Satisfaction of Radiologists in the United States: A Comparison between 2003 and 1995

United States of America Child and Adolescent Psychiatrists' Career Satisfaction by Career Stage

OBJECTIVE

This study sought to examine career satisfaction among United States of America child and adolescent psychiatrists (CAPs) across career stages, identifying predictive factors for their career satisfaction.

METHODS

A total of 526 CAPs responded to a national career satisfaction survey. Satisfaction was assessed via responses to statements about their career on a Likert scale. Career satisfaction was defined as the sum of the scores for satisfaction with their choice of career, career advancement, and career recognition. Responses were disaggregated by the number of years post child and adolescent psychiatry residency training (early career: 0-10 years; midcareer: 11-20 years; and late career: 21 + years post-training). Stepwise linear regression analyses identified predictive factors of career satisfaction.

RESULTS

CAPs' career satisfaction was high (3.95) and increased with career stage. It was most positively correlated with advancement opportunities, job enjoyment, and control of assigned tasks, and most negatively correlated with workload. Job enjoyment was the leading predictive factor of career satisfaction for early career and late career CAPs, with midcareer CAPs identifying task assignment control as the leading contributor to their career satisfaction (all p = .000).

CONCLUSIONS

Career satisfaction in Child and Adolescent Psychiatry is high, increases with career stage, and is most predicted by advancement opportunities. Further study of the predictive factors of CAPs' career satisfaction is warranted as we focus on increasing the workforce in child and adolescent psychiatry.

How Well Are Radiology Residents Prepared for Practice After Training? A Survey of French-Speaking Quebec Recent Graduates and Department Chiefs

OBJECTIVE

Radiology residents must fulfill a standardized curriculum to complete residency and pass a certification exam before they are granted a licence to practice. We sought to evaluate how well residency prepares trainees for practice as perceived by recent graduates and their department chiefs. Subjects and Methods: Radiologists who graduated from the 4 Quebec radiology residency programs between 2005 and 2016 (n = 237) and Quebec radiology department chiefs (n = 98) were anonymously surveyed. Two electronic surveys were created, for recent graduates (74 questions) and for department chiefs (11 questions), with multiple-choice questions and open questions covering all fields of radiology. Surveys were administered between April and June 2016 using the Association des radiologistes du Québec database.

RESULTS

Response rate was 75 (31.6%) of 237 from recent graduates and 96% rated their training as excellent or good. Satisfaction with training in computed tomography and magnetic resonance imaging was high, with musculoskeletal (MSK) imaging, particularly MSK ultrasound (US), as well as pediatric, cardiac, and vascular imaging needing more training. Thirty-nine (39.8%) of 98 department chiefs answered the survey and highlighted weaknesses in the interpretation of conventional radiography, obstetrical US, and invasive procedures, as well as limited leadership and administrative skills. Recent graduates and department chiefs both reported difficulties in the ability to interpret daily volume of examinations as scheduled and invasive procedure competency.

CONCLUSION

This survey highlights areas of the radiology curriculum which may benefit from more emphasis during training. Adjustments in the residency program would ensure graduates are successful both in their certification exams and clinical practice.

Burnout, Professional Fulfillment, Intention to Leave, and Sleep-Related Impairment Among Faculty Radiologists in the United States: An Epidemiologic Study

OBJECTIVE

To examine the prevalence of burnout in faculty radiologists in the United States and to explore the relationship between burnout and professional fulfillment (PF), intention to leave (ITL), and sleep-related impairment by gender.

METHODS

This cross-sectional study was conducted through a voluntary anonymous, electronic survey of radiologists at 11 academic medical institutions participating in the Physician Wellness Academic Consortium between January 2017 and September 2018. Faculty radiologists who completed the survey were included in the study. The survey contained the validated professional fulfillment index and National Institute of Health Patient Reported Outcomes Measurement Information System sleep-related impairment scale. Demographics of participants only included gender to protect anonymity. Sample t tests and χ² exact tests were used for analysis with significance level set at P < .05.

RESULTS

In all, 456 faculty radiologists (171 women) answered the survey. The overall prevalence of burnout was 37.4%, PF was 35.6%, ITL was 33.3%, and sleep-related impairment was 45.3%. Burnout was higher in female versus male respondents (44% versus 31%, P < .05), and PF and ITL were lower (30% versus 42%, P < .05, 26% versus 38%, P < .05, respectively). When faculty were stratified into burned out versus not burned out, PF was significantly lower in those with burnout (12% versus 52%, P < .05), and ITL and sleep-related impairment was higher (51% versus 24%, P < .05 and 75% versus 30%, P < .05, respectively).

DISCUSSION

Higher burnout was associated with reports of greater ITL and sleep-related impairment and lower PF. Female radiologists experience more burnout but less ITL than their male counterparts.

What Causes the Most Stress in Breast Radiology Practice? A Survey of Members of the Society of Breast Imaging

OBJECTIVE

The objective of this study is to determine the major stressors affecting practicing breast radiologists.

METHODS

All members of the Society of Breast Imaging within the United States received an email invitation to complete an anonymous survey evaluating stressors that may contribute to physician burnout. Stressors evaluated included pace at work, work-life balance, care of dependents, job security, financial strain, decreasing reimbursement, new regulations, delivering bad news, fear of getting sued, and dealing with difficult patients, radiologists, and administrators.

RESULTS

The overall response rate was 13.5% (312/2308). For those who opened the email, response rate was 24.6% (312/1269). The most prevalent stressors reported were working too fast (222/312, 71.2%), balancing demands of work with personal life (209/312, 70.0%), fear of getting sued (164/312, 52.6%), and dealing with difficult administrators (156/312, 50%). Prevalence of stress related to new regulation requirements, job security, financial strain, decreased reimbursement, dependent care, call, delivering bad news, and dealing with difficult patients, difficult referrers, and difficult radiologists were present in fewer than 50% of respondents.

CONCLUSION

The most prevalent sources of stress in breast imaging radiologists relate to working too fast and balancing demands of work with time needed for personal life.

Preventing Physician Burnout in Breast Imaging: Scope of the Problem and Keys to Success

Physicians, including radiologists and specifically breast imagers, face many challenges, and stressors during their daily routine, many of which can contribute to burnout. While there is an increasing body of literature evaluating burnout, including its prevalence in and impact on radiologists, there is a relative lack of information specifically addressing this topic as it relates to breast imaging. This article reviews key concepts in burnout, describes the potential impact on physicians at all levels of training and work, highlights unique aspects to the specialty of breast imaging that may contribute to burnout, and suggests tool and/or strategies that may help to combat and prevent burnout among breast imagers.

Recognizing and Overcoming Burnout in Breast Imaging

Burnout is a psychological syndrome created by chronic job stress, and it is typified by emotional exhaustion, depersonalization, and feelings of decreased personal accomplishment. In physicians, burnout occurs at alarming rates, and it is on the rise. High burnout rates are ubiquitous in radiology across multiple subspecialties. We know of no study specifically examining burnout among breast imaging radiologists, but given the rates across multiple specialties in radiology, we must assume that a significant portion of breast imaging radiologists also experience burnout. As breast imaging increases in volume and complexity, we must find new ways of practicing that help achieve a healthy work environment.

Non-radiation occupational hazards and health issues faced by radiologists – A cross-sectional study of Indian radiologists

Context: Radiologists as a group face unique occupational health hazards among which musculoskeletal injuries, chronic eye strain, and others are yet to receive adequate attention. Constant mental strain due to demanding turnaround times and work pressures may lead to burnout and depression. These combine to decrease overall work satisfaction and productivity. Aims: To study the prevalence of various health issues faced by radiologists in India and to assess whether specific demographic and occupational factors are associated with an increased risk. Settings and Design: Cross-sectional observational study conducted as a voluntary anonymous electronic survey. Methods and Materials: A 36-item survey was sent to radiologists through email and social media. All respondents who completed survey were included in the study. Questions regarding workload, repetitive stress injuries, eye strain, burnout, and so on were asked. Statistical Analysis Used: Chi-square test was used to test significance of correlation (P < 0.05). Results: In all, 383 radiologists completed the survey. A high prevalence of repetitive stress injuries, chronic eye strain, depression, and burnout was found. Significant correlation was found between repetitive stress injuries and burnout. Pre-Conception and Pre-Natal Diagnostic Techniques Act (PCPNDT) related issues and work overload were the most common causes of high stress levels. Radiologists whose practices followed ergonomic design showed significantly less prevalence of neck pain. Conclusion: Radiologists in India have a high prevalence of repetitive stress injuries, chronic eye strain, and burnout, along with unique mental stressors such as PCPNDT-related issues.

Radiology Workflow Dynamics: How Workflow Patterns Impact Radiologist Perceptions of Workplace Satisfaction

RATIONALE AND OBJECTIVES

The study aimed to assess perceptions of reading room workflow and the impact separating image-interpretive and nonimage-interpretive task workflows can have on radiologist perceptions of workplace disruptions, workload, and overall satisfaction.

MATERIALS AND METHODS

A 14-question survey instrument was developed to measure radiologist perceptions of workplace interruptions, satisfaction, and workload prior to and following implementation of separate image-interpretive and nonimage-interpretive reading room workflows. The results were collected over 2 weeks preceding the intervention and 2 weeks following the end of the intervention. The results were anonymized and analyzed using univariate analysis.

RESULTS

A total of 18 people responded to the preintervention survey: 6 neuroradiology fellows and 12 attending neuroradiologists. Fifteen people who were then present for the 1-month intervention period responded to the postintervention survey. Perceptions of workplace disruptions, image interpretation, quality of trainee education, ability to perform nonimage-interpretive tasks, and quality of consultations (P < 0.0001) all improved following the intervention. Mental effort and workload also improved across all assessment domains, as did satisfaction with quality of image interpretation and consultative work.

CONCLUSION

Implementation of parallel dedicated image-interpretive and nonimage-interpretive workflows may improve markers of radiologist perceptions of workplace satisfaction.

Burnout of Radiologists: Frequency, Risk Factors, and Remedies: A Report of the ACR Commission on Human Resources

Burnout is a concern for radiologists. The burnout rate is greater among diagnostic radiologists than the mean for all physicians, while radiation oncologists have a slightly lower burnout rate. Burnout can result in unprofessional behavior, thoughts of suicide, premature retirement, and errors in patient care. Strategies to reduce burnout include addressing the sources of job dissatisfaction, instilling lifestyle balance, finding reasons to work other than money, improving money management, developing a support group, and seeking help when needed.

Job satisfaction, income, workload, workplace, and demographics of Japanese radiologists in the 2008 survey

PURPOSE

This study aimed to verify radiologists' demographics and job satisfaction in Japan and analyze factors affecting job satisfaction.

MATERIALS AND METHODS

A self-administered questionnaire was mailed to 7,491 eligible radiologists between April and June 2008. The questionnaire consisted of items concerning participants' demographics and job satisfaction. A multivariate regression analysis was conducted to analyze the impact of practice environments on radiologists' overall job satisfaction.

RESULTS

There were 3,986 (53 %) valid responses. In 2008, 67.7 % of radiologists reported being extremely or somewhat satisfied with their job. With regard to changes in job satisfaction over the previous 5 years, 45.8 % felt much increased or somewhat increased satisfaction, whereas 18.8 % felt somewhat decreased or much decreased. The significant factors associated with overall job satisfaction were annual income (p < 0.01) and working at larger hospitals (500 or more beds) (p < 0.01). Older age (p < 0.01) and night duty (p < 0.01) was significantly related to dissatisfaction. The main reasons for increasing job satisfaction over 5 years were interest and lifestyle, whereas the strongest reason for decreasing job satisfaction was workload.

CONCLUSION

This survey revealed Japanese radiologists had a high level of job satisfaction.

Inovação tecnológica e cargas de trabalho dos profissionais de saúde: uma relação ambígua

Trata-se de uma revisão integrativa com objetivo de rastrear a produção científica acerca da influência da inovação tecnológica nas cargas de trabalho dos profissionais de saúde. Selecionou-se 57 publicações nas bases de interesse de 2004 a 2009. Predominaram as pesquisas de campo com abordagem qualitativa, realizadas em hospitais. Nenhum estudo teve por objetivo relacionar inovação tecnológica e cargas de trabalho. Nos estudos sobre inovação tecnológica destacaram-se publicações sobre tecnologias de informação e comunicação e novas formas de organização do trabalho; no tema cargas de trabalho predominaram estudos sobre condições promotoras de estresse e Burnout. Os achados mostraram que as inovações influenciam as cargas de trabalho de modo ambíguo, podendo aumentá-las ou diminuí-las.

The pediatric radiologist in private practice

Pediatric radiologists in private practice compose a significant group in our subspecialty. Specific issues relating to practicing pediatric radiology in the private setting will be discussed. Private and academic pediatric radiologists can together more effectively address the issues facing our subspecialty.

U.S. physician satisfaction: a systematic review

INTRODUCTION

There is concern in the US about the burden and potential ramifications of dissatisfaction among physicians. The purpose of this article is to systematically review the literature on US physician satisfaction.

METHODS

A MEDLINE search with the medical subject headings (MeSH) phrases: (physicians OR physician's role OR physician's women) AND (job satisfaction OR career satisfaction OR burnout), limited to humans and abstracts, with 1157 abstracts reviewed. After exclusions by 2 independent reviewers, 97 articles were included. Physician type sampled, sample size/response rate, satisfaction type, and satisfaction results were extracted for each study. Satisfaction trends were extracted from those studies with longitudinal or repeated cross sectional design. Variables associated with satisfaction were extracted from those studies that included multivariate analyses.

RESULTS

Physician satisfaction was relatively stable, with small decreases primarily among primary care physicians (PCPs). The major pertinent mediating factors of satisfaction for hospitalists include both physician factors (age and specialty), and job factors (job demands, job control, collegial support, income, and incentives).

CONCLUSIONS

The majority of factors associated with satisfaction are modifiable. Tangible recommendations for measuring and diminishing dissatisfaction are given.

Satisfaction at work among radiologists

PURPOSE

This study sought to evaluate professional satisfaction among Italian radiologists and identify what personal characteristics of radiologists and features of their work and work setting affect job satisfaction.

MATERIALS AND METHODS

Satisfaction was assessed by using Warr et al.'s 17-item Job Satisfaction Scale (JSS) in 206 radiologists, 108 radiotherapists and 34 specialists in infectious diseases used as controls.

RESULTS

Forty-nine per cent of diagnostic radiologists reported being satisfied with their jobs. The frequency is significantly lower than that found among radiotherapists (64%) and controls (62%). Middle-aged radiologists on lower rungs of the career ladder were more dissatisfied than were their older colleagues in top positions. Female radiologists were less satisfied than their male counterparts with regard to recognition for good work, amount of job variety and distribution of workloads. Stepwise logistic regression analysis showed that job satisfaction was especially affected by physical working conditions, freedom to choose one's own work method, relationship with one's immediate boss, attention paid to one's suggestions and the amount of job variety.

CONCLUSIONS

This pilot study identified the sources of professional satisfaction and dissatisfaction among radiologists. A future survey of a stratified random sample of Italian radiologists appears to be feasible.

Satisfaction at work among radiologists

PURPOSE

This study sought to evaluate professional satisfaction among Italian radiologists and identify what personal characteristics of radiologists and features of their work and work setting affect job satisfaction.

MATERIALS AND METHODS

Satisfaction was assessed by using Warr et al.'s 17-item Job Satisfaction Scale (JSS) in 206 radiologists, 108 radiotherapists and 34 specialists in infectious diseases used as controls.

RESULTS

Forty-nine per cent of diagnostic radiologists reported being satisfied with their jobs. The frequency is significantly lower than that found among radiotherapists (64%) and controls (62%). Middle-aged radiologists on lower rungs of the career ladder were more dissatisfied than were their older colleagues in top positions. Female radiologists were less satisfied than their male counterparts with regard to recognition for good work, amount of job variety and distribution of workloads. Stepwise logistic regression analysis showed that job satisfaction was especially affected by physical working conditions, freedom to choose one's own work method, relationship with one's immediate boss, attention paid to one's suggestions and the amount of job variety.

CONCLUSIONS

This pilot study identified the sources of professional satisfaction and dissatisfaction among radiologists. A future survey of a stratified random sample of Italian radiologists appears to be feasible.

Radiologists' performance and their enjoyment of interpreting screening mammograms

OBJECTIVE

One might speculate that radiologists who enjoy mammography may exhibit better performance than radiologists who do not.

MATERIALS AND METHODS

One hundred thirty-one radiologists at three Breast Cancer Surveillance Consortium (BCSC) registries completed a survey about their characteristics, clinical practices, and attitudes related to screening mammography. Survey results were linked with BCSC performance data for 662,084 screening and 33,977 diagnostic mammograms. Using logistic regression, we modeled the odds of an abnormal interpretation, cancer detection, sensitivity, and specificity among radiologists who reported they enjoy interpreting screening mammograms compared with those who do not.

RESULTS

Overall, 44.3% of radiologists reported not enjoying interpreting screening mammograms. Radiologists who reported enjoying interpreting screening mammograms were more likely to be women, spend at least 20% of their time in breast imaging, have a primary academic affiliation, read more than 2,000 mammograms per year, and be salaried. Enjoyment was not associated with screening mammography performance. Among diagnostic mammograms, there was a significant increase in sensitivity among radiologists who reported enjoyment (85.2%) compared with those who did not (78.2%). In models adjusting for radiologist characteristics, similar trends were found; however, no statistically significant associations remained.

CONCLUSION

Almost one half of radiologists actively interpreting mammograms do not enjoy that part of their job. Once we adjusted for radiologist and patient characteristics, we found that reported enjoyment was not related to performance in our study, although suggestive trends were noted.

Radiologists' clinical practice of neuroimaging

PURPOSE

Because of the importance of neuroimaging as a radiology subspecialty, the aim of this study was to provide a detailed portrait of the demographics, clinical activities, and practices of radiologists heavily involved in neuroimaging.

METHODS

The authors analyzed data from the ACR's 2003 Survey of Radiologists, a large, stratified random-sample survey in which respondents were guaranteed confidentiality. The survey achieved a 63% response rate, and responses were weighted to make them representative of all radiologists in the United States.

RESULTS

Three-fourths of US radiologists reported doing neuroradiology; 9% reported that neuroradiology was their main subspecialty, and 9% reported spending more than 50% of their clinical work time doing neuroradiology. Of these latter two categories, more than about 75% had certificates of added qualification (CAQs) in neuroradiology, and more than 80% had done neuroradiology fellowships. However, of those spending more than 50% of their clinical work time doing neuroradiology, 7% neither had CAQs nor had done fellowships in the field. One-fourth of radiologists with CAQs or who had done neuroradiology fellowships spent less than 30% of their clinical work time doing neuroradiology. One-third to one-half of neuroimaging was performed by radiologists not heavily involved in the field. Only 6% to 8% of radiologists heavily involved in the field were women, compared with 22% in other subspecialties.

CONCLUSIONS

Neuroimaging has the great strength of being a relatively well-integrated subspecialty in that a very large majority of those heavily involved in its practice have CAQs and did fellowships in the field. Among possible concerns are the relatively few women in the field and the apparent waste of expertise resulting from one-fourth of those with neuroradiology subspecialty training or certification being relatively little immersed in its practice.

The growing size of radiology practices

PURPOSE

To describe trends in the size of radiology practices from 1990 to 2007.

METHODS

Data from the American College of Radiology's 1990, 1995, 2000, and 2003 surveys of radiologists and radiation oncologists and its 2007 survey of radiologist members are compiled to describe the changing distribution of radiologists by practice size over time. All estimates are weighted to be representative of all radiologists in the United States.

RESULTS

The fraction of radiologists in small practices (1-4 radiologists) decreased from 29% in 1990 to 22% in 2007. The fraction in medium-sized practices (5-14 radiologists) decreased from 51% in 1990 to 38% in 2007. The fraction in practices with 15 to 29 radiologists increased from 14% in 1990 to 21% in 1995 and has since remained constant. The fraction in practices with 30 or more radiologists grew from 5% in 1990 to 19% in 2007, but since 2000, growth among these practices has largely been limited to practices with 60 or more radiologists. The median radiologist was in a 7-radiologist practice in 1990. This size increased to 11 in 2000 and was the same in 2007. The size of a practice at the 90th percentile of radiologists increased from 22 in 1990 to 45 in 2007.

CONCLUSION

Radiology practices grew in size throughout the 1990 to 2007 period. In general, changes were more rapid in 1990 to 2000 than since. The most conspicuous growth was in practices with 30 radiologists or more. This category almost quadrupled its share of radiologists. In contrast, the share of very small practices (1-4 radiologists) declined relatively little, by only approximately one-fourth.

Pay for performance and the revolution in American medical culture

The recent implementation of pay for performance by CMS in radiology practices is not going to be an isolated event. Instead, it reflects an early manifestation of what will likely be a revolution in how we work and how we are paid in diagnostic imaging. Examining the factors that underly this revolution are critical for understanding the next waves of change that will drive our future.