Radiologist Burnout Blues and Impact on The Job Market

Where have all the radiologists gone?

In 2019, employers of all practice types reported finding it more challenging to fill positions.

The number of soon-to-retire radiologists is likely to play a significant role in changing workforce needs, according to the ACR.

The increased rate of burnout among radiologists could also influence the number of radiologists practicing part-time or retiring early [1].

There are, of course, multiple contributing factors and possible explanations for the current shortage of radiologists and market changes.

In this post, however, we’re going to focus on one particular hot button issue—the burnout element.

 

Burnout among radiologists

Much like the job market itself, the incidence of burnout among radiologists seems to undergo ups and downs.

While 47.7% of radiologists reported experiencing burnout in 2011, that number jumped to 61.4% in 2014.

In 2014, radiologists ranked fifth out of more than 23 physician specialties surveyed in their reported burnout rate [2].

A 2017 follow-up survey, however, showed that the burnout rate for radiologists (and most other specialties) had improved, dropping back down again to the 2011 levels [3].

This trend was encouraging, although the symptoms of burnout still remained a pervasive problem. Its prevalence among physicians continues to be markedly higher than in the general US working population.

This begs several crucial questions. What factors contribute to the high burnout rate amongst radiologists? Why was 2014 such a red letter year? What changed, or what are the key elements that might improve morale and reduce the burnout rate? Let’s break it down.

Burnout causes

In some ways, practicing medicine in today’s marketplace might be likened to the human body–a whole network of systems working together–or not–making up an organism, that is at once, both simple and complex.

What causes burnout is a question that comes with a tangle of symptoms, but perhaps no single answer. Some contributing factors commonly cited, however, include increasing work volumes, a heavy emphasis on reducing turnaround times, decreasing reimbursement, and an increasing amount of required after-hours work. But is it more than just overwork, underappreciation and frustration with systemic dysfunction?

“Moral injury”

Some argue that “burnout” is not the proper term to describe the current situation, and that what physicians are experiencing is “moral injury.” It results from doctors working in a system that forces them to choose between the needs of their patients and the demands imposed by their employers, productivity metrics, insurance companies, mandates to reduce “leakage,” and satisfaction surveys. The patients’ needs cannot always win—and often don’t.  

Why 2014?

There are several possibilities that may explain why 2014 was a particularly challenging time. Potential reasons include the consolidation of hospitals and medical groups, a number of new regulatory factors, increasing electronic health record (EHR) penetration, and increased administrative burden.

What has changed?

As for causes of the decline in burnout rates, one theory is that the situation may be improving as physicians and organizations adapt to the new practice environment. There has also been improvement in work-life integration.

It is also possible that the prevalence of burnout has decreased due to physicians experiencing burnout leaving the workforce or reducing clinical effort [5].

Burnout outlook

Despite some measure of improvement, burnout among radiologists is still considered to be a critical concern.

The situation is not helped by the fact that radiology groups have started to compensate for lost income by taking back the night from teleradiology. Another discouraging signifier is the trend of companies and hospitals increasingly requesting in-house (and in some cases, subspecialty) coverage.

While today’s medical students are expressing a preference for lifestyle-oriented fields, the average radiology group is shifting in the other direction. Thus, brewing yet another fundamental conflict that does not bode well for the health of the radiologist workforce.

So does that mean trying to find employment that allows you to engage in fulfilling work is merely tilting at windmills?

Ha! Trick question.

The answer makes it no less worthy of a fight. The real task is to choose your battle path accordingly and determine what’s right for you. Stay tuned for more to come on helpful tips for navigating the job market.

And if you do end up taking a wrong turn to Burnoutville, where Google Maps leads you in circles just to mess with your head, cell reception is spotty, and your battery is draining before your eyes with no backup charger on hand…well, just send up the Rad Signal (e.g., shoot me an e-mail) and I’ll help you find a way back.

1. Harolds J, Parikh J, Bluth E, Dutton S, Recht M. Burnout of radiologists: frequency, risk factors, and remedies: a report of the ACR Commission on Human Resources. J Am Coll Radiol 2016; 13:411-416
2. Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc 2015; 90(12):1600-1613
3. Shanafelt TD, West CP, Sinsky C, et al. Changes in burnout and satisfaction with work-life integration in physicians and the general US working population between 2011 and 2017. Mayo Clin Proc 2019; XX:1-14 (article in press)