Generalist versus Subspecialist Characteristics of the US Radiologist Workforce
Generalist versus Subspecialist Characteristics of the US Radiologist Workforce
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DOI：
10.1148/radiol.2017171684
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发表时间：
2018-03-01
期刊：
影响因子：
19.7
通讯作者：
Duszak, Richard, Jr.
中科院分区：
文献类型：
--
作者：
Rosenkrantz, Andrew B.;Wang, Wenyi;Duszak, Richard, Jr.
目的：评估美国放射科医生队伍的亚专业实践特征。材料和方法：本研究使用医疗保险医生和其他供应商公共使用文件，不构成人类受试者研究。作者确定了 2012 年至 2014 年间为专业服务付费的 33 090 名放射科医生，并使用经过验证的分类系统将服务映射到七个亚专业，并根据工作相对价值单位 (RVU) 量化以亚专业为中心的工作量。超过一半的计费工作 RVU 属于单一亚专科的放射科医生被指定为亚专科医师；其余的人被归类为通才。将放射科医生与从其他公开数据集中提取的各种特征进行匹配，通过使用方差分析和多变量逻辑回归来探索关联。结果：超过一半 (55.3%) 的美国放射科医生主要作为通才执业，但平均将 36.0% 的精力投入到一个亚专业上。在以亚专科医生身份执业的放射科医生中，神经放射科医生（占所有放射科医生的 10.1%）和乳腺成像师（8.4%）最为常见。亚专业化在女性放射科医生、职业生涯较早、在较大的诊所工作、有学术背景并在东北地区执业的放射科医生中更为常见 (P < .001)。按亚专业划分，女性比例从 8.6%（介入放射学）到 63.1%（乳腺影像学）不等；心胸成像师更常见的是早期职业放射科医生，而核医学医师则是后来的职业放射科医生。在规模较大（>= 100 名成员）的诊所中，细分专业化更为常见 (63.1%)。学术背景是亚专业化最强的独立预测因素（比值比，3.56；95% 置信区间：3.30, 3.84）。 结论：尽管人们越来越关注放射学亚专业化，但大多数美国放射科医生根据其工作 RVU 大部分都是普通放射科医生。迄今为止，亚专业化在更大的学术实践中更为普遍。 (C) 北美放射学会，2017
Purpose: To assess subspecialty practice characteristics of the U.S. radiologist workforce.Materials and Methods: This study used the Medicare Physician and Other Supplier Public Use File and did not constitute human subject research. The authors identified 33 090 radiologists who billed for professional services between 2012 and 2014 and used a validated classification system to map services to seven subspecialties and quantify subspecialty- focused effort on the basis of work relative value units (RVUs). Radiologists with more than half of their billed work RVUs in a single subspecialty were designated subspecialists; the remainder were classified as generalists. Matching radiologists with various characteristics extracted from other publicly available data sets, associations were explored through use of analysis of variance and multivariable logistic regression.Results: More than half ( 55.3%) of U.S. radiologists practice predominantly as generalists but dedicate on average 36.0% effort to one subspecialty. Among radiologists practicing as majority subspecialists, neuroradiologists ( 10.1% of all radiologists) and breast imagers ( 8.4%) are most common. Subspecialization is more common ( P < .001) among radiologists who are female, are earlier in their career, work in larger practices, have academic affiliations, and practice in the Northeast. By subspecialty, female representation varies from 8.6% ( interventional radiology) to 63.1% ( breast imaging); cardiothoracic imagers were more commonly early career radiologists, and nuclear medicine physicians were later career radiologists. Subspecialization is considerably more common in larger (>= 100 members) practices (63.1%). An academic affiliation is the strongest independent predictor of subspecialization (odds ratio, 3.56; 95% confidence interval: 3.30, 3.84).Conclusion: Despite an increased focus on radiology subspecialization, most U.S. radiologists are majority general radiologists on the basis of their work RVUs. Subspecialization is by far more prevalent in larger and academic practices. (C) RSNA, 2017