Key Contributing Factors & How to Address Them
The ability for an industry to deliver high-quality goods and services strongly depends on its workforce. During the COVID-19 pandemic, staff shortages have been a central issue for many industries worldwide. The healthcare delivery industry is not an exception, marking significant staff deficit across departments, many of them related to professional burnout during the pandemic. The radiology department is one area where staff challenges are more serious, with radiologists, radiographers and clinical oncologists experiencing the largest shortages. 
To outline the importance of this problem, RSNA 22 hosted several sessions such as “Physician Service Reimagined” led by Mr. Marcus McLemore, CEO at Empower Radiology, and “Why AI Matters” led by Dr. David Gruen, Chief Medical Officer at Merative. Companies such as Philips also briefly touched upon the subject in separate interviews.
Solving these challenges is important for the radiology departments, and crucial for patients. Staff shortages are causing serious limitations to physicians’ speed in diagnosing life threating illnesses such as hearth disease and stroke but most notably, their ability to treat cancer in a timely manner. . The delays caused by the overstretched workforce are having a negative impact on patients’ experience due to the increased waiting times, anxiety levels, and risk of false positive and false negative screening outcomes. 
The global market for artificial intelligence and machine learning is set for a robust growth, projecting increase of $570 million by 2030.  This enables radiology leaders and entire departments to cope with the ever-growing volume of diagnostic imaging procedures, despite the current shortage challenges they are facing.
Ageing population and increasing medical imaging demand
The world’s population is ageing, and this is taking its toll on multiple industries. According to the World Health Organization, 22% of the world’s population will be over sixty by 2050, which is almost double compared to 2015.  This will impact various aspect of the healthcare industry but for radiology the main outcome will be the continuous increase in demand for medical imaging services, as older population needs more frequent screening exams.
During 2018 research, Frost & Sullivan looked at utilisation controls versus the growing Medicare population, which encompasses people with a higher demand for medical imaging. In conclusion, they predicted that at least in the midterm, the demand for imaging services will continue to grow.  Few years later, the demand is still continuously increasing, which the healthcare delivery sector is struggling to meet.
Ageing workforce and challenging recruitment
Another influencing factor is physicians’ demographics. A US observation shows a global trend in increasing the average age of radiology physicians. Studies show a tendency that out of 20 970 radiologists engaged in active patient care in 2020, 82% were aged 45 and over, whilst 53% were aged 55 and over.
A big percentage of these radiologists will soon be close to retirement age and will have to be replaced by new entrants. However, this proves to be a challenge on its own, as we study the demand and supply of radiologists and compare that with the demand for medical imaging. According to a Frost & Sullivan study conducted in 2019, the demand for medical imaging exams such as CT and MRI have been growing notably faster than the supply of radiologists capable of delivering the exams.  Radiologist supply has stagnated over the second half of the last decade, widening the gap to the demand curve.
This stagnation can be explained by looking at two key factors: physician burnout and job perception. Radiology professionals have been reporting burnout for some time now, the effects of which were strongly enhanced during the COVID-19 pandemic. According to a recent Mayo Clinic study Mayo Clinic, radiologists rank 5th out of 23 surveyed specialties in frequency of reporting burnout.  To add on top of this, during the pandemic, many of these radiologists also either retired or moved to other practices such as teleradiology with more alternatives to work remotely and achieve a better work and personal life balance.
Job perception of young medical students will have a key impact on the future supply of radiology professionals. Many studies across the globe have shown that there is an ongoing struggle to motivate medical students to pursue a career in radiology, especially in the rural areas. One reason behind it is the lack of clear understanding and accurate perception of what the job is. 
The way forward
Demand for medical imaging will continue to rise for the foreseeable future. It’s up to radiology leaders worldwide to focus on expanding radiology training programs, leveraging new technology and improving the overall working environment if the increasing demand is to be met.
Adopting AI and ML technologies
Countless studies have shown the workflow efficiency benefits from implementing AI and ML technologies in the radiology workflow. However, its wide scale adoption is still challenging. Radiology leaders globally should further promote and integrate AL & ML technologies as they can capture, manage, view, and analyse medical imaging data on a grander scale.  This technology has the potential to drastically improve the overall radiology workflow and productivity, allowing the existing workforce to meet the increasing medical imaging demand. 
Expanding radiology training programs
The most straightforward way to expand the radiology workforce is to recruit new physicians. However, to do so properly, practices worldwide must focus recruitment efforts on early-stage medical students.
Unfortunately, the perception that radiologists work in the “backend” still exists. Training programs do not educate students that radiology is a clear and visible part of the healthcare system. “We need to start at the medical school level to stimulate interest in radiology and show that the radiologist is not sequestered in a dark reporting room but is a visible part of a health care team”, said Dr. Ho, a member of RSNA News Editorial Board. 
Improving the overall work environment
The proper recruitment of new entrants is crucial to the future radiology force and its ability to deal with the increasing medical imaging demand. However, retaining that workforce is as important. COVID-19 pushed many radiology professionals into leaving the profession or switching to teleradiology as they were looking for a better work environment alternative. The healthcare delivery industry should prioritise the improvement of the overall work environment by introducing improvements such as a work from home policy. Although it is not considered natural for a physician to work from home, there is the clear opportunity to take some tasks home, such as the reading of diagnostic images.
This will ease the burden of physicians, allowing them to work from the comfort of their home. This idea is widely supported by doctors across the world such as Dr. Sarah Vinnicombe from the University of Dundee in the UK: “We need to get creative with job opportunities to keep people engaged,” “When we advertise our open positions as hybrid, we garner more applicants. There’s no reason why some reading cannot be done at home.” 
The radiology workforce is overstretched and there is no universal solution to it. It is for radiology leaders around the world to prioritise solving it on top of their to-do-list and start acting on it step by step. The growing demand for medical imaging is already at levels causing severe burnout in physicians and what is more – increased burden on patients, which are in greater need of strong patient experience and better clinical outcomes.
- Lilly Matson New Reports Show Staff Shortages Continue to Hold Back Cancer Care (Cancer Research UK, 06/09/2022)
- Mary Henderson, Radiology Facing a Global Shortage (RSNA, 10/05/2022)
- Howard B. Fleishon, MD, MMM, FACR, The Radiology Labor Shortage (The American College of Radiology, 10/02/2022)
- Kendra Hall Ph.D. RT(R), Filling the Gaps in Radiographer Staffing Shortages (Carestream, 19/10/2021)
- Mariana Fernandez, Frost & Sullivan Unfolds The Future Of The Us Medical Imaging Industry (Frost.com, 20/05/2019)
- Raymond Montecalvo, MD, Radiologist Staffing Trends 2021 (Vrad, 18/02/2021)
- Frost & Sullivan, Frost & Sullivan – Best Practives Awards (Frost.com, 2019)
- Shehmir Javaid, Radiology AI in 2023: Importance & Top 5 Use Cases (AI Multiple, 18/04/2022)