The Exodus of Radiologists from Large to Small Groups

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Burned out radiologist.

Change is in the Air

The landscape of radiology is experiencing a notable transformation marked by a significant trend of radiologists departing from large radiology groups to join smaller, more independent groups and practices.

At the heart of this movement lies a complex interplay of factors, each contributing to the changing dynamics of the radiology profession and pushing practitioners to reevaluate their career trajectories.  Chief among these driving forces is the rising incidence of burnout. Additionally, the rapid advancement of technology is another major factor. Not only has technology revolutionized diagnostic imaging but new avenues for improving practice management and remote work opportunities are much more prevalent. Finally, new healthcare models have evolved, such as value-based care. Add to that personal, financial, and professional satisfaction and one can begin to understand the shift. But these changes present new challenges and opportunities for today’s radiologists.

Burnout: A Leading Factor

Burnout is probably the number one factor that drives radiologists to smaller groups and practices.  The demanding nature of their job, which includes long work hours, excessive patient volumes, and the psychological strain associated with interpreting complex medical images, can lead to feelings of exhaustion and dissatisfaction. Many radiologists find themselves overwhelmed by the pressures of their roles.

In contrast, smaller radiology groups frequently provide a more relaxed and supportive work environment. This allows radiologists to achieve a better work-life balance.  Plus, smaller practices tend to have fewer administrative burdens. This enables radiologists to dedicate more time to patient care, which ultimately leads to improved job satisfaction.

Technological Advancements

Technological advancements like cloud computing, the growth of artificial intelligence (AI), new advanced workflow orchestration and reporting solutions that incorporate AI, are all reducing the burden for today’s radiologists by allowing them to work faster and more efficiently with greater accuracy.  However, even with these impressive advancements, feelings of job insecurity and anxiety can still affect radiologists’ mental well-being, as many worry that they will be replaced by machines (although that scenario is highly unlikely).

Larger radiology practices may have the financial ability to invest in new technologies but are often heavily invested in long-term arrangements with early vendors they partnered with.  This may lead to spending less on new technology adoption, often staying with solutions offered by their preferred partners.  Smaller groups often do not carry legacy relationships, making technology adoption much more agile. 

Changing Healthcare Landscape

The shift towards value-based and patient centric care models, as well as population health management initiatives has introduced new challenges (such as increased pressures to reduce costs and improve overall efficiency) for radiology groups and may have a bearing on their desire to join smaller groups. Smaller practices may be better equipped to navigate these on-going changes, as they typically possess more flexibility to tailor their services to meet the specific needs of their communities. This adaptability can lead to improved patient outcomes and greater satisfaction for both patients and providers.

Financial Considerations and Professional Satisfaction

It may seem counterintuitive but smaller organizations may offer higher earning potential for radiologists.  Besides competitive salaries, providing a “skin in the game” financial approach, these smaller organizations provide a financial stake in the business as it begins to grow and this offers a better correlation between work effort and financial rewards.

Smaller organizations may also be more open to pursuing new revenue opportunities while expanding the services they offer.  Using profits from these new ventures may be used to invest in new cutting-edge technology or new service lines.  Furthermore, physicians in smaller practices often have a personal stake in the overall growth of the group, providing them with a vote in new avenues the business is taking.  This helps to improve their overall satisfaction with the company they work for and encourages creative contributions to elevate their group competitively.

Professional satisfaction derives from more autonomy the members are often afforded in smaller groups.  Instead of adhering to strict rules implemented to provide consistency and scale, the desire to provide more personalized clinical decision-making while implementing best practices with fewer constraints is rewarding to many radiologists.  Better work life balance, improved care teams, reduced administrative burdens, and flexible work options all lead to higher professional satisfaction that smaller groups often provide.

Changing Market Dynamics

Radiology has evolved from a fee-for-service model to new care models like value-based care, opening the door for radiologists to expand their professional duties.  Radiologists are becoming more focused on being the “physician consultants”, or the doctor’s doctor.  Increasing consultations decreases the time radiologists have for reading new studies.  But providing clinical consultations improves their value to healthcare organizations and leads to better patient outcomes.  When radiologists are part of a patient’s clinical care team, better collaboration results in better care pathways, further improving patient outcomes. 

As these shifts continue, the need for even more subspecialty expertise and adaptive care models will continue to grow, making the smaller practice more agile to champion and adopt these changes.

Weighing the Pros and Cons

While the trend towards smaller radiology groups is gaining momentum, it is essential to recognize that there are still advantages to working within a large group. Benefits like access to advanced technology, greater financial stability, and opportunities for specialization are just a few reasons some radiologists will choose to stay with larger groups. Large groups often have more resources to invest in cutting-edge equipment and provide comprehensive training. However, many radiologists may still desire more autonomy and personal stake in their group, driving them to leave the large groups in favor of a more fulfilling and rewarding career at a smaller group.

What Do You Think?

The exodus of radiologists from large groups to smaller practices is a multifaceted phenomenon driven by a multitude of reasons, as mentioned in this blog.  Smaller practices may offer a more supportive work environment, greater autonomy, and the flexibility to adapt to new challenges, while large groups provide financial stability, valuable resources and opportunities for growth.  The appeal of smaller, independent practices is becoming increasingly attractive to radiologists seeking a more balanced and satisfying professional life. As this trend continues, it will be interesting to observe how the dynamics of radiology continues to evolve and how both large and small groups adapt to meet the needs of their practitioners and patients alike.

InsiteOne Provides the Foundation

InsiteOne has evolved as a vendor that supports the workflow and technology needs of smaller radiology practices.  By offering a comprehensive, yet cost effective suite of workflow solutions, InsiteOne is paving the way to help this new breed of smaller radiology practices grow and flourish.

Our cutting edge, cloud-native PACS and RIS are designed for imaging centers and high throughput teleradiology practices, while adding our comprehensive suite of partner solutions (such as a radiologist digital cockpit by NewVue, advanced AI reporting tools from RADPAIR, and revenue cycle solutions from Imagine Software). The combination of these cutting edge and customizable solutions work together to drive greater efficiency, speed, and accuracy like never before. Even better – we do this at a cost that makes sense for the smaller group or practice. 

As your organization continues to evolve, consider speaking with our expert consultants at InsiteOne.  We’re here to help you plan and design the right future-proof technology infrastructure to propel your business forward, streamline your operations, and give you the necessary tools to elevate patient care.

How Technology can Help Ease Radiologist Workloads

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Tired doctor sitting in hospital corridor.
Tired doctor sitting in hospital corridor.

The Looming Healthcare Crisis

The healthcare industry is facing a significant challenge: a growing shortage of physicians and, specifically for this blog, radiologists.  Although hard to pinpoint, there are several converging factors that have worsened this issue:

  1. An aging population in need of medical care
  2. Fewer people entering the field of radiology
  3. Radiologists leaving the profession due to retirement or career changes
  4. Continued reduction in insurance and Medicare reimbursements

Compounding this problem is a broader shortage of radiology staff.  With fewer programs offering radiologic technology degrees and professionals who left the workforce during the COVID-19 pandemic, staffing continues to be a challenge for many organizations. 

According to the 2023 ASRT Staffing Survey, the average vacancy rates have increased from 6.2% in 2021 to 18.1% in 2023.    Furthermore, according to The Complexities of Physician Supply and Demand: Projections From 2019 to 2034, a report released by the Association of American Medical Colleges (AAMC), by 2034, we may see physician shortages significantly increase:

  • Between 17,800 and 48,000 primary care physicians
  • Between 21,000 and 77,100 non-primary care physicians

These shortages threaten patient care, particularly in rural and underserved areas. While there’s no single solution, we must explore various approaches to mitigate this crisis and maintain high-quality healthcare delivery. 

Economic Solutions to Address Staffing Shortages

Becoming a licenses physician is a lengthy and expensive process, often leaving new doctors with significant debt (often exceeding $250,000). 

Although the salaries are higher for sub-specialty careers, primary care physicians’ salaries are generally lower than their sub-specialty counterparts.  Regardless, Time Magazine mentioned a few economic suggestions that could be considered to better support young people to choose a medical career:

  1. Develop increased funding to help offset the steep costs of attending medical school.  Funding can be at the federal level or even provided by various healthcare systems to lure new students into the profession.
  2. Provide some form of debt relief to those who complete medical school.  Although some of these programs could be federal or state funded, hospitals providing debt relief in lieu of employment guarantees offer interesting alternatives.
  3. Increase focus on multispecialty care groups.  Spreading care across experts in a care team could help improve patient outcomes faster while lowering healthcare costs.
  4. Reduce the required paperwork burden.  Not only do physicians have to cope with busy patient schedules, but they must also contend with significant paperwork burdens. 

Additionally, the following suggestions are further areas of consideration for the short term:

  1. Hiring part-time retired radiologists.
  2. Consider adding a slight bit more time to part-time radiologists per month.
  3. Provide reading room assistants to off-load other burdens from radiologists so they can focus on reading studies.
  4. Provide more funding for radiology assistances to assist in reading studies and performing procedures traditionally performed by radiologists.

Although not an exhaustive list, the above options could appeal to students as they consider their career options, which over time could begin to lessen the burden of those already practicing in their respective fields today.

Technology Considerations to Improve Clinical Workflows

While technology can benefit various medical specialties, this blog will focus on how technology can reduce their workload burdens, while elevating care, as they relate to the field of radiology.

According to a recent article in Radiology Business, are technologies that could help address the radiologist shortage we’re experiencing today.

Teleradiology Solutions

Teleradiology solutions may be one of the biggest drivers to reduce workload burdens radiologists face today. 

  • Studies can be matched to radiologist specialties and expertise, which can improve care quality and clinical outcomes.   
  • 24×7 coverage – Teleradiology can provide around the clock coverage and continue care continuity.  Exams are performed and exported to radiologists working after hours to provide reports any time of day, reducing the time it takes for reports to be generated and providing after hours relief to staff radiologists.
  • Support for rural hospitals: Rural hospitals struggle to attract and retain radiologists, where teleradiology can provide specialist expertise over a wider geographical area.  By serving small hospitals, teleradiologists can provide guidance, clinical consultations, and reading services to underserved facilities, providing patients with better care.
  • Cost-effective care: Teleradiology can reduce the cost of care by providing off-site radiology reading services at a lower rate, all while maintaining a high level of patient care.

Artificial Intelligence Solutions (AI)

Contrary to earlier concerns, Artificial Intelligence (AI) have not replaced radiologists.  As Health Imaging reports, there are about 950 AI applications approved for clinical use, with 723 or 70%, specific for radiology.  AI solutions help augment the workload radiologists perform, improving productivity, reducing the cost of care, and providing improved work balance for busy radiologists.

While reimbursements for many AI algorithms remains to be a challenge, radiology professionals continue to be optimistic that as these tools continue to evolve and prove their benefits, reimbursements will follow. 

AI has the potential to improve screening study workloads, often the bulk of some providers’ workload.  With accuracy rates approaching experienced radiologists, AI can filter out routine studies and alert radiologists to exams that need immediate attention., significantly improving day-to-day workflow.

Finally, other useful operational applications for AI in radiology include scanning reports and alert providers that follow-up is necessary, while tracking those follow-ups which saves radiologists valuable time and ensures patient’s receive proper care.  Areas like study protocoling, automated workload balancing, patient schedule management, and reducing clinical errors during exam reporting, are other areas where AI promised to offer a big impact.

Image Sharing

Image sharing continues to be a challenge.  Repeating studies is an unnecessary cost that can be avoided if comparison studies are readily available.  Image sharing can help reduce repeated studies, which also reduces radiation exposure for the patient.  Image sharing technology can allow facilities or patients to provide their imaging exams at different facilities prior to their follow-up care.  Historical studies provide radiologists with more information about the patient, which can improve follow-up care, resulting in better patient outcomes.

Cloud Technology

An article in Radiology Business, suggests moving your imaging infrastructure to the cloud offers multifaceted advantages to on-premises configurations.  Freeing up physical space previously occupied by on-premises servers is one key advantage, as that space can be repurposed or other critical needs.  Additionally, air conditioning and electrical cost savings can help out, while redirecting IT staff to other strategic initiatives provides another key benefit.

As cybersecurity concerns grow, cloud solutions provide relief by offloading those responsibilities to their cloud/imaging IT vendor.  Since many organizations lack the expertise to maintain 24×7 cybersecurity measures, relying on your cloud provider to handle this protection is a nice advantage. 

If you’re not 100% ready to commit to full cloud operations, hybrid configurations provide the best of both worlds.  A small on-premises IT footprint allows organizations to take advantage of cloud technology while balancing the need of providing enhanced care continuity in case of internet outages or other disruptions. 

InsiteOne is Here to Help!

New technology is one short-term strategy to improve radiologist shortages.  Offering one of the original cloud-based image storage solution, InsiteOne provides the solutions discussed in this blog which can provide a bit impact on improving radiology workflows. 

InsiteOne’s innovative PACS/RIS solutions offer tools to improve radiologist and staff productivity.  Our advanced teleradiology solutions can help teleradiologists be more productive with a world-class digital cockpit.  By ensuring the right exam lands with the best matched radiologist, time and higher quality reads can be ensured, which improves patient outcomes.  With significant integration capabilities, plugging in clinical and operational AI tools provide your organization with an integration platform that grows and adapts based on your future needs.  Finally, we make it easy for patients and organizations to share studies, which can improve care and reduce repeating unnecessary exams. 

InsiteOne offers our solutions as cloud, hybrid, or on-premises configurations to suit your organization’s needs.  Our extensive expertise as a dedicated healthcare cloud provider, ensures we provide the highest level of customer satisfaction possible, while facilitating cross-team collaboration and easy access to patient studies from anywhere, at any time.

Next Steps

As staff shortages in healthcare continue to evolve, the role of technology will continue to make an impact on improving productivity while maintaining – and even improving – patient care.  By working with InsiteOne, your healthcare organization can feel confident your technology investment is future-proofed and emerging technologies can be easily integrated to accommodate new workflows.

Reach out to us at InsiteOne to begin your consultation with our team on ways you can use technology to reduce staff burdens and improve your operational workflows.