Researchers report radiologists were more likely to subspecialize after a practice closure, a trend that may reshape workforce dynamics and widen rural-urban disparities.
A new study from the Harvey L. Neiman Health Policy Institute found that radiologists who experienced closure of their practice were 10% more likely to subsequently practice as a subspecialist (ie, majority practice in one area—abdomen, breast, cardiothoracic, musculoskeletal, neuroradiology, nuclear medicine, or vascular and interventional radiology).
The study, published in the Journal of the American College of Radiology, was based on nearly 240,000 radiologist-years between 2014 and 2021. The study highlights how practice consolidation and subspecialization trends are not isolated but related.
“Recent studies have shown that an increasing percentage of radiologists are practicing as subspecialists versus generalists, and that practices with radiologists are consolidating into larger practices that are often multispecialty versus radiology-only,” says Eric Christensen, PhD, research director at the Neiman Institute and lead author of the study. “Given these trends, we studied whether these two trends were related. Specifically, if practice closure independently predicts increased subspecialization.”
Elizabeth Rula, PhD, executive director of the Neiman Institute, adds in a release, “We found that radiologists were 10% more likely to practice as a subspecialist after their practice closed. This increase in subspecialization is above and beyond the 21% higher likelihood of subspecialization among all radiologists that occurred between 2014 and 2021, during which time the percentage of subspecialists rose from 45.6% to 57.0%.”
The study found that subspecialization trends differ by setting. Radiologists in practices with at least one rural site were 29% less likely than those in practices without rural sites to practice as a subspecialists in the following year.
“Growing subspecialization in medicine has the benefit of advanced expertise for complex care, but it can also cause access challenges for care across more common clinical needs. The increasing trend toward practice consolidation may inadvertently affect the distribution of subspecialization in the field of radiology. In particular, we observed a rural/urban difference in subspecialization trends that could result in discrepancies in access to specialized care,” says Rula in a release. “Our work to understand how subspecialization intersects with other market and geographic factors is important to prepare the workforce and practices to meet the increasing demands for radiologic care.”
