The physician shortage is a pressing concern for healthcare, with radiology among the specialties facing some of the most significant challenges.
The worldwide shortage of radiologists comes amid rising demand for their expertise, driven by an aging population and an unprecedented number of radiologists retiring after the stress of the pandemic.
The American College of Radiology warns that the shortage will worsen as the number of imaging studies ordered continues to rise. The group forecasts that, by 2025, the number of annual imaging studies will surpass one billion, further straining an already burdened radiologist workforce.
Much attention is being paid to this worrisome problem and the possible solutions, which range from the adoption of new artificial intelligence tools to federal legislation to increase funding for residency positions.
Facts about the shortage
- A shortage of up to 42,000 radiologists is expected by 2033.
- The number of imaging studies increases by up to 5% per year, but the number of radiology residency positions only increases by 2%.
- Nearly half of U.S. radiologists are at retirement age.
- The radiology technologist vacancy rate is 18.1%, up from 6.2% only three years ago.
- The U.S. Bureau of Labor Statistics predicts a 4% job growth in radiology until 2033, resulting in more than 1,000 radiology job openings annually.
According to a recent ACR bulletin these are the top reasons for the shortage:
- The U.S. population has increased at a faster rate than the number of radiologists being trained each year.
- The number of federally funded graduate medical education positions has remained relatively flat for the past 30 years.
- Growth in the number of nonphysician and physician providers has outpaced the increase in radiologists, leading to more imaging studies being ordered per provider.
- The increased incidence of cancer is fueling greater imaging needs.
- The volume and complexity of medical images have increased significantly, making each study more detailed and time-consuming for the radiologist.
How will this shortage affect U.S. healthcare?
The radiologist shortage is poised to significantly strain the U.S. healthcare system, potentially leading to delayed diagnoses and care. On the ACR's job board, there are more than 1,800 open radiologist jobs. With those numbers, a dangerous bottleneck for patients could be created. An editorial in Diagnostic Imaging warns that the shortage could lead to increased turnaround times for study results, which can hinder patient outcomes.
One study found that radiology imaging delays were associated with longer length of stays. Another study of more than 10,000 CT scans ordered through a single emergency department found that 42% of the time, it took more than three hours to get a report due to high radiology workload
What are the possible solutions?
Various short- and long-term solutions are needed to address the looming radiologist shortage. Here are five of the 17 strategies outlined in a recent study to address the shortage, narrowed down to three areas: people, process and physical infrastructure and resources.
- Augment the workforce with people in the short-term, including retaining radiologists in the workforce, recruiting international radiologists and building up the supply with nonphysicians to serve in support roles.
- Use retired radiologists as a potential untapped workforce. Job-sharing, part-time positions, per diem work and phased retirements could give senior radiologists more time in their clinical practice.
- Use radiology residents in fellowship programs to work part-time if allowed by their training program, providing a potential workforce of approximately 1,000 radiologists.
- Encourage the alternate pathway allowed by the American Board of Radiology for international medical graduates who are not planning to enter a standard radiology residency as a path to enter the U.S. radiology workforce.
- Hire reading room coordinators or assistants to provide administrative support to radiologists.
How AI can help the radiologist shortage
Industry leaders are evaluating AI as another potential solution to combat the growing shortage. These tools can quickly analyze images, improve the accuracy of image interpretations and help radiologists manage heavy workloads. However, healthcare leaders must ensure the safe and ethical implementation of such AI tools, researchers said.
The ACR reports that around 60% of radiology departments in the U.S. have already adopted AI solutions or are evaluating their implementation.
The FDA as of December has cleared about 1,000 clinical AI algorithms. Of these, close to 80% are for medical imaging. Radiology has the highest number of submissions and has the steadiest increase of AI-enabled device submissions of any specialty.
How legislation can help the radiology shortage
Researchers in the radiology field fear an imbalance between the number of radiology residents trained, the number of vacant radiology positions available and the escalating volume of imaging services.
The Resident Physician Shortage Reduction Act of 2023, introduced by U.S. Representatives Terri Sewell and Brian Fitzpatrick, proposes expanding the number of Medicare-supported medical residency positions by 14,000 over seven years. The ACR is pushing for passage of the bill as a possible solution for the growing demand for radiologists and other specialties. The Association of American Medical College also supports the bill, which is in the first phase of Congressional consideration.