Physician workload in mammography.

Area of Science:

• Radiology
• Medical Imaging
• Public Health

Background:

• Current United States Food and Drug Administration (FDA) guidelines mandate radiologists interpret at least 960 mammography examinations every two years (approx. 480 annually).
• Mammography interpretation volume is a key metric for quality assurance and certification.
• Understanding physician interpretive volumes is crucial for assessing the impact of regulatory changes.

Purpose of the Study:

• To estimate the annual mammography interpretation volumes per physician across the United States.
• To analyze the distribution of mammography interpretations among radiologists with varying caseloads.
• To evaluate the potential impact of increased mammography interpretation volume requirements on overall capacity and access.

Main Methods:

• Analysis of 4.2 million mammography examinations from 196 facilities between 1998 and 2004.
• Calculation of per-physician annual interpretive volumes.
• Modeling the effect of increased minimum annual volume requirements on mammography capacity.

Main Results:

• The mean annual mammographic interpretive volume was 1,777 examinations per radiologist.
• Approximately 31% of radiologists interpreted fewer than 1,000 mammograms annually, accounting for only 10% of total interpretations.
• Increasing the minimum annual requirement to 2,000 mammograms could eliminate 47% of current mammography capacity, necessitating significant workload redistribution.

Conclusions:

• Doubling the annual volume requirement would have a minimal impact on overall mammography capacity.
• Raising the annual requirement to 2,000 mammograms would disproportionately affect higher-volume radiologists and could significantly reduce mammography capacity.
• Potential increases in mammography interpretation requirements could curtail access, particularly for rural populations, unless low-volume radiologists increase their caseloads.