"Whatever happened to the class of 2000?" An outcome survey of potential interventional radiologists

OBJECTIVES: To find out what final career choices were made by trainee doctors who had indicated a strong interest in pursuing a career in interventional radiology and to establish the reasons behind their final career choice. METHODS: Eighty-eight doctors who attended a meeting in 2000 designed to promote interventional radiology as a career were questioned as to whether the meeting influenced their potential career choices and then further surveyed via postal questionnaire 5 years later to find out their eventual career choices. Of the 88 doctors who attended, 56 were radiology trainees and 32 were training in either medical or surgical specialties. There were 25 women and 63 men. RESULTS: Five years after the meeting, six are now interventional radiologists (6.8%) though four of these are still in a 6th year interventional radiology fellowship. A further 12 (13.6%) are systems based, predominantly diagnostic radiologists with an interest in intervention. Thirty-two (43.2%) are diagnostic radiologists who undertake little or no therapeutic intervention. Of the 32 non-radiologists who attended the meeting only three entered radiology and are still in training. CONCLUSIONS: Interventional radiology is a popular initial career choice amongst trainee doctors. However, only a small number eventually pursue the specialty. If the manpower shortage of interventional radiologists is to be addressed, there needs to be improvements in training, accreditation, career opportunities and working conditions.     

A Survey of Interventional Radiology Awareness Among Final-Year Medical Students in a European Country

Interventional radiology (IR) is a rapidly expanding specialty that is facing the challenges of turf wars and personnel shortages. Appropriate exposure of medical students to this field can be vital to recruitment of potential future trainees or referring physicians. The aim of this study was to determine the knowledge and views of final-year medical students in a single EU country regarding various aspects of IR. An electronic survey was sent via e-mail to all final-year medical students in a European country. The students were given a month to respond to the questionnaire. A total of 234 students of 675 (34.5%) replied to the survey. Of the respondents, 35% had previously completed an attachment to the radiology department. The majority of students (63%) thought their knowledge in radiology in general was poor. The percentage of students who correctly identified procedures performed by interventional radiologists was 69% for Hickman line insertion, 79% for fibroid embolization, and 67.5% for lower limb angioplasty. Sixty percent, 30%, and 47% thought that interventional radiologists perform cardiac angioplasties, perform arterial bypasses, and create AV fistulas, respectively. Forty-nine percent felt that interventional radiologists are surgically trained. Eighty-three percent of students were first made aware of angioplasty by a cardiologist. Thirty-one percent thought that interventional radiologists do ward rounds, 24% thought that interventional radiologists have admitting rights, and 26% felt that interventional radiologists run an outpatient practice. A significant number of students (76%) thought that the job prospects in IR are good or excellent but only 40.5% were willing to consider a career in IR. In conclusion, this study indicates that IR remains a nascent but attractive specialty to the majority of medical students. Further development of the existing informal undergraduate curriculum to address shortcomings will ensure that IR continues to attract the brightest talents to the field.     

Factors influencing radiologists to choose research careers

The future of radiology is threatened by the paucity of competent researchers who are radiologists. To determine what influences are most important in selecting and training potential radiology researchers, we conducted a survey of 5000 practicing radiologists, including all members of the Association of University Radiologists. We also surveyed 3000 randomly selected radiology trainees. A research career was empirically defined as 20% or more of a radiologist's time being involved with research. Response to the practicing radiologists and radiology trainees surveys was 28% and 19%, respectively. Radiologists who attended medical school or trained in radiology at an institution among the top 20 for research funding more frequently chose careers in research than those who matriculated and trained elsewhere. Publishing at least one research article, having a dedicated radiology research fellowship, having access to grant funds, and using computers during medical school or radiology training were factors typifying radiologists who chose research careers. Research radiologists were more concerned about the value of performing research and less concerned about personal income than those choosing careers not focusing on research. These results suggest that it might be possible to select radiology trainees who are more likely to become researchers based on their backgrounds and attitudes. An appropriate milieu during training enhances the likelihood of radiologists choosing research careers.     

Influences affecting radiologists' choices of academic or private practice careers

The authors surveyed 5,000 practicing radiologists and 3,000 individuals currently in radiology training to determine the aspects of their backgrounds, education, training, and attitudes that most affected their career decisions. The choice of academic radiology was associated with receiving medical school education or radiology training at an institution ranking among the 20 with the most federal grant funding, publishing research articles, and participating in a variety of interpersonal research experiences during radiology training. Academic radiologists were more likely to choose their careers because of their interests, aptitudes, and greater concern for the value of doing research. Private practitioners rated family obligations, leisure time, and level of personal income as more significant influences on their career choices. Programs interested in training more academic radiologists should reconsider how they select trainees and provide an appropriate research environment during training.     

Medicolegal training in radiology; an overlooked component of the non-interpretive skills curriculum

ObjectiveRadiologists comprise approximately 3.6% of US physicians while ranked 6th–8th in medicolegal claims. Studies suggest that by the age of 60, about half of all radiologists will be sued at least once. Given this likelihood, it is surprising how little attention is paid to teaching of medicolegal issues. It is hypothesized that most trainees emerge from residency with only a vague notion of the medicolegal issues inherent in radiology.MethodsAll of the radiology attendings, trainees and alumni in our tertiary care teaching hospital were surveyed via an electronic questionnaire. Respondents were surveyed on overall knowledge of job-related medicolegal issues and willingness to receive additional education. The survey also included two real life medicolegal scenarios and the radiologists were asked to choose the most likely outcome.ResultsA questionnaire was sent to total of 359 trainees, attendings and alumni. There were 168 responses, constituting a 46.7% response rate, F:M 48:112. Only 41% of the respondents were aware that by the age of 60, half of them would be involved in at least one lawsuit. All knew the most common causes of malpractice claims; however, one-fourth were not aware of available medicolegal resources offered by radiological organizations; 85% of the respondents expressed willingness to attend medicolegal CME courses. All residents surveyed believed that medicolegal lectures should be included in their didactics.ConclusionThere is a dearth of knowledge among radiologists on job-related medicolegal topics. This survey suggests that incorporating additional medicolegal topics into the non-interpretive skills curriculum of residents and medicolegal CME for graduates would be well received.     

The Challenge With Clinical Radiology Electives: Student and Faculty Perspectives Identify Areas for Improvement

PurposeTo determine medical students' and radiologists’ attitude toward radiology electives at a distributed medical school and identify specific areas for improvement.MethodsDuring a single academic year, both students and faculty preceptors were surveyed anonymously following a senior radiology elective. The survey was based on an established theoretical framework for studying the educational environment which takes into account domains: (1) goal orientation, (2) organization/regulation, and (3) relationships. Mann-Whitney tests were performed to determine if there was any difference between the overall satisfaction of students and preceptors, responses from the different elective sites and students’ ratings of the domains. Statistical significance was set at P < .05. Thematic analysis was performed on the narrative comments to identify specific challenges.ResultsThe response rate was 82.0% for students (95/116) and 19.5% (31/159) for radiologists. There was no difference in responses based on elective site. Overall, the elective was viewed positively by both groups however students rated their experience as significantly better than their preceptors (P = .0012). Students viewed the relationships domain more positively than both the other two (goal orientation, P = .0001; organization/regulation, P = .0038). Thematic analysis identified that the student challenges were lack of autonomy, structured teaching, and preceptor continuity and the preceptor challenges were ambiguous learning objectives/expectations and insufficient resources.ConclusionsThe radiology elective challenges identified in this study provide educators with specific areas to target when updating radiology electives. A better elective experience may improve students' radiology knowledge and attitude towards the specialty as well as radiologists’ interest in teaching.     

Factors that influence radiologists' career choices

RATIONALE AND OBJECTIVES: The authors performed this study to examine the factors, particularly the modifiable factors, that influence the career choices of radiologists immediately after graduation from residency and later. MATERIALS AND METHODS: A survey was sent to 119 radiologists who had graduated from a large academic training program between 1981 and 2000. The graduates were asked to classify their first job and any subsequent jobs in academic radiology or private practice and to identify the reasons for their initial job choices and any job changes. A nested cohort study was performed to evaluate the effect of research experience on career choice. RESULTS: Seventy-nine (66%) graduates responded to the survey. Forty-three (54%) of the respondents had chosen academic positions as their first jobs. Those who had published during their residency were 26.4 times more likely to choose an academic position as a first job. Twenty-four graduates had since left their academic jobs for private practice. Although the discrepancy in financial rewards between academic radiology and private practice was the main reason for the job switch in 71% of these cases, 33% of the respondents cited difficulty with research as a reason. In addition, only 25% of current academic radiologists were satisfied with their research activities. CONCLUSION: An exodus from academic radiology to private practice is evident among graduates from this large academic residency program, with greater financial reward being the primary motivation. However, a positive research experience during residency could persuade more graduates to choose and to continue in an academic career.     

Communication in the diagnostic mammography suite: implications for practice and training

RATIONALE AND OBJECTIVES: The diagnostic mammography suite is a microcosm of challenging physician-patient communication in radiology. Little has been written about communication practices in the diagnostic mammography suite, the effect of this communication on both physicians and patients, and implications for radiology training programs. We surveyed radiology residents and staff about communication training, practices, and experiences communicating directly with patients in the diagnostic mammography suite. MATERIALS AND METHODS: We asked the membership of the Association of Program Directors in Radiology to disseminate surveys to radiology residents and staff radiologists in their institutions. We analyzed response frequencies and correlations. RESULTS: We received responses from 142 residents and 120 staff radiologists. More than half of staff respondents spoke personally with every patient who had an abnormal diagnostic mammogram; 37% felt they had inadequate time to do so. Most residents and staff highly rated their own communication skills and confidence in ability to explain results and respond to patients' emotions, but experienced stress doing so. A majority of respondents reported no formal communication skills education after medical school. Twenty-nine percent of staff respondents regularly observed residents' communication with patients and 39% of residents reported receiving feedback about their communication. Residents' opportunities to observe staff communicate with a patient and to receive feedback on their own patient interactions were correlated with self-rated communication skill and confidence in ability to respond to patients' emotions (P < .05). CONCLUSIONS: Radiologists engage in challenging and stressful patient communication interactions. There is a paucity of educational curricula on interpersonal and communication skills in radiology. This has implications for both patient and physician satisfaction and patient outcomes.     

Limitations Influencing Interventional Radiology in Canada: Results of a National Survey by the Canadian Interventional Radiology Association (CIRA)

Purpose To describe the current state and limitations to interventional radiology (IR) in Canada through a large, national survey of Canadian interventional radiologists. Methods An anonymous online survey was offered to members of the Canadian Interventional Radiology Association (CIRA). Only staff radiologists were invited to participate. Results Seventy-five (75) responses were received from a total of 247, giving a response rate of 30%. Respondents were split approximately equally between academic centers (47%) and community practice (53%), and the majority of interventional radiologists worked in hospitals with either 200–500 (49%) or 500–1,000 (39%) beds. Procedures listed by respondents as most commonly performed in their practice included PICC line insertion (83%), angiography and stenting (65%), and percutaneous biopsy (37%). Procedures listed as not currently performed but which interventional radiologists believed would benefit their patient population included radiofrequency ablation (36%), carotid stenting (34%), and aortic stenting (21%); the majority of respondents noted that a lack of support from referring services was the main reason for not performing these procedures (56%). Impediments to increasing scope and volume of practice in Canadian IR were most commonly related to room or equipment shortage (35%), radiologist shortage (33%), and a lack of funding or administrative support (28%). Conclusion Interventional radiology in Canada is limited by a number of factors including funding, manpower, and referral support. A concerted effort should be undertaken by individual interventional radiologists and IR organizations to increase training capacity, funding, remuneration, and public exposure to IR in order to help advance the subspecialty.     

Do radiologists use the American College of Radiology Musculoskeletal Appropriateness Criteria?

OBJECTIVE: The objective of this study was to determine the proportion of radiologists in three different radiology organizations who report using the American College of Radiology (ACR) musculoskeletal appropriateness criteria. MATERIALS AND METHODS: Radiologists from the Society of Skeletal Radiology, Georgia Radiological Society, and Utah Radiological Society were surveyed regarding their use of the ACR musculoskeletal appropriateness criteria. The surveys were carried out during 1998 and data were collected using written survey forms, telephone, and fax. RESULTS: The overall survey response rate was 298 (64%) of 465. Overall, 30% of respondents reported using the musculoskeletal appropriateness criteria. The proportion of respondents who used the musculoskeletal criteria was not different across the three organizations or for private practice compared with academic radiologists. CONCLUSION: The proportion of radiologists who report using the ACR musculoskeletal radiology appropriateness criteria is low. This result is consistent with other reports in the literature that show little impact on the practice of physicians after the distribution of written practice guidelines.     

Family practice career attrition, 1969 to 1993: a comparison of 336 civilian and military graduates of one medical school

Instability of specialty choice and career after initial residency entry will affect health personnel projections. Military physicians may differ from civilian physicians in their specialty choice behaviors during their careers. A cohort of 336 graduates who chose family medicine residency training was identified from the graduating classes of 1969 through 1993 at a large private medical school. Current specialty identification was determined, and attrition from family medicine was computed. As of 1997, 275 graduates (82%) were still in family medicine careers, defined by American Academy of Family Physicians membership or current American Board of Family Practice certification. Of graduates who entered military programs, 22 of 77 (28%) had left family medicine careers; 39 of 259 (15%) of the graduates who entered civilian programs had left. This difference was statistically significant (p = 0.007). Family medicine career retention is lower for males in military programs compared with males in civilian programs or females in military programs.     

The clinical interventional radiologist: results of a national survey by the Canadian Interventional Radiology Association.

OBJECTIVE: To determine the level of clinical responsibility interventional radiologists in Canada currently have within their practice and would like to have within their future practices. METHODS: An anonymous online survey was e-mailed to all members of the Canadian Interventional Radiology Association. The survey was open for a period of 2 months. RESULTS: A total of 75 surveys were received, of a possible 247, a response rate of 30.4%. Responses regarding general measures of clinical duties were collected. The current situation in Canada is mixed, in that while most (82%) respondents perform procedures that require an overnight admission, only 11% have a dedicated interventional radiology (IR) ward and 29% have admitting privileges. Most (73%) respondents stated that interventional radiologists in Canada should become more clinical. The most common reason cited for a lack of admitting privileges was a lack of time (44%), followed by a lack of hospital or administrative support (40%), "other" (20%), and inadequate remuneration (14%). CONCLUSIONS: Most respondents believe that interventional radiologists should become more clinically oriented. The most frequently noted obstacles to becoming more clinically oriented are reluctant administration, lack of time, and inadequate remuneration for clinical duties.     

Interpretation of Emergency Department radiographs: a comparison of emergency medicine physicians with radiologists, residents with faculty, and film with digital display

OBJECTIVE: We determined the relative value of teleradiology and radiology resident coverage of the emergency department by measuring and comparing the effects of physician specialty, training level, and image display method on accuracy of radiograph interpretation. MATERIALS AND METHODS: A sample of four faculty emergency medicine physicians, four emergency medicine residents, four faculty radiologists, and four radiology residents participated in our study. Each physician interpreted 120 radiographs, approximately half containing a clinically important index finding. Radiographs were interpreted using the original films and high-resolution digital monitors. Accuracy of radiograph interpretation was measured as the area under the physicians' receiver operating characteristic (ROC) curves. RESULTS: The area under the ROC curve was 0.15 (95% confidence interval [CI], 0.10-0.20) greater for radiologists than for emergency medicine physicians, 0.07 (95% CI, 0.02-0.12) greater for faculty than for residents, and 0.07 (95% CI, 0.02-0.12) greater for films than for video monitors. Using these results, we estimated that teleradiology coverage by faculty radiologists would add 0.09 (95% CI, 0.03-0.15) to the area under the ROC curve for radiograph interpretation by emergency medicine faculty alone, and radiology resident coverage would add 0.08 (95% CI, 0.02-0.14) to this area. CONCLUSION: We observed significant differences between the interpretation of radiographs on film and on digital monitors. However, we observed differences of equal or greater magnitude associated with the training level and physician specialty of each observer. In evaluating teleradiology services, observer characteristics must be considered in addition to the quality of image display.     

Why don’t female medical students choose diagnostic radiology? A review of the current literature

While the number of women entering medical schools is approaching 50% nationally, women continue to be underrepresented in a number of specialties including diagnostic radiology. While diagnostic radiology has many characteristics that might be desirable to women, such as reasonable call hours, flexible scheduling, and high salaries, women still do not choose diagnostic radiology as a career. This article examines the literature to discern possible reasons for why women are entering diagnostic radiology at a lower rate. We address trends among women in academic medicine, which resemble trends among women in diagnostic radiology, and examine the effects of gender and socialization in medical school on specialty choices among women. The current literature suggests a constellation of factors may be responsible for the gender differences in diagnostic radiology. We suggest that further research is needed to elucidate why women do not seem to be choosing diagnostic radiology as frequently as one might predict based on the lifestyle of diagnostic radiologists and the numbers of women currently entering medical school. Once these reasons are made clear, it will be possible for residency program directors and medical schools to ensure that women are making informed specialty choices, whatever those choices may be.     

Management of patients treated with aspirin or warfarin and evaluation of haemostasis prior to prostatic biopsy: a survey of current practice amongst radiologists and urologists.

AIM: To document current practice concerning the management of patients taking aspirin or warfarin and the evaluation of haemostatic function prior to prostatic biopsy. METHOD: A postal survey was performed with typed questionnaires being sent to 275 urology and 275 radiology centres. RESULTS: A high proportion of radiology departments in particular (83%) had protocols in place concerning the management of aspirin or warfarin prior to prostatic biopsy. A significant proportion of both radiologists and urologists have postponed biopsies due to patients unexpectedly taking these medications. Few of the respondents reported the use of pre-biopsy screening blood tests. Fifty-two percent of radiologists and 27% of urologists terminated aspirin prior to prostatic biopsy, although the urologists stopped aspirin for a long time period. Ninety-five percent of radiologists and 84% of urologists terminated warfarin prior to prostatic biopsy, although again the urologists stopped warfarin at an earlier stage. Most of those respondents who stopped warfarin prior to biopsy, also checked the INR. The urologists generally stated a higher threshold (INR) which would be considered too high to proceed. CONCLUSION: There are wide variations in practice both within and between the radiology and urology groups. This is unsurprising, since there is conflicting advice in the relevant literature.     

Career choices for radiology: national surveys of graduates of 1974-2002 from UK medical schools

AIM: To report on trends in career choices for radiology among UK medical graduates. MATERIALS AND METHODS: One and 3 years after graduation, and at longer time intervals thereafter, postal questionnaire surveys were sent to all doctors who graduated from UK medical schools in 1974, 1977, 1980, 1983, 1993, 1996, 1999, 2000 and 2002. Doctors were asked to specify their choice of long-term career and to identify factors influencing their choice. Employment details were also collected. Results were analysed using chi(2) statistics and binary logistic regression. RESULTS: Seventy-four percent (24,621/33,412) and 73% (20,720/28,459) of doctors responded 1 and 3 years after graduation. Choices for radiology in year 1 increased significantly over time (1.7% of 1974 graduates to 3.2% of 2002 graduates; chi(2) test for trend=15.3, p<0.001). In particular, there has been a steady increase from the cohorts of 1993 onwards. Thirty-eight percent of those who chose radiology in year 1, and 80% who chose radiology in year 3, were still working in radiology 10 years after graduation. Hours and working conditions influenced long-term career choices more for radiology than for other careers. CONCLUSIONS: The proportion of UK trained junior doctors who want to become radiologists has increased in recent years. However, although medical school intake and the numbers making an early choice for radiology have risen, it is unclear whether sufficient UK graduates will be attracted to radiology to fulfil future service requirements from UK trained graduates alone.     

Percepciones de estudiantes de Medicina sobre el impacto de la inteligencia artificial en radiología

ObjectivesTo analyze medical students’ perceptions of the impact of artificial intelligence in radiology.Material and methodsA structured questionnaire comprising 28 items organized into six sections was distributed to students of medicine in Spain in December 2019.ResultsA total of 341 students responded. Of these, 27 (7.9%) included radiology among their three main choices for specialization, and 51.9% considered that they clearly understood what artificial intelligence is. The overall rate of correct answers to the objective true-or-false questions about artificial intelligence was 70.7%. Whereas 75.9% expressed their disagreement with the hypothesis that artificial intelligence would replace radiologists, only 41.9% disagreed with the hypothesis that the demand for radiologists would decrease in the future. Only 36.7% expressed concerns about the role of artificial intelligence related to choosing radiology as a specialty. A greater proportion of students in the early years of medical school agreed with statements that radiologists accept artificial-intelligence-related technological changes and work with the industry to apply them as well as with statements about the need to include basic training about artificial intelligence in the medical school curriculum.ConclusionsThe students surveyed are aware of the impact of artificial intelligence in daily life, but not of the current debate about its potential applications in radiology. In general, they think that artificial intelligence will revolutionize radiology without having an alarming effect on the employability of radiologists. The students surveyed think that it is necessary to provide basic training about artificial intelligence in undergraduate medical school programs.     

24/7/365 Neuroradiologist Coverage Improves Resident Perception of Educational Experience,Referring Physician Satisfaction,and Turnaround Time

PurposeTo quantitatively and qualitatively assess the impact of attending neuroradiology coverage on radiology resident perceptions of the on-call experience, referring physician satisfaction, and final report turnaround times.Materials and Methods24/7/365 attending neuroradiologist coverage began in October 2016 at our institution. In March 2017, an online survey of referring physicians, (emergency medicine, neurosurgery, and stroke neurology) and radiology residents was administered at a large academic medical center. Referring physicians were queried regarding their perceptions of patient care, report accuracy, timeliness, and availability of attending radiologists before and after the implementation of overnight neuroradiology coverage. Radiology residents were asked about their level of independence, workload, and education while on-call. Turnaround time (TAT) was measured over a 5-month period before and after the implementation of overnight neuroradiology coverage.ResultsA total of 28 of 64 referring physicians surveyed responded, for a response rate of 67%. Specifically, 19 of 23 second (junior resident on-call) and third year radiology residents (senior resident on-call) replied, 4 of 4 stroke neurology fellows replied, 8 of 21 neurosurgery residents, and 16 of 39 emergency medicine residents replied. Ninety-five percent of radiology residents stated they had adequate independence on call, 100% felt they have enough faculty support while on call, and 84% reported that overnight attending coverage has improved the educational value of their on-call experience. Residents who were present both before and after the implementation of TAT metrics thought their education, and independence had been positively affected. After overnight neuroradiology coverage, 85% of emergency physicians perceived improved accuracy of reports, 69% noted improved timeliness, and 77% found that attending radiologists were more accessible for consultation. The surveyed stroke neurology fellows and neurosurgery residents reported positive perception of the TAT, report quality, and availability of accessibility of attending radiologist.ConclusionsIn concordance with prior results, overnight attending coverage significantly reduced turnaround time. As expected, referring physicians report increased satisfaction with overnight attending coverage, particularly with respect to patient care and report accuracy. In contrast to some prior studies, radiology residents reported both improved educational value of the on-call shifts and preserved independence. This may be due to the tasking the overnight neuroradiology attending with dual goals of optimized TAT, and trainee growth. Unique implementation including subspecialty trained attendings may facilitate radiology resident independence and educational experience with improved finalized report turnaround.     

Effects of Changing the Reporting System from Decentralized/Modality-Based to Centralized/Subspecialized Radiology on Radiologists,Radiologic Technicians and Referring Physicians of a Multi-Center Radiology Network

Objectives:To determine the effects of reorganizing a radiology institute from decentralized/modality-based to centralized/subspecialized radiology on radiologists, radiologic technicians, and referring physicians at a multi-center radiology network.Material and Methods:In 2017/2018 our multi-center radiology network was changed from decentralized/modality-based to centralized/subspecialized reporting. A survey was conducted among radiologists, technicians and two groups of referring physicians (main hospital and non-main hospitals). The following items were tested: Overall satisfaction, perceived quality of radiological reports, subjective productivity/efficiency, confidence of radiologists in their subspecialty, availability of radiologists and turnaround time. Two of five answering options on a 5-point Likert scale were considered to represent agreement. The Mann-Whitney-U-test served for statistical analyses in agreement before and after reorganization in each group.Results:For radiologists, a significant difference was observed in perceived quality of radiological reports 42/46 (91.3%) compared to 51/52 (98.1%; p = 0.013).For technicians, no significant differences were observed. In the group of main hospital referring physicians, significant differences were observed in overall satisfaction 129/152 (84.9%) compared to 164/174 (94.3%; p < 0.001) and in perceived quality of radiological reports 125/148 (72.8%) compared to 157/170 (92.4%; p = 0.001). In the group of non-main hospital referring physicians no significant differences were observed.Conclusion:The reorganization resulted in a significantly higher perceived quality of radiological reports for the groups of radiologists and main hospital referring physicians besides overall satisfaction for main hospital referring physicians. Specialized main hospital referring physicians value reports of specialized radiology, whereas less specialized, non-main hospital referring physicians did not experience any significant effect.     

Radiology Practices Employing Nurse Practitioners and Physician Assistants: Characteristics and Trends From 2017 Through 2019

PurposeThe number and roles of US nonphysician practitioners (NPPs) have expanded considerably, but little is known about their use by radiology practices. The authors assessed characteristics and trends of radiology practices employing Medicare-recognized NPPs.MethodsUsing Medicare databases from 2017 through 2019, the authors mapped all nurse practitioners and physician assistants (together “NPPs”) to employer groups for which all physicians were radiologists (“radiology practices”). Practices were characterized by size, geography, and radiologist characteristics. Temporal changes were assessed, and NPP employment likelihood was estimated using multivariate logistic regression modeling.ResultsAs the number of US radiology practices declined by 36.5% (from 2,643 to 1,679) between 2017 and 2019, the number employing NPPs increased by 10.5% (from 228 [8.6%] to 252 [15.0%]). The number of radiologists in NPP-employing practices increased by 10.4% (from 6,596 [35.1%] to 7,282 [40.0%]) as the number of radiology-employed NPPs increased by 17.5% (from 588 to 691). Practices were more likely to employ NPPs when medium (odds ratio [OR], 1.31) or large (OR, 1.25) in size, when urban located (OR, 1.35), and as their percentages of interventional radiologists increased (OR, 5.53 per percentage point) (P < .01 for all). Practices were less likely to employ NPPs as mean radiologist years since completing training increased (OR, 0.99 per year; P < .01).ConclusionsEmployment of NPPs by radiology practices has grown considerably in recent years, particularly in larger and urban practices and in those that employ more interventional and early-career radiologists. More work is necessary to better understand how this expanding use of NPPs affects the specialty.