Workload of radiologists in United States in 2006-2007 and trends since 1991-1992

Purpose: To determine radiologists' workloads in 2006-2007, as measured by both procedures per full-time equivalent (FTE) radiologist and relative value units (RVUs) per FTE radiologist, and to discover trends since 1991-1992. Materials and Methods: Non-individually identifiable data from the American College of Radiology (ACR) 2007 Survey of Radiologists were compared with data from previous ACR surveys; all surveys were weighted to make them nationally representative. Under National Institutes of Health rules for protection of human subjects, studies based on anonymized surveys do not require approval by an institutional review board. Workload according to individual practice characteristics, such as type (eg, academic, private, multispecialty) and setting, was tested for statistically significant differences from the average for all radiologists. Time trends and the independent effect on workload of practice characteristics were measured with regression analyses. Changes in average procedure complexity were calculated in physician work RVUs per Medicare procedure. Results: In 2006-2007, the average annual workload per FTE radiologist was 14 900 procedures, an increase of 7% since 2002-2003 and 34.0% since 1991-1992. Annual RVUs per FTE radiologist were 10 200, an increase of 10% since 2002-2003 and 70.3% since 1991-1992. Academic practices performed about one-third fewer procedures per FTE radiologist than others. In most types of practice, radiologists in a 75th-percentile practice performed at least 65% more procedures annually than radiologists in a 25th-percentile practice. Regression analysis showed that practices that used external off-hours teleradiology services performed 27% more procedures than otherwise similar practices that did not use these services. Conclusion: Radiologists' workload continued to increase in recent years. Because there is much unexplained variation, averages or medians should not be used as norms. However, such statistics can help practices to understand how they compare with other, similar practices.