June 24, 2026
Interventional Radiology Work has Become Increasingly Concentrated Among Fewer Radiologists
Radiologists performing no interventional radiology-related (IR-related) work increased from one-third in 2008 to one-half in 2023. Among radiologists with IR-related work, the proportion whose work was a majority IR-related increased from 12.6% in 2008 to 18.5% in 2023. These findings, based on a national Medicare analysis of 46,533 radiologists covering 476,688 radiologist years from 2008 to 2023 period, were published in the Journal of Vascular and Interventional Radiology (JVIR) by the Harvey L. Neiman Health Policy Institute in collaboration with IR experts.
“The percentage of radiologists doing some IR-related work fell from 66.9% in 2008 to 49.6% in 2023. Accordingly, radiologists who practiced IR in 2023 typically performed proportionally more IR-related work compared with those who practiced IR in 2008,” said Eric Christensen, PhD, research director at the Neiman Institute and study senior author. “In particular, the percentage of those with a super-majority (>90%) of IR-related work more than doubled between 2008 and 2023, increasing from 4.1% to 8.8% of all radiologists.”
“These temporal trends coincide with IR’s evolution from a procedural component of diagnostic radiology to a clinically oriented specialty providing minimally invasive, image-guided therapies for a wide-range of vascular and nonvascular disease,” explained Luke Wilkins, MD, professor of vascular and interventional radiology at the University of Virginia and study lead author. “The 2016 advent of integrated IR/DR residency positions was an important milestone in this evolution and may have plausibly contributed to different temporal distribution of IR-related work.”
“We found that, among radiologists with IR-related work in 2023, a higher percentage of younger radiologists (ages 25-34) versus older radiologists (65+) had majority IR-related work (24.7% vs 11.9%) or super-majority IR-related work (9.2% vs 6.8%),” said Dr. Christensen. “However, temporal trends toward increasing IR concentration were not greater among younger compared with older radiologists. In fact, the increase in super-majority IR-related work was steeper among older radiologists.”
“Likewise, we observed consistent distributional shifts in IR-related work across urbanicity, academic status, practice type, and practice size,” continued Dr. Christensen. “For example, academic practices maintained higher absolute levels of IR-related work, but relative growth in super-majority IR-related work was also observed in non-academic settings, smaller practices, and multi-specialty practices.” Dr. Wilkins noted, “These patterns may reflect differences in local workflow, call coverage, procedural volume, staffing, or practice organization.”
“Since IR’s formal recognition as a specialty, the optimal practice model for interventional radiologists (IRs) has remained debated. Much of this discussion centers on whether IR should function as an independent specialty or remain integrated within general radiology departments,” explained Dr. Wilkins.
“Practical considerations complicate independent IR practice making complete separation from diagnostic radiology neither optimal nor attainable across all practice settings,” stated Dr. Wilkins. “The integrated IR/DR pathway was intentionally designed to preserve dual competency in imaging interpretation and procedural expertise. The study’s results suggest that this flexibility remains necessary as a substantial portion of radiologists performing IR-related work continued to practice in mixed IR/DR roles, even in the youngest cohort.”
To arrange an interview with a spokesperson, contact Nichole Gonzalez at ngonzalez@neimanhpi.org.
About the Harvey L. Neiman Health Policy Institute
The Harvey L. Neiman Health Policy Institute is one of the nation’s leading medical imaging socioeconomic research organizations. The Neiman Institute studies the role and value of radiology and radiologists in evolving health care delivery and payment systems and the impact of medical imaging on the cost, quality, safety and efficiency of health care. Visit us at www.neimanhpi.org and follow us on X, BlueSky or LinkedIn.