Academic Radiology and Doctor Discontent: The Good News and the Bad News

Abstract

“Many American doctors are unhappy with the quality of their professional lives” (1). Physicians in all specialties are frustrated by outside forces that interfere with their ability to deliver ideal medical care. Managed care and other forces have decreased their income, and, perhaps because of these forces, disability claims among physicians have escalated (1). There are increased workloads and falling levels of reimbursement coupled with intrusive paperwork and increasing pressures from managed care organizations, licensing agencies, and government entities. The malpractice environment continues to be unpleasant for physicians. Academic physicians are not immune from these stresses. The academic physician is caught between the demands of the marketplace and the demands of providing quality teaching and research. Recent surveys have shown that the workload per radiologist has increased substantially in the past decade (2,3). Private, nonacademic, non-multispecialty practice radiologists perform an average of 12,300 procedures per year (3). Academic radiologists perform an average of 8,000 procedures per year. The average workload for all radiologists has increased 13% between 1991–1992 and 1995–1996 (3). Academic radiologists average less time away from work than full-time nonacademic radiologists in group practice (2). Academic radiologists have, on average, less vacation time and less sick time, but they and nonacademic radiologists have a similar number of days away from work for continuing medical education and professional meetings (2,3). While academic radiologists have a smaller average workload than other radiologists, their workweek is as long as, if not longer than, that of other radiologists. The American College of Radiology (ACR) 1995 survey of radiologists showed that full-time posttraining radiologists reported working, on average, 50 hours per week and 5.l days per week, while academic radiologists reported working, on average, 53 hours per week and 5.3 days per week (2). The perception of radiologists in our own university department and that of our colleagues in other academic radiology departments is that conditions have deteriorated considerably in the past decade. Many believe that academic time is disappearing, salaries are decreasing, and clinical workloads are increasing. To gauge the accuracy of these perceptions, we sent a simple one-page questionnaire to all members of the Association of University Radiologists in which we asked about the quality of their academic lives. We informally looked at such issues as clinical workloads, the amount of academic time, the amount of managed care, and one’s perception of his or her academic productivity today compared with that 5 years ago. We sent out 1,200 surveys and received responses from 521 individuals (43%) at 188 institutions. In this editorial we refer to the survey only in the context of examining our thesis that there is at present a good news/ bad news environment for the academic radiologist. The radiologists in our department are expected to perform clinical work 4 full days per week, and they receive 1 academic day per week free from clinical duties. While we perceive of this as not being conducive for good acaAcad Radiol 2001; 8:509–511