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Study finds majority of U.S. radiologists practice as generalists

by John W. Mitchell, Senior Correspondent | April 16, 2018
Business Affairs X-Ray
Until recently, the makeup of the U.S. radiology workforce was, at best, an educated guess. But a just-published study online by Radiology using insurance claims data has put a specific number on practice patterns: some 55.3 percent of U.S. radiologists practice predominantly as generalists.

“There’s a lack of objective data about the subspecialization of the national radiologist workforce. It’s largely been done with surveys and opinion, with no consistent definition of what is a generalist or a subspecialist,” Andrew B. Rosenkrantz, M.D., professor, director of Health Policy at New York University Langone Health, and one of the researchers, told HCB News. “So, we did this to take a transparent, reproducible and objective approach.”

According to Rosenkrantz, there has been as an emphasis in recent years on how more radiologists are becoming subspecialists, but the study found a little more than half of radiologists are generalists. According to the study, a generalist was defined as a radiologist who dedicated less than 36 percent of their practice to any one subspecialty.
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The study findings were based on an analysis of 33,090 radiologists who billed for professional services between 2012 and 2014. In the database, the radiologists relied on a validated classification system to assign relative value units (RVUs) to seven subspecialties. Radiologists who billed more than half of their work in subspecialty areas were defined as subspecialists.

“We can’t lose sight of the preponderance of generalist radiologists. They are still important and vital in today’s radiologist workforce market,” said Rosenkrantz. ”I think radiologists in training can be aware of these findings. We highlighted a large number of trends related to the radiologist workforce that, to our knowledge, have not been previously highlighted.”

The study found that academic status, group practice size, geographic location of a practice and years in practice can determine which career track a radiologist follows. For example, the study revealed that nuclear medicine physicians tend to have more years in practice, while cardiac-thoracic imaging specialists tend to specialize earlier in their careers.

The six leading radiology subspecialties, according to the billing data, are neuroradiology, breast, abdominal, vascular and interventional, musculoskeletal and nuclear medicine.

“Some of (the findings) may challenge previously held views, as we’ve built this as a model to use claims data to look at radiologists,” said Rosenkrantz.

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