Research indicates the percentage of radiologists performing interventional procedures has declined as the field moves toward a specialized clinical model.
The proportion of radiologists performing no interventional radiology (IR)-related work increased from one-third in 2008 to one-half in 2023, according to a national Medicare analysis.
The analysis, published in the Journal of Vascular and Interventional Radiology by the Harvey L. Neiman Health Policy Institute in collaboration with IR experts, found that among radiologists who do perform interventional tasks, the work is becoming increasingly concentrated. The percentage of radiologists whose workload consists of a majority of interventional work grew from 12.6% in 2008 to 18.5% in 2023. The research was conducted by the Harvey L Neiman Health Policy Institute and involved an analysis of 46,533 radiologists.
“The percentage of radiologists doing some IR-related work fell from 66.9% in 2008 to 49.6% in 2023. Accordingly, radiologists who practiced IR in 2023 typically performed proportionally more IR-related work compared with those who practiced IR in 2008,” says Eric Christensen, PhD, research director at the Neiman Institute and study senior author, in a release.
Christensen notes that the percentage of specialists with a super-majority of interventional work—defined as more than 90% of their total workload—more than doubled during the study period, rising from 4.1% to 8.8% of all radiologists.
Shifting Toward a Clinical Specialty
The findings coincide with the evolution of the field from a procedural component of diagnostic radiology into a clinical specialty providing minimally invasive, image-guided therapies. Luke Wilkins, MD, professor of vascular and IR at the University of Virginia and study lead author, says the 2016 introduction of integrated residency positions for interventional and diagnostic radiology was a major milestone that likely contributed to the current distribution of work.
“Since IR’s formal recognition as a specialty, the optimal practice model for interventional radiologists has remained debated. Much of this discussion centers on whether IR should function as an independent specialty or remain integrated within general radiology departments,” says Wilkins in a release.
The data show consistent shifts across various practice environments, including different levels of urbanicity, academic status, practice type, and practice size. While academic practices maintained higher absolute levels of interventional work, relative growth in super-majority workloads was also seen in non-academic settings, smaller practices, and multi-specialty practices.
Age and Practice Trends
In 2023, younger radiologists between the ages of 25 and 34 were more likely to have a majority interventional workload compared to radiologists aged 65 and older. Specifically, 24.7% of the younger cohort had majority interventional work, while only 11.9% of the older cohort met that threshold. However, the increase in super-majority work was steeper among older radiologists during the 15-year period.
Despite the trend toward specialization, many professionals continue to work in mixed roles. Wilkins suggests that the flexibility to practice both diagnostic radiology (DR) and IR remains necessary across different clinical settings.
“The integrated IR/DR pathway was intentionally designed to preserve dual competency in imaging interpretation and procedural expertise. The study’s results suggest that this flexibility remains necessary as a substantial portion of radiologists performing IR-related work continued to practice in mixed IR/DR roles, even in the youngest cohort,” says Wilkins in a release.
