Women in the radiology profession: data from a 1995 national survey.

OBJECTIVE: This report provides an in-depth picture of similarities and differences in the professional and practice characteristics of women and men who are radiologists in the United States, with specific attention to whether gender differences are less pronounced among younger radiologists. MATERIALS AND METHODS: Data were taken from a national stratified random sample survey of radiologists. The response rate was 75%. The 1731 men and 294 women responding included diagnostic radiologists, radiation oncologists, and radiology-related nuclear medicine specialists. RESULTS: Seven percent of respondents who completed their radiology residency before 1970 were women, compared with 9% in 1970-1979, 19% in 1980-1989, and 27% in 1990-1995. Gender differences were smaller among posttraining radiologists younger than 40 years old than among those 40 years old or older for the following questions: when the respondent decided to specialize in radiology, whether the respondent is a subspecialist within diagnostic radiology, whether the respondent's practice is primarily academic, whether the practice is privately owned, and whether the respondent is a practice owner (partner, shareholder). Women who were residents and fellows more frequently indicated problems with unwanted sexual attention occurring in the past 2 years than did women who were not in training positions. However, posttraining women were more likely to have encountered discrimination in salary, hiring, or promotion at some time in their careers. CONCLUSION: Women's professional roles in radiology are changing slowly. A narrowing gender gap among younger radiologists on some professional and practice characteristics may indicate a further diminishing of gender differences in radiology in the future. It may also reflect greater gender equality at earlier rather than later stages of one's career.

Profile of U.S. radiologists at middecade: overview of findings from the 1995 survey of radiologists.

PURPOSE: To profile the demographic, professional, and practice characteristics of diagnostic radiologists and radiation oncologists in the United States. MATERIALS AND METHODS: Questionnaires mailed to a national stratified random sample of 3,024 diagnostic radiologists, radiation oncologists, and nuclear medicine specialists yielded a 75% response rate. Weighted data reflect what responses would be if all radiologists had been surveyed and had responded. RESULTS: Among professionally active, posttraining radiologists in 1995, 14% were women; 12% were radiation oncologists, 62% diagnostic generalists, and 26% diagnostic subspecialists; 92% were board certified in radiology; 48% had postresidency fellowship training; 69% were in a position where practice ownership was a potential, and of these, 80% were practice owners. Enjoyment of work was less the greater the perceived effect of managed care on a radiologists practice, but average work satisfaction was unchanged from 1990. Among radiologists aged 55 years or older, the percentage who were retired was unchanged from 1990. Average hours worked by professionally active radiologists aged 65 years or older increased since 1990. CONCLUSION: Despite the spread of managed care and other trends that affect radiologists, surprisingly, few changes were evident in the demographic or professional characteristics of U.S. radiologists in 1995 compared with 1990.

Hiring by radiology groups in 1994.

PURPOSE: To assess the hiring activities of radiology groups in 1994 and changes between 1991 and 1994 in the employment market for diagnostic radiologists and radiation oncologists. MATERIALS AND METHODS: Questionnaires about recruitment and hiring were mailed to a stratified random sample of radiology groups in the United States; 92% (341 groups) responded. Data were compared with a 1991 telephone survey that included responses from 150 radiology groups. RESULTS: In 1994, radiology groups sought candidates for approximately 1,600 positions, a 29% decline from 1991. Fifteen percent of positions were in radiation oncology, 52% in general diagnostic radiology, and 33% in diagnostic subspecialties. As in 1991, groups filled three-fourths of their openings. The percentage of openings filled did not differ statistically significantly from one field or subspecialty to another. CONCLUSION: Available positions declined sharply. However, approximately 400 positions remained vacant at the end of the hiring season, with groups still actively recruiting for 75% of them. Employment is about equally difficult regardless of field.

The employment market for diagnostic radiologists and radiation oncologists: an update.

OBJECTIVE: In response to concern throughout the profession about the employment market for radiologists in the United States, the American College of Radiology, through several information-gathering activities, is monitoring the situation, including the amount of hiring done, job vacancies, and unemployment. To provide context, we compare our findings with data for earlier years and for all physicians. MATERIALS AND METHODS: The American College of Radiology undertook systematic sample surveys of approximately 60 training program directors with regard to their graduates; 3000 radiologists with regard to unemployment; and 400 radiology groups with regard to hiring. Good response rates (> or = 70%) were achieved; separate data for radiation oncology and diagnostic radiology are generally available. Data on use of the College's placement service also are presented. RESULTS: Among trainees completing a diagnostic radiology fellowship or a radiation oncology residency in 1994, 1% (standard error = 1%) were unemployed in December 1994 and 15% (standard error = 4%) were working in jobs not in keeping with their training and employment goals. Among all radiologists, the 1994 unemployment rate was 0.5% (standard error = 0.2%). Radiology groups were hiring for approximately 1600 positions in 1994, of which about three fifths were replacements and two fifths were expansions. After hiring was completed, remaining vacancies numbered approximately 400, or 2% of the radiology workforce. In early 1995, program directors reported that trainees completing a residency or fellowship in 1995 were having greater difficulty finding positions than had their 1994 counterparts. CONCLUSION: The unemployment rate for radiologists was similar to that for all physicians and lower than that for other persons with advanced degrees (1.5-2%). In 1994, expansion positions for which groups were hiring nearly equaled the growth of the radiology workforce. However, 1994 hiring (and vacancy) rates were only approximately 70% of 1991 levels. It is clear that the employment market is weakening; however, contrary to some anecdotal reports, a large-scale collapse has not occurred.

How U.S. radiologists use their professional time: factors that affect work activity and retirement plans.

PURPOSE: To determine what demographic, professional, and practice characteristics are related to the amount of time radiologists work per week, to their allocation of time among professional activities, and to their plans for retirement. MATERIALS AND METHODS: The American College of Radiology surveyed 2,804 radiologists and nuclear medicine specialists. Means and percentiles were calculated for the radiologists' number of hours and days worked per week, number of weeks away, percentage allocation of time, and retirement intentions. Multiple linear and logistic regression analyses were performed. RESULTS: Full-time, post-training radiologists worked a mean of 50 hours per week. Radiologists spent 2 weeks on professional education and 4.4 weeks on vacation each year. On average, 68% of professional time was spent on hospital patient care; 18%, on office patient care; 7%, on teaching and research; and 5% on administration. Forty-one percent of radiologists planned to eventually work part-time; 47% intended to retire fully. CONCLUSION: These data will provide an important baseline for modeling the future size of the radiologist workforce and for assessing changes in the ways radiologists use their time and plan their futures.

Quality assessment and improvement: what radiologists do and think.

OBJECTIVE: The main objectives of the study were as follows: first to study the nature and extent of radiologists' involvement in and their attitudes toward quality assessment (QA) and continuous quality improvement (CQI)/total quality management (TQM) in hospitals and in offices; and second, to ascertain whether differences in size, type, and location among hospitals and nonhospital radiology offices affect the QA and CQI/TQM activities of radiologists. We analyzed data from a national survey conducted by the American College of Radiology (ACR) in 1993. MATERIALS AND METHODS: Questionnaires about QA and CQI/TQM activities and attitudes were mailed to 216 hospital-affiliated diagnostic radiology group practices using a sample selected from the ACR master list of radiology practices in the United States. The response rate was 90%. A stratified random sample ensured representation of different geographic regions, various group sizes, and both academic and nonacademic groups. Responses were weighted so that our data show what answers about hospitals would have been if (i) the survey had been answered by all hospital radiology departments in the United States (except for those few staffed by solo practitioners or nonradiologists) and (ii) our questions about nonhospital offices had been answered by all radiology groups in the United States (except those few having no hospital activity). RESULTS: The majority (86%) of hospital radiology departments report having a program to monitor and evaluate physicians' performances. Fifty-one percent collect incorrect diagnoses by specific radiologist. Twenty-eight percent collect some of their QA data through computerized information systems. We found some statistically significant differences by hospital size and location, with larger hospitals and urban hospitals being more likely to engage in some QA activities. Multivariate analyses, once controlled for hospital size and location, found no significant differences in QA activity between university and community hospitals or between hospitals with and without a residency program. QA and CQI programs were less common in offices than in hospitals. With the exception of mammographic interpretations, most practices did not monitor and evaluate physicians' performances in the office setting. Respondents representing 58% of hospital radiology departments thought that QA and CQI contributed to improvement in patient care. Only 19% of radiology practices answered that CQI has been of cost benefit to their organization. CONCLUSION: Most radiology practices engage in a variety of QA and CQI activities in hospitals. However, this is less true in offices, in which radiologists have more discretion, and radiologists remain skeptical about the usefulness of CQI.

Patterns of professional organization membership among radiologists in the United States.

RATIONALE AND OBJECTIVES: The extent of membership in a professional association is an indicator of the level of cohesiveness or fragmentation of the profession. In this study, membership patterns in the American College of Radiology (ACR) were examined to assess how much different groups within radiology identify with the profession. METHODS: Patterns of membership in the ACR, the principal professional organization (as opposed to scientific society) of American radiologists, were examined by studying different demographic and professional groups within radiology. Data from the 1990 American Medical Association (AMA) Physician Masterfile were matched with ACR membership data for post-training radiologists and nuclear medicine specialists. RESULTS: Seventy-four percent of post-training American Board of Radiology (ABR)--certified diagnostic radiologists and radiation oncologists were ACR members. Membership rates were significantly lower for radiologists who were the following: 1) younger than 45 years of age; 2) women; 3) located in the western United States; 4) not certified by the ABR; or 5) listed their major professional activity as administration, teaching and research, or exclusively hospital-based patient care. Logit analysis showed that each of the above factors had a statistically significant effect on membership independently of the others. There were no statistically significant differences in membership rates between diagnostic radiologists and radiation oncologists, or between diagnostic subspecialists and diagnostic generalists. Among those with ABR certification, there was no significant difference between nuclear medicine specialists and other radiologists. CONCLUSIONS: The data suggest that, to increase the size and representativeness of ACR membership, target areas for recruitment effort might include younger radiologists, female radiologists, and radiologists located in the western United States.

Radiologists in the United States: demographic, professional, and practice characteristics.

OBJECTIVE: The purpose of this report is to present a statistical portrait of radiologists in the United States based on the 1990 American College of Radiology Manpower Survey. Unlike previous surveys, this survey included radiologists who were not members of the College and was thus more representative of all radiologists. (Approximately three quarters of radiologists are College members.) We examined how the demographic, professional, and practice characteristics of radiologists vary among major groups within the profession. MATERIALS AND METHODS: A stratified random sample of 2804 radiologists and nuclear medicine specialists was drawn from the American Medical Association Physician Masterfile, which is the most complete and extensive single source of information on physicians in the United States. Because the total numbers of female radiologists, nuclear medicine specialists, and radiologists less than 35 years old are relatively small, these groups were deliberately "oversampled" (hence the term stratified random sample) to ensure sufficient numbers of responses in these categories for meaningful analysis. A total of 1845 completed questionnaires were received, which yields a response rate of 68% if the questionnaires sent to invalid addresses are excluded. Responses were weighted to make the data representative of all radiologists, despite differences in sampling rates. RESULTS: Findings for professionally active radiologists who completed their training included the following: 94% were certified by the American Board of Radiology, 13% were women, 47% were less than 45 years old, fees for service were the primary remuneration for 62%, and 72% are in practices owned by physician members of the practice. By major activity in radiology, 69% were diagnostic radiology generalists; 11% were radiation oncologists; 18% were diagnostic radiology subspecialists; and 2% were nuclear medicine specialists. A breakdown by age indicated that the age group of radiologists less than 45 years old included more women, diagnostic subspecialists, and persons who had fellowship training than other age groups did. Percentages of diagnostic radiology generalists and solo practitioners were lower among younger radiologists. Radiation oncologists, compared with all others, were the most likely to practice solo or in small groups of two to four members. The subfields with the highest percentages (60% or more) of diagnostic radiologists reporting expertise or proficiency were CT, mammography, and sonography. Among radiologists who were retired, half had retired by the time they were 65 years old. However, a majority of radiologists 65-69 years old were still working, as were 40% of those 70-74 years old. CONCLUSION: The profession of radiology is changing, with more women, subspecialists, and fellowship-trained radiologists in younger age groups and fewer solo practitioners. Only a small percentage of radiologists are not board certified. Radiologists typically remain professionally active into their late 60s or even beyond.

Recruiting radiologists: the 1991 hiring survey.

Recent studies present widely varying views on the radiologist staffing situation, ranging from a projected surplus of over 6,000 radiologists to an estimated shortage of 5,000. To help clarify the situation, the American College of Radiology undertook a stratified random sample survey of radiology groups' recruitment efforts and hiring results in 1991. This survey of 192 groups achieved a 78% response rate. It found that half of all groups recruited, seeking to fill a nationwide total of 1,900 positions. Larger groups were more likely to recruit than smaller ones. Groups filled 1,348 (71%) of these positions, while 552 positions remained unfilled, which was 2.8% of groups' total staff. Remaining vacancies ranged from 5% of total staff in the Northeast and 3% in the Midwest to 2% in the South and 1% in the West. The percentage of positions filled was higher (76%) in nonmetropolitan areas than elsewhere. The authors conclude that the supply of radiologists is very close to balancing the number of positions available; the disparity is about 1/10 of some numbers mentioned previously and is probably shrinking. Also, recruiting is not less successful in nonmetropolitan areas and small cities than elsewhere.

Ideology and opposition to abortion: trends in public opinion, 1972-1980.

Data from the National Opinion Research Center General Social Survey 1972-1980 are examined to determine the extent to which the conflict over legal abortion has come to be associated, in the structure of public opinion, with broader ideological differences concerning sexuality, feminism, and political liberalissm. Specifically, attitudes toward premarital sex, homosexuality, women's roles, liberal versus conservative political self-identification, and views on government spending policies are examined as possible ideological correlates of position on abortion. Log-linear analysis demonstrates that a clear, significant, and persistent association exists between abortion attitude and each of the other 5 issues, independent of religion, education, or sex of the respondent. Furthermore, there is no evidence of any change from 1972 to 1980 in the strength of the association of abortion attitude with any of the other questions considered, despite the increased polarization and politicization of the abortion issue over the time period studied.