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What radiology practitioners must be aware of to correct the market-wide capacity imbalance

The demand for imaging studies is expected to continue to increase for the foreseeable future. However, the number of radiologists on hand to perform those studies will remain relatively flat, and potentially decline. This is creating a market-wide capacity imbalance that is straining performance across radiology.

Teleradiology is playing a critical and expanding role for hospitals and practices as they strive to manage increased study volumes while maintaining high standards of care.

Imaging demand growth

A number of factors are contributing to the increasing demand for diagnostic imaging studies.

  • Aging population. As people get older, they require more frequent medical attention – including imaging. The last of the baby boomers will reach retirement age in the next 10 years; at the same time Americans in general are living longer. Between 2020 and 2030 alone, the number of people over 65 is projected to increase by almost 18 million and comprise 21% of the U.S. population, up from 15% in 2014. By 2060, nearly ¼ of the population will be over 65. [Source: Population Reference Bureau analysis of U.S. Census Bureau data.]
  • Rising ED volumes. Advanced CT and MRI procedures have become more accessible to both hospital and freestanding emergency departments, driving significant increases in their use and, therefore, requests for diagnostic imaging studies. Advisory Board reports that “ED volumes show strong growth, posing challenges related to capacity and appropriateness.”
  • Same-site volume up. In general, analysts predict steady increases in hospital and emergency department visits. Still, we’ve seen client requests consistently beating even aggressive forecasts. Through May 31, 2019, same-site volume was up nearly 4.7%.
  • Volatile spikes in demand. Surges in teleradiology orders are becoming more common, as local radiology groups grapple with capacity challenges. In early 2019, for example, vRad experienced multiple time periods where over 25% of clients were sending volumes that exceeded their historical sending patterns by between 20% and 50%.

Radiologist capacity decline

The growing study volume is met with a declining pool of practitioners. This imbalance is creating greater competition for hiring skilled radiologists.

  • Aging radiologists. Just like the general population, boomer radiologists are approaching retirement age. “Close to 50% of radiologists are 55 and older and attrition is beginning to reduce the candidate pool,” according to Merritt Hawkins.
  • Fewer new radiologists. By 2025 the American Association of Medical Schools anticipates a shortage of specialists on the order of tens of thousands, a contributing factor being fewer people pursuing radiology training.

  • Rise of major players. Economies of scale continue to drive consolidation among radiology practices – both traditional on-site and teleradiology firms – leading to the rise of a few major players. However, whether driving organic growth or filling vacancies left by attrition, everyone will still be recruiting from a finite pool of diagnosticians. Which leads us to…
  • Hiring challenges. Attracting talented radiologists is becoming much more competitive. Recruiting will require significantly more time and investment in the coming years. Successful practices must differentiate themselves not just through compensation, but by rewarding based on individual motivations regarding quality of life and professional development.


As the supply of radiologists dwindles, hospitals and radiology practices must place renewed focus on hiring and retaining radiological expertise to keep pace with increasing demand for studies. (For an in-depth discussion, see Staffing Strategies for a Tightening Radiologist Hiring Market, A How-To Guide.)

The role of teleradiology in achieving and maintaining balance

Increasingly, teleradiology is becoming an essential component of the long-term plans for clinical organizations. Advanced workflow systems have virtually eliminated geographic barriers and scheduling obstacles, enabling hospitals and practices the flexibility to integrate teleradiology into service plans as needed – whether short- or long-term, overnights, weekends or around-the-clock.

Hospitals and EDs are relying on teleradiology partnerships to streamline workflows and to prepare for inevitable volume spikes or staff shortages. This reduces the risk of overburdening the onsite radiology team, and potentially compromising study accuracy or employee morale. In fact, some hospitals and practices have begun to cite teleradiology partnerships in their recruiting efforts as evidence that they are committed to managing workloads, reducing stress and enabling radiologists to focus on their important cases.

In addition to better management of imaging workflow, many are recognizing teleradiology as an effective way to reduce the time and expenses associated with hiring and maintaining an extended staff. Partnering with a teleradiology firm allows hospitals to reduce the costs associated with identifying, recruiting, licensing, training and retaining onsite radiologists.


vRad is embracing a growing role in ensuring each diagnostic study gets the attention it deserves. We know workflows will need to evolve to balance the growing demand for imaging studies with decreasing capacity of radiologists while ensuring uncompromised patient care. In another blog entry, my colleague Ben Strong offers some insight into performance initiatives that are improving study accuracy and efficiency.


Author Shannon Werb

Former President and Chief Operating Officer. Mr. Werb is a healthcare IT authority, advisor and evangelist. He has published numerous articles regarding the confluence of technology and medicine, and was recognized as a Health Information Technology Change Agent by Health IT Outcomes in 2015 for leading innovation in radiology. With more than 20 years of healthcare information technology experience, Werb is a recognized healthcare IT authority, advisor, and evangelist.

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