Diagnostic radiologists in 2000: basic characteristics, practices, and issues related to the radiologist shortage.

OBJECTIVE: We sought to describe radiologists and their practices, emphasizing trends in retirement age, practice size, and perceived workload burden. MATERIALS AND METHODS: In spring 2000, we surveyed 3,027 randomly selected radiologists by mail, of whom 74% responded. We weighted responses to make answers representative of all radiologists and compared findings with a similar 1995 survey. RESULTS: Thirty percent of radiologists age 65-69 were working full-time; 21% were working part-time. Overall, the full-time equivalency of radiologists age 55-74 was 67.6%, not significantly different from 1995. If current patterns of retirement and production of graduates continue, the workforce will grow at a rate of approximately 2% annually. Fifty-one percent of radiologists said that recognizing that income depends largely on work done, they had "much too much work" or "somewhat too much work"; 5% reported "somewhat too little work" or "much too little work." Six percent of posttraining professionally active radiologists were in solo practice, down from 8% in 1995; 15% were in two-to-four-radiologists groups, down from 17%; and 38% were in groups of 15 or more, up from 30%. Sixteen percent of posttraining professionally active radiologists were women. The percentage was highest (29%) for those younger than age 35 but was lower (22%) among trainees. CONCLUSION: The findings of excess work are further evidence of a radiologist shortage. However, contrary to surveys of groups that are hiring, we found minimal evidence of earlier retirement. Nonetheless, workload currently is increasing faster than the workforce is likely to grow, so the shortage will probably intensify. The typical number of radiologists in a practice is increasing, but slowly.     

Trends in the on-call workload of radiologists

AIM: To evaluate the radiologist on-call clinical workload of an inner-city acute teaching hospital. MATERIALS AND METHODS: Data were collected prospectively from a 9-week assessment of the workload of the radiologists on-call at our Trust. Data collection was undertaken using a questionnaire-based survey detailing the date and time of request, and where appropriate, the imaging examination performed. The referring clinician's grade and speciality were also recorded. The results obtained were compared with a similar study carried out in 1996. RESULTS: A total of 160 requests for out-of-hours imaging were received over the 9-week period. CONCLUSIONS: The figures indicate that on-call work is increasing with an approximate doubling of out-of-hours requests compared with the survey performed 7 years earlier.     

Anatomy instruction by radiologists

Ninety-four academic radiology departments responded to a questionnaire concerning anatomy instruction by radiologists. Seventy-six departments reported that radiologists teach anatomy to medical students in courses sponsored by anatomy departments (63), radiology departments (7), or both (6). The most frequent format for teaching anatomy was classroom lectures alone (25) or a combination of classroom lectures and small group instruction (24). Eighty departments indicated that additional teaching aids would be helpful.     

Technology assessment for radiologists

Health technology assessment is the systematic and quantitative evaluation of the safety, efficacy, and cost of health care interventions. This article outlines aspects of technology assessment of diagnostic imaging. First, it presents a conceptual framework of a hierarchy of levels of efficacy that should guide thinking about imaging test evaluation. In particular, the framework shows how the question answered by most evaluations of imaging tests, "How well does this test distinguish disease from the nondiseased state?" relates to the fundamental questions for all health technology assessment, "How much does this intervention improve the health of people?" and "What is the cost of that improvement?" Second, it describes decision analysis and cost-effectiveness analysis, which are quantitative modeling techniques usually used to answer the two core questions for imaging. Third, it outlines design and operational considerations that are vital if researchers who are conducting an experimental study are to make a quality contribution to technology assessment, either directly through their findings or as an input into decision analyses. Finally, it includes a separate discussion of screening--that is, the application of diagnostic tests to nonsymptomatic populations--because the requirements for good screening tests are different from those for diagnostic tests of symptomatic patients and because the appropriate evaluation methods also differ.