Who’s Overworked and Who’s Underworked among Radiologists

2. Who’s Overworked and Who’s Underworked among Radiologists Academy Health Annual Meeting June 26-28, 2005 Boston, MA Cristian Meghea, PhD (cristianm@acr.org) Jonathan Sunshine, PhD (jonathans@acr.org ) Research Dept., Am. College of Radiology, Reston, VA Pre-publication information. Please do not cite

3. 1. Context • Physicians in general • 1980s and 1990s: predicted excess by 2000 • At present, and in future: shortage, specialists in particular • Radiologists in particular • Past decades: relationship between supply and demand fluctuated • A few years ago: severe shortage • Recently: situation changed, shortage eased(some indicators even suggest no shortage)

4. 2. Radiologist shortage: long-term trends Number of job listings per job seeker at Professional Bureau Placement Service of the American College of Radiology during week of annual meeting of Radiological Society of North America, 1990-2004.

5. 3. This paper… • Provides an update on the radiologist labor market • Uses innovative measure for shortage/surplus: the extent to which physicians wanted more/less work if income changes proportionately • real world, physician preference measure for shortage/surplus • Want more work = surplus; want less work = shortage • Uses information on workload in addition to radiologist counts

6. 4. Data: 2003 Survey of Radiologists • American College of Radiology, 2003 Survey of Radiologists • Nationally representative random sample of all radiologists in the U.S. • Question of interest: how does your workload compare with the desired one • Workload OK • Want __% less work and proportionately less income • Want __% more work and proportionately more income

7. 5. Method for analyzing shortage/surplus • Overall (all radiologists): desired change in workload • By subgroups (by subspecialty, gender, practice type, and practice location): desired change in workload • What accounts for the different workload changes desired by radiologists: multivariate regression analysis

8. 6. Overall shortage/surplus

9. 7. Overall shortage/surplus • Close overall balance supply/demand? • Same percentages want less (17%) and more (16%) work • Overall desired percentage change not different than 0 • Accounting for the hours worked, overall desired workload change not different than 0

10. 8. Imbalances by subspecialty

11. 9. Imbalances by subspecialty • Imbalances within subspecialties? • Each subspecialty: average desired workload change not different than 0

12. 10. Imbalances, other subgroups

13. 11. Imbalances, other subgroups • Other factors associated with desire for workload change? • Practice type: • Academic: want to work more (+ 4%) • Government: want to work more (+ 12%) • Private: want to work less (- 2%) • Location: • Non-metro area: want to work less (- 3%)

14. 12. Desired change in workload *: p<0.10; **: p<0.05; ***: p<0.01. Full-time radiologists.

15. 13. Desired change in workload • What accounts for the different workload changes desired by radiologists • Hours worked: more hour worked  smaller increase desired, as expected • Age: younger radiologists want larger workload increases • Location: non-metro radiologists want smaller increase • Practice type: academic and government radiologists want larger increase than private radiologists

16. 14. Summary and conclusions • Overall balance between the demand and supply of radiologists in 2003 • Within this overall balance • shortages of private radiologists and of radiologists in non-metropolitan areas • surpluses of academic and government radiologists • Relevance • Present and projected shortage of physicians, specialists in particular • The shortage of radiologists eased in the recent years • Innovative measure of shortage/surplus broadly applicable in the health workforce