The U.S. Radiologist Workforce: An Analysis of Temporal and Geographic Variation by Using Large National Datasets

Abstract

To determine recent trends related to temporal as well as national and statewide geographic variation in the U.S. radiologist and radiology resident workforce. This retrospective HIPAA-compliant study was exempted from the internal review board. Federal Area Health Resources Files and Medicare 5% research identifiable files were used to compute parameters related to the radiologist workforce. Geographic variation and annual temporal trends were analyzed. Pearson and Spearman correlations were assessed. Nationally, the number of radiology trainees increased 84.2% from a nadir in 1997 (3080 trainees) to 2011 (5674 trainees) and showed high state-to-state variation (range, 0-678 trainees in 2011). However, total radiologists nationally increased 39.2% from 1995 (27 906 radiologists) to 2011 (38 875 radiologists), and radiologists per 100 000 population nationally increased by 7.5% from 1995 (10.62%) to 2011 (11.42%), while showing high state-to-state variation (highest-to-lowest state ratio of 4.3). Radiologists' share of the overall physician workforce declined nationally by 8.8% from 1995 (4.0%) to 2011 (3.7%), with moderate state-to-state variation (highest-to-lowest state ratio of 1.7). Radiology trainee numbers exhibited weak-to-moderate positive state-by-state correlation with radiologists per 100 000 population (r = 0.292-0.532), but moderate-to-strong inverse correlation with the percentage of radiologists in rural practice (r = -0.464 to -0.635). Although the number of radiology trainees dramatically increased, radiologists per 100 000 population increased only slightly, and radiologists' share of the overall physician workforce declined. State-to-state variations in radiologist and radiology resident workforces are high, which suggests a potential role for geographic redistribution rather than changes in the overall workforce size.