​​New studies shed light on the future radiologist workforce shortage by projecting future radiologist supply and demand for imaging.

Summary:

New research from the Harvey L. Neiman Health Policy Institute projects that the radiologist shortage in the US will persist through 2055 unless action is taken to expand the workforce or curb imaging demand. The studies, published in the Journal of the American College of Radiology, estimate that the number of radiologists will grow by 25.7% by 2055, but imaging utilization is expected to increase by up to 26.9%, keeping supply and demand roughly balanced. Researchers highlight factors influencing the shortage, including high attrition rates since COVID-19, an aging population driving increased imaging demand, and the need for policy interventions such as increasing residency positions or leveraging AI to improve efficiency.

Key Takeaways:

  • Workforce Growth Won’t Outpace Demand: Without intervention, the number of radiologists is projected to increase by 25.7% by 2055, but imaging demand is expected to rise by up to 26.9%, meaning the shortage will persist.
  • COVID-19 Accelerated Attrition: Since 2020, radiologist workforce attrition has been 50% higher than pre-pandemic levels, highlighting the need for retention strategies and workplace well-being initiatives.
  • Aging Population Driving Increased Imaging Needs: The ≥75 age group—which requires the most imaging—is expected to grow significantly by 2055, further straining radiology services unless measures like AI integration or improved imaging efficiency are implemented.

The current radiologist shortage is projected to persist over the next three decades unless steps are taken to expand the workforce or curb imaging demand, according to companion studies from the Harvey L. Neiman Health Policy Institute published in the Journal of the American College of Radiology.

The objective of these studies, which estimated the future radiologist workforce (supply) and imaging utilization (demand) through 2055, was to inform the policy discussion surrounding the current shortage of radiologists in the United States by projecting what will happen if current conditions persist and quantifying the impact of multiple factors (ie, attrition, residency positions, imaging use per person) on future workforce sufficiency. 

The Association of American Medical Colleges estimated a 4.3% shortage of physicians generally in 2024, with differences across specialty groups, but the extent to which the radiologist shortage will improve or worsen into the future is unknown.

Workforce Growth vs Imaging Demand

The radiologist supply study projected that the number of radiologists will increase 25.7% between 2023 and 2055 if there is no future growth in the number of radiology residency positions. This increase in supply can be compared to results of the companion imaging demand study, which estimated a baseline increase in imaging utilization by 2055 ranging from 16.9% to 26.9%, depending on the imaging modality. These estimates assume current per person imaging utilization persists into the future. 

“Given the comparable projected levels of growth in supply and demand, the present radiologist shortage is projected to persist unless steps are taken to grow the workforce and/or decrease per person imaging utilization,” says Eric Christensen, PhD, research director at the Neiman Institute, in a release. “In other words, the shortage is not projected to get worse, nor will it likely improve in the next three decades without effective action.”

Eric Rubin, MD, ACR Board of Chancellors and chair of the Commission on Human Resources, adds in a release, “The size of the future radiology workforce depends on the difference between new radiologists (based on residency positions) and attrition or retirements of the existing workforce. 

“We designed our study to inform policymakers about the importance of having sufficient residency positions to replace radiologists leaving the workforce, with consideration of the use of imaging per person. Our study shows that each of these factors can have a substantial impact on future supply and demand, both individually and collectively.”

COVID-19’s Lasting Impact on Radiologist Attrition

The workforce supply study revealed that radiologists have left the workforce at a 50% higher rate starting in 2020 with the COVID pandemic.

“These pre-COVID and post-COVID attrition differences are substantial. If attrition rates return to pre-COVID levels, it will equate to 3,116 more radiologists in 2055 compared to our current (post-COVID) trajectory. Hence, monitoring attrition patterns and implementing effective programs to improve workplace well-being, is crucial,” says Elizabeth Rula, PhD, executive director at the Neiman Institute, in a release. “A sustainable workforce will depend on balancing the capacity of the workforce with the demand for imaging.”

Aging Population Driving Higher Imaging Demand

In the companion study of imaging demand trends, the Neiman Institute research team projected future imaging utilization estimates using US secular trends in population growth, age distribution, and insurance mix. They used the Neiman Imaging Comorbidity Index, a validated tool to predict future utilization levels at the patient level, to estimate imaging utilization based on population demographics and disease burden.

“According to the US Census Bureau, the US population will grow 8.2% between 2023 and 2055. This growth is concentrated in older individuals who consume more imaging. The 75-84, 85-94, and ≥95 age groups are projected to increase 51.5%, 149.6%, and 282.1% in size by 2055, respectively,” says Christensen in a release. “Both the projected increase in the number of older individuals and the relative aging of the US population contribute substantially to the projected increased future imaging demand.”

Potential Solutions to Address the Radiologist Shortage

Rula adds, “We hope that estimates of how these factors each influence future imaging rates will benefit policymakers working to ensure sustainable access and affordability of healthcare. Given the strong influence of population demographics on future utilization, we must consider solutions to bend these curves and ensure that outcomes do not deteriorate due to patients not having imaging access, or experiencing long delays

“Our Institute is researching solutions, such as the potential for technology such as artificial intelligence can facilitate greater efficiency, common sources of unnecessary or inappropriate imaging orders. Similarly, the American College of Radiology has already taken action with programs to ensure appropriate imaging use and to facilitate the development of effective AI to assist radiologists in triage and interpretation which, if implemented, will have a substantial impact on addressing the current radiologist shortage.”

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