JACR® April Highlights
2018 ACR Commission on Human Resources Workforce Survey
Three-hundred and sixty-seven practice leaders, who collectively represent 30 percent of all practicing radiologists, responded to this year’s annual survey regarding makeup of the current workforce and plans for future hiring. The number of groups represented in the survey decreased by over 200 — from 1,811 to 1,588 — consistent with increasing consolidation. Overall, results were positive for radiologists preparing to enter the job market — with no statistical difference between 2017 projections and actual number of hirings. Similar projections hold for 2018, with 1,393 and 1,808 new job openings anticipated. The subspecialties in highest demand are breast imaging, neuroradiology, and IR. There has been a steady decrease since 2012 in the number of general radiologists, from 35.2 percent to 8.6 percent. There continues to be a trend towards radiologists working part-time — with eighteen percent of practices reporting radiologists changing from full-time to part-time.
The Resilient Radiologist: You Will Still Feel the Burn
Until the underlying causes of burnout can be adequately addressed in our broader healthcare system, radiologists should consider using practical strategies to reduce burnout and improve resilience. Solutions focusing on adaptability may help improve workflow and can address workplace “quality of life” issues. These include hiring reading room assistants to help filter phone calls or establishing specific consultation times to compartmentalize cognitive tasks. Finding other ways to establish structure within the workflow and taking frequent breaks within the established structure will maintain focus and improve endurance. However, it is worth remembering that resilience is not the antidote for burnout. That only comes from identifying and addressing the greater systemic issues that lead to physician burnout.
Racial and Ethnic Disparities in Radiology: A Call to Action
Despite controlling for socioeconomic status, insurance plans, comorbidities, and other cofounders, medical literature has suggested that minorities often receive lower quality of care. Disparities in care were estimated to have cost Americans $1.24 trillion from 2003 to 2006. Such disparities in care easily compound themselves due to poorer outcomes, decreased adherence, and low patient satisfaction. As radiologists, our practices are not exempt from these disparities. Achieving more equitable care is not only a moral imperative and necessary to improve patient outcomes, it is also becoming more essential in the setting of rising healthcare costs. Steps must be taken to address social determinants of health, create appropriate clinical outreach programs, and diversify the radiology workforce.
Relationships Between Healthcare Disparities and Coverage Policies for Breast, Colon, and Lung Cancer Screening
Mortality rates for cancer patients from underrepresented minorities (URMs) and lower income patients are demonstrably higher than those of other patient populations. This disparity can be exacerbated due to differences in access to routine cancer screenings. There are potential steps from a policy standpoint that CMS and the USPSTF could undertake to address these disparities. Options include extending evidence base to studies involving more high-risk groups, lowering age thresholds, approving CT colonography coverage, streamlining guidelines, and supporting research on improving access and navigation of healthcare services for URMs. Ultimately, improved screening compliance has the potential to save lives, reduce disparities, and streamline cancer care in the United States.