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Association Between Practice Closure and Subsequent Subspecialization Among Affiliated Radiologists.

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Radiologists whose practices closed were 10% more likely to become subspecialists. This finding highlights practice closure

Keywords:
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Area of Science:

  • Radiology
  • Healthcare Economics
  • Medical Practice Management

Background:

  • Subspecialization in radiology has been a growing trend.
  • Understanding factors influencing subspecialization is crucial for workforce planning.

Purpose of the Study:

  • To investigate the association between radiology practice closure and subsequent subspecialization.
  • To determine if practice closure independently influences a radiologist's decision to subspecialize.

Main Methods:

  • Analysis of Centers for Medicare & Medicaid Services (CMS) data from 2014-2022.
  • Classification of radiologists as subspecialists (>50% workload in one subspecialty) versus generalists.
  • Multivariable logistic regression to assess the impact of practice closure on subspecialization, controlling for covariates.

Main Results:

  • Radiologists experiencing practice closure showed a 10% higher likelihood of practicing as subspecialists (OR, 1.10; 95% CI, 1.03-1.17).
  • The year-over-year increase in subspecialization was higher post-closure (2.5 pp) compared to non-closed practices (1.8 pp).
  • Factors like more practice years, larger practices, and multispecialty affiliations were linked to increased subspecialization after closure.

Conclusions:

  • Radiologists are more likely to subspecialize following a practice closure.
  • This effect is independent of the general trend of increasing subspecialization in radiology.
  • Practice closure may act as a catalyst for increased subspecialization within the radiology field.