Radiologist-Practice Separation: Recent Trends and Characteristics

Stefan Santavicca; Danny R Hughes; Howard B Fleishon; Frank Lexa; Eric Rubin; Andrew B Rosenkrantz; Richard Duszak Jr

doi:10.1016/j.jacr.2020.10.006

Radiologist-Practice Separation: Recent Trends and Characteristics

J Am Coll Radiol. 2021 Apr;18(4):580-589. doi: 10.1016/j.jacr.2020.10.006. Epub 2020 Nov 14.

Authors

Stefan Santavicca¹, Danny R Hughes², Howard B Fleishon³, Frank Lexa⁴, Eric Rubin⁵, Andrew B Rosenkrantz⁶, Richard Duszak Jr⁷

Affiliations

¹ School of Economics, Georgia Institute of Technology, Atlanta, Georgia. Electronic address: ssantavicca3@gatech.edu.
² Department of Radiology and Imaging Sciences, Emory University, Atlanta, Georgia; Professor, School of Economics and Director, Health Economics and Analytics Lab (HEAL) Georgia Institute of Technology, Atlanta, Georgia.
³ Chair, ACR Board of Chancellors, American College of Radiology, Reston, Virginia; Associate Professor, Department of Radiology and Medical Imaging, Emory University, Atlanta, Georgia and Chief of Radiology Services, Emory Johns Creek Hospital, Johns Creek, Georgia.
⁴ Professor and Vice Chair-Faculty Affairs, Department of Radiology, University of Pittsburgh and UPMC International. Chief Medical Officer, The Radiology Leadership Institute and Chair of the Commission on Leadership and Practice Development of the American College of Radiology.
⁵ Director, CT Division, Southeast Radiology Limited, Ridley Park, Pennsylvania.
⁶ Professor of Radiology and Urology, Director of Prostate Imaging, Director of Health Policy, and Section Chief of Abdominal Imaging, Department of Radiology, NYU Grossman School of Medicine, and NYU Langone Health, New York, New York.
⁷ Professor and Vice Chair of Radiology, Department of Radiology and Imaging Sciences, Emory University School of Medicine, and Emory Healthcare, Atlanta, Georgia.

PMID: 33197406
DOI: 10.1016/j.jacr.2020.10.006

Abstract

Purpose: To assess recent trends and characteristics in radiologist-practice separation across the United States.

Methods: Using the Medicare Physician Compare and Medicare Physician and Other Supplier Public Use File data sets, we linked all radiologists to associated group practices annually between 2014 and 2018 and assessed radiologist-practice separation over a variety of physician and group characteristics. Multivariate logistic regression modeling was used to estimate the likelihood of radiologist-practice separation.

Results: Of 25,228 unique radiologists associated with 4,381 unique group practices, 41.1% separated from at least one group practice between 2014 and 2018, and annual separation rates increased 38.4% over time (13.8% from 2014 to 2015 to 19.2% from 2017 to 2018). Radiologist-practice separation rates ranged from 57.4% in Utah to 26.3% in Virginia. Separation rates were 42.8% for general radiologists versus 38.2% for subspecialty radiologists. Among subspecialists, separation rates ranged from 43.0% for breast imagers to 33.5% for cardiothoracic radiologists. Early career status (odds ratio [OR] = 1.286) and late (OR = 1.554) career status were both independent positive predictors of radiologist-practice separation (both P < .001). Larger practice size (OR = 0.795), radiology-only (versus multispecialty) group (OR = 0.468), academic (versus nonacademic) practice (OR = 0.709), and abdominal (OR = 0.820), musculoskeletal (OR = 0.659), and neuroradiology (OR = 0.895) subspecialization were independent negative predictors (all P < .05).

Conclusions: With over 40% of radiologists separating from at least one practice in recent years, the US radiologist workforce is highly and increasingly mobile. Because reasons for separation (eg, resignation, practice acquisition) cannot be assessed using administrative data, further attention is warranted given the manifold financial, operational, and patient care implications.

Keywords: Burnout; consolidation; corporatization; physician-practice separation; radiologist workforce; recruiting and retention.

MeSH terms

Aged
Humans
Medicare*
Radiologists
Radiology*
United States
Utah
Virginia