Study: Radiology subspecialization growing
In carrying out their work, the researchers leveraged CMS Medicare Physician and Other Supplier Public Use Files from 2012 through 2017. Work relative value units (RVUs) associated with radiologists’ billed claims were mapped to subspecialties using the Neiman Imaging Types of Service (NITOS) system to classify radiologists as subspecialists when their RVUs exceeding more than half of their billed work effort in a given subspecialty and those with less than half were classified as generalists. Additional practice characteristics for radiologists’ year of medical school graduation, group practice size and group practice identifiers were also obtained from CMS Physician Compare.
“A range of recent factors could be serving to disrupt the historic balance of these two groups. The growing demand for 24/7 radiology services, increasing volumes, expectations for robust patient access in rural and critical access areas, could all promote more demand for generalist radiologists,” stated Andrew Rosenkrantz, MD, MPA, lead study author, professor and director of health policy in the department of radiology at NYU Grossman School of Medicine and a Neiman Institute affiliate senior research fellow. “On the other hand, the growing complexity of medical care, ongoing consolidation of radiology practices into larger groups, as well as the technical ease of interpreting remotely performed imaging studies could all foster more demand for subspecialists.”
The percentage of radiologists practicing as subspecialists increased from 37% in 2012 and 2013, to almost 45% in 2017. By subspecialty during the study time period, workforce changes were greatest seen in breast, +3.7%; abdominal, +2.4%; and neuroradiology, +1.8%; and a decline in interventional by -1.2%. The degree of increasing subspecialization was greatest seen for female with an increase of 12% and earlier-career radiologists with an increase of 10% and those in larger than 100 member groups with an increase of 7.2%.
“While radiology’s growing subspecialization is a positive change in the advancement of more sophisticated care, the potential impact on patient access from a diminishing supply of general radiologists, particularly in rural communities, is not yet known,” wrote Richard Duszak, MD, FACR, professor of radiology and imaging sciences at Emory University and senior affiliate research fellow at the Neiman Institute.
To obtain a copy of the study, contact Nichole Gay at (703) 648-1665 or ngay@neimanhpi.org.