Workload of radiologists in United States in 2006-2007 and trends since 1991-1992.

PURPOSE: To determine radiologists' workloads in 2006-2007, as measured by both procedures per full-time equivalent (FTE) radiologist and relative value units (RVUs) per FTE radiologist, and to discover trends since 1991-1992. MATERIALS AND METHODS: Non-individually identifiable data from the American College of Radiology (ACR) 2007 Survey of Radiologists were compared with data from previous ACR surveys; all surveys were weighted to make them nationally representative. Under National Institutes of Health rules for protection of human subjects, studies based on anonymized surveys do not require approval by an institutional review board. Workload according to individual practice characteristics, such as type (eg, academic, private, multispecialty) and setting, was tested for statistically significant differences from the average for all radiologists. Time trends and the independent effect on workload of practice characteristics were measured with regression analyses. Changes in average procedure complexity were calculated in physician work RVUs per Medicare procedure. RESULTS: In 2006-2007, the average annual workload per FTE radiologist was 14,900 procedures, an increase of 7% since 2002-2003 and 34.0% since 1991-1992. Annual RVUs per FTE radiologist were 10 200, an increase of 10% since 2002-2003 and 70.3% since 1991-1992. Academic practices performed about one-third fewer procedures per FTE radiologist than others. In most types of practice, radiologists in a 75th-percentile practice performed at least 65% more procedures annually than radiologists in a 25th-percentile practice. Regression analysis showed that practices that used external off-hours teleradiology services performed 27% more procedures than otherwise similar practices that did not use these services. CONCLUSION: Radiologists' workload continued to increase in recent years. Because there is much unexplained variation, averages or medians should not be used as norms. However, such statistics can help practices to understand how they compare with other, similar practices. SUPPLEMENTAL MATERIAL: http://radiology.rsnajnls.org/cgi/content/full/2522081895/DC1.

The growing size of radiology practices.

PURPOSE: To describe trends in the size of radiology practices from 1990 to 2007. METHODS: Data from the American College of Radiology's 1990, 1995, 2000, and 2003 surveys of radiologists and radiation oncologists and its 2007 survey of radiologist members are compiled to describe the changing distribution of radiologists by practice size over time. All estimates are weighted to be representative of all radiologists in the United States. RESULTS: The fraction of radiologists in small practices (1-4 radiologists) decreased from 29% in 1990 to 22% in 2007. The fraction in medium-sized practices (5-14 radiologists) decreased from 51% in 1990 to 38% in 2007. The fraction in practices with 15 to 29 radiologists increased from 14% in 1990 to 21% in 1995 and has since remained constant. The fraction in practices with 30 or more radiologists grew from 5% in 1990 to 19% in 2007, but since 2000, growth among these practices has largely been limited to practices with 60 or more radiologists. The median radiologist was in a 7-radiologist practice in 1990. This size increased to 11 in 2000 and was the same in 2007. The size of a practice at the 90th percentile of radiologists increased from 22 in 1990 to 45 in 2007. CONCLUSION: Radiology practices grew in size throughout the 1990 to 2007 period. In general, changes were more rapid in 1990 to 2000 than since. The most conspicuous growth was in practices with 30 radiologists or more. This category almost quadrupled its share of radiologists. In contrast, the share of very small practices (1-4 radiologists) declined relatively little, by only approximately one-fourth.

A portrait of interventional radiologists in the United States.

OBJECTIVE: In recognition of the emergence of interventional radiology as an important "new component of...radiology," the objective of our study was to provide an extensive and detailed portrait of interventional radiologists, their professional activities, and the practices in which they work. MATERIALS AND METHODS: We tabulated data from the American College of Radiology's 2003 Survey of Radiologists, a stratified random-sample survey that oversampled interventionalists and achieved a 63% response rate with a total of 1,924 responses. Responses were weighted to make them representative of all radiologists in the United States. We compared information about interventionalists with that for other radiologists. RESULTS: Depending on the definition of who is an interventionalist, 8.5-11.5% of radiologists are interventionalists. By most definitions, only slightly under half of interventionalists spend 70% or more of their clinical work time performing interventional procedures. Interventionalists work, on average, 56-58 hr weekly, a few hours longer than other radiologists. The average interventionalist performs procedures in five of the seven categories of procedures into which we divided interventional radiology, compared with one or two categories for other radiologists. The average interventionalist performs procedures in five of the seven broad categories (such as MRI, CT, and nuclear medicine) into which we divided all of radiology, much the same breadth of practice as other subspecialists and also as nonsubspecialists. CONCLUSION: Interventionalists have become a sizable group within radiology. They are in some ways like other radiologists and in other ways different, but they do not spend as much of their time in their subspecialty as some assume and, overall, are not as different.