Who’s Overworked and Who’s
Underworked among Radiologists
Academy Health Annual Meeting
June 26-28, 2005
Boston, MA
Cristian Meghea, PhD (cristianm@acr.org)
Jonathan Sunshine, PhD (jonathans@acr.org )
Research Dept., Am. College of Radiology, Reston, VA
Pre-publication information. Please do not cite
1. Context
• Physicians in general
– 1980s and 1990s: predicted excess by 2000
– At present, and in future: shortage, specialists in
particular
• Radiologists in particular
– Past decades: relationship between supply and
demand fluctuated
– A few years ago: severe shortage
– Recently: situation changed, shortage eased (some
indicators even suggest no shortage)
2. Radiologist shortage: long-term trends
Job Listings Per Job Seeker
5
4
3
2
1
0
1990
1992
1994
1996
1998
2000
2002
2004
Year
Number of job listings per job seeker at Professional Bureau Placement
Service of the American College of Radiology during week of annual
meeting of Radiological Society of North America, 1990-2004.
3. This paper…
• Provides an update on the radiologist labor market
• Uses innovative measure for shortage/surplus: the extent
to which physicians wanted more/less work if income
changes proportionately
– real world, physician preference measure for
shortage/surplus
• Want more work = surplus; want less work = shortage
• Uses information on workload in addition to radiologist
counts
4. Data: 2003 Survey of Radiologists
•
American College of Radiology, 2003 Survey of
Radiologists
•
Nationally representative random sample of all
radiologists in the U.S.
•
Question of interest: how does your workload compare
with the desired one
1. Workload OK
2. Want __% less work and proportionately less income
3. Want __% more work and proportionately more
income
5. Method for analyzing shortage/surplus
• Overall (all radiologists): desired change in workload
• By subgroups (by subspecialty, gender, practice type,
and practice location): desired change in workload
• What accounts for the different workload changes
desired by radiologists: multivariate regression analysis
6. Overall shortage/surplus
Want
LESS
work
Work
OK
Want
MORE
work
ALL
Percentage of radiologists
17
67
16
100
Mean weekly hours
54
(0.98)
47
(0.48)
49
(0.88)
49
(0.40)
Mean annual hours
2283
(50.49)
1964
(23.03)
2064
(43.91)
2034
(19.36)
Mean % change sought
21
(0.71)
NA
26
(1.28)
0.59
(0.46)
Mean annual hour change sought
501
(24.69)
NA
546
(33.67)
1.59
(10.90)
7. Overall shortage/surplus
•
Close overall balance supply/demand?
•
Same percentages want less (17%) and more (16%)
work
•
Overall desired percentage change not different than 0
•
Accounting for the hours worked, overall desired
workload change not different than 0
8. Imbalances by subspecialty
Subspecialty
Mean annual hours
Change
sought (hours)
Change sought
(%)
Body
2150
(60)
49
(32)
2.3
Breast
1797
(53)
- 26
(26)
- 1.4
MRI
2048
(84)
27
(53)
1.3
Musculoskeletal
2102
(82)
- 70
(45)
- 3.3
Neuroradiology
2142
(59)
35
(33)
1.6
Nuclear
2107
(78)
46
(47)
2.2
Ultrasound
2033
(90)
26
(72)
1.3
9. Imbalances by subspecialty
•
Imbalances within subspecialties?
•
Each subspecialty: average desired workload
change not different than 0
10. Imbalances, other subgroups
Annual hours
Change sought
(hours)
Change
sought (%)
Academic
2229
(46)
83**
(36)
3.7
Non-acad, government
2013
(108)
246**
(88)
12
Non-acad, private
2094
(26)
- 52**
(15)
- 2.4
Large metro
2038
(25)
22
(17)
1.1
Small metro
2088
(30)
-4
(17)
- 0.2
Non metro
2056
(53)
- 58**
(30)
- 2.8
Women
1859
(42)
-1
(21)
- 0.05
Men
2102
(20)
2
(12)
0.1
11. Imbalances, other subgroups
•
Other factors associated with desire for workload
change?
• Practice type:
• Academic: want to work more (+ 4%)
• Government: want to work more (+ 12%)
• Private: want to work less (- 2%)
• Location:
• Non-metro area: want to work less (- 3%)
12. Desired change in workload
Coefficient
Standard error
Annual hours
-0.09*
0.06
Age 34 and less (vs. 45-54)
168.91**
79.08
Age between 35 and 44 (vs. 45-54)
39.73
32.42
Age between 55 and 64 (vs. 45-54)
-74.73**
37.83
Age 65 and over (vs. 45-54)
-54.23
68.09
Gender: male (vs. female)
59.70*
36.21
Practice is in small metro area (vs. large)
-16.97
30.21
Practice is in non-metro area (vs. large)
-84.10*
45.10
Academic practice (vs. private)
151.51***
51.73
Govt, non-acad. practice (vs. private)
466.82***
159.01
*: p<0.10; **: p<0.05; ***: p<0.01. Full-time radiologists.
13. Desired change in workload
• What accounts for the different workload changes desired
by radiologists
– Hours worked: more hour worked  smaller increase
desired, as expected
– Age: younger radiologists want larger workload
increases
– Location: non-metro radiologists want smaller increase
– Practice type: academic and government radiologists
want larger increase than private radiologists
14. Summary and conclusions
• Overall balance between the demand and supply of
radiologists in 2003
• Within this overall balance
– shortages of private radiologists and of radiologists in
non-metropolitan areas
– surpluses of academic and government radiologists
• Relevance
– Present and projected shortage of physicians, specialists
in particular
– The shortage of radiologists eased in the recent years
– Innovative measure of shortage/surplus broadly
applicable in the health workforce