Navigating the challenges of radiography

A pillar of modern healthcare

Radiography plays a crucial role in medical diagnosis and treatment, along with other advanced imaging modalities that complement its capabilities. This non-invasive imaging technique uses X-rays to visualize the internal structures of the human body.

By utilizing these imaging techniques, as well as magnetic resonance imaging and ultrasound, healthcare professionals can obtain comprehensive and accurate information, enabling them to make informed diagnostic and treatment decisions.

The importance of radiography can be attributed to the following factors:

• Early detection and diagnosis: Radiography enables the identification of diseases and conditions, thus facilitating timely intervention and treatment, improving patient outcomes, and potentially saving lives.
• Enhanced precision: The images obtained provide high-resolution, detailed information about the body’s internal structures, allowing healthcare professionals to make precise and informed decisions.
• Access to otherwise unattainable information: Radiography enables healthcare practitioners to visualize structures that are difficult to access or examine. This helps in identifying a wide range of disorders, as well as guiding interventional or surgical procedures.
• Monitoring treatment efficacy: Radiography is also important when it comes to assessing the success of treatments, e.g. determining the response of a tumor to chemotherapy, or confirming the proper alignment of a bone fracture after surgical intervention.

Radiographers, also known as radiologic technologists, hold vital positions within the healthcare system. Their primary responsibilities include producing high-quality images and ensuring patient safety. However, they have a fundamental role within patient care and communication since they interact directly with patients, explaining procedures, obtaining patient histories, addressing concerns, and positioning patients correctly for imaging. They also work closely with other healthcare teams and are crucial to modern healthcare.

A workforce crisis

The world’s population is aging. This is taking its toll on many industries, including healthcare. According to the World Health Organization, 22% of the world’s population will be over the age of 60 by 2050, which is almost double compared with 2015. The aging population and the growing prevalence of chronic diseases have increased the demand for diagnostic imaging services. As a result, the radiology workforce is hugely overstretched, leading to high workloads and burnout.

According to a Frost & Sullivan study conducted in 2019, the demand for medical imaging exams has been growing faster than the supply of radiologists, with the current workforce skewed toward seasoned professionals nearing retirement age. In the US, of the 20,970 radiologists engaged in active patient care, 82% are aged 45 and over, while 53% are aged 55 and over.¹ The physician density of 2.6 per 1,000 inhabitants is below the OECD average of 3.6.²

The situation is precarious. More than 80% of healthcare facilities surveyed by the Advanced Health Education Center in 2021 were struggling to fill open radiography positions.³ Furthermore, the Association of American Medical Colleges predicts a shortage of between 38,000 and 124,000 medical doctors by 2034.⁴

The situation is similar in the UK, where the NHS is experiencing a decline in radiographer numbers. Based on recent data collected by the Society of Radiographers (SoR), 94% of respondents reported an unfilled diagnostic radiographer position in their department.⁵ The current shortfall in the radiology workforce is expected to increase to 44% during 2024.⁶

In September 2023, independent health think tank the Nuffield Trust released a report alerting that many fail to finish their training or leave the NHS early in their careers. Among the 190,000 student records, 87% of newly trained radiographers join the hospital sector, but 17% leave the NHS or community setting within five years.⁷

Although governments have consistently pledged to reduce the mounting waiting lists, this objective is unattainable unless workforce shortages are urgently addressed. To help combat this, the Nuffield Trust has called for a student loan forgiveness program where the government would write off NHS employees’ student debt over ten years. This suggestion has been supported by the SoR. Finding a viable solution, regardless of approach, is not only important for radiology departments, but also crucial for patient care.

Fostering radiography talent

The most straightforward way to expand the workforce is to recruit new professionals. However, apart from burnout, job perception could explain the increased turnover rates and the stagnation in supply. Many studies show that it is difficult to motivate medical students to pursue a career in radiology. One reason for this could be the lack of a clear understanding of what the job entails.

Fewer people are choosing to study radiography, but the student dropout rates are also cause for concern. British universities report that there were not enough students to fill the places on diagnostic radiography courses in 2021–2022, and according to SoR, more than one in five radiography students dropped out of their courses during the same period.⁸ Attrition seems to be multi-factorial, but academic and personal support are key to students continuing their studies. Clinical placement experience is also likely to influence their decision as to whether or not to continue.

While the structure and requirements of radiography education vary between countries, each pathway emphasizes a blend of theoretical knowledge, practical experience, clinical training and continuing professional development. This doesn’t come without challenges that could impact students’ learning experiences, skills development, and overall preparedness.

For example, the rapid pace of technology development could create a gap between curriculum and real-world practice. Educational institutions must therefore ensure they are up to date with the latest technology. There are also cases of limited clinical placement opportunities. At the same time, hands-on clinical training is essential for radiography students to develop practical skills and gain experience. Consequently, in addition to receiving correct training, they must have access to state-of-the-art equipment and resources. This safeguards high-quality standards, which is crucial for their competence and success in the workplace.

However, due to advancements in technology, medical research, and changing healthcare demands, the healthcare landscape is continuing to evolve, which is creating new clinical demands. This requires radiographers to adapt and expand their skillset, emphasizing the need for continuing education and professional development programs that accommodate these advancements.

Nonetheless, when faculties have shortages of qualified educators and high workloads, the availability of academic support and mentoring might be limited. A lack of qualified faculty in radiography education results in higher student-to-teacher ratios, which could in turn impact the capacity to train new radiographers effectively.

Addressing these challenges is essential for improving the quality and effectiveness of radiography education, with the goal of producing well-trained and competent professionals who can meet the demands and expectations of their future roles in the healthcare sector.

Securing radiography’s future

In conclusion, radiography plays a crucial role in medical diagnosis, treatment, and patient care, providing healthcare professionals with invaluable information for informed decision-making.

The increasing demand for diagnostic imaging services, driven by an aging population and the rise of chronic diseases, has put immense pressure on the radiology workforce, leading to shortages and high workloads. To address these challenges and ensure the provision of high-quality patient care, it is essential to expand the workforce by attracting and retaining new radiography professionals, as well as improving radiography education and training. This includes providing hands-on clinical experiences, access to state-of-the-art equipment and resources, and adequate academic support and mentorship to students. Addressing these issues is critical for the future success of radiography as a field and will ultimately contribute to better patient outcomes and the overall effectiveness of healthcare systems worldwide.

References:

1. Montecalvo R. Radiologist Staffing Trends 2021. V Rad. Feb. 18, 2021
2. Doctors (overall number) | Health at a Glance 2021 : OECD Indicators | OECD iLibrary (oecd-ilibrary.org)
3. Radiology Staffing Shortages Nation Wide? – AHEConline Blog
4. The Complexities of Physician Supply and Demand: Projections From 2019 to 2034 (aamc.org)
5. Supporting students: How to address the radiography workforce crisis  | SoR
6. The Royal College of Radiologists. London: The Royal College of Radiologists; 2020. Clinical Radiology UK Workforce Census 2019 Report.
7. Waste not, want not (nuffieldtrust.org.uk)
8. Supporting students: How to address the radiography workforce crisis  | SoR