competitive market become challenging,” they said. “We have also experienced unplanned increases in teleradiology pricing over the last year, resulting in a negative margin for this volume subset as the reimbursement for most interpretations outweigh the professional fee collections.”
How systems are meeting demand
Endeavor Health and Grand Blanc, Mich.-based McLaren Health Care both utilize a mixed model of employed and contracted radiology groups to help meet demand.
“[Arrangements with independent radiology groups] has been historically a sustainable model for us,” Chad Grant, McLaren’s COO, told Becker’s. “We are continuously monitoring the performance of contracts with independent groups along with the larger trends and forces throughout the industry. If there comes a time when another model will better suit our needs and the needs of our patients and providers, then we will consider adjusting our operating model.”
At Endeavor, leaders primarily rely on internal radiologists, except for the occasional locums.
“It’s imperative our radiologists have great partnerships with our referring physicians,” Endeavor leaders said. “We believe in the benefit of employment and long-term partnerships rather than interim arrangements with outside groups.”
Both systems also use internal training programs to attract and keep radiologists, on top of offering competitive wages, benefits and career advancement opportunities. But there are a few things the systems do differently.
Endeavor uses a mix of teleradiology and ED radiologists for overnight reads, which offers a work-life balance for traditional daytime radiologists. Within workflows, the health system utilizes AI to reduce burnout and increase efficiency. And it has hired internal and out-of-state moonlighters to work remotely to fill gaps.
“Being willing to recruit and hire entirely remote radiologists is an important tool to effectively widen the pipeline of potential partners,” the system’s leaders said. “The most effective recruitment and retention tool for our radiologists and staff is our reputation of being a great place to work.”
McLaren has focused on radiology technologists to ensure hospitals have that position properly staffed to meet patients’ needs for imaging services.
The cost of the shortage
With the shortage of radiologists, many systems turn to independent radiology groups to fill staff needs — but this can come at a higher cost than hiring internal radiologists.
“It is a cost we closely monitor,” Mr. Grant said. “The main driver of these arrangements are the quality and timeliness of the interpretations for our providers and patients. Unfortunately, the reimbursement levels for radiologist professional fees are not matching the salary requirements in the market so many independent groups are struggling to recruit the physicians they need to provide the service. We already employ a large number of radiologists, and the industry forces continue to push in that direction. “
Endeavor’s leaders said what they need next are more competitive pay and more residency slots.
“As an industry, given the long training timeline, we need to be looking and anticipating at least five to 10 years ahead,” they said.
Note: The Endeavor leaders who contributed to responses are Matthew Walker, MD, chair of the department of radiology at Endeavor Health NorthShore Hospitals; Ryan Garland, MHA, assistant vice president of radiology at Endeavor Health; and Beth Tobias, MEd, assistant vice president of radiology at Endeavor Health.
