Bansal S, Sunshine J
Research Department, American College of Radiology, Reston, VA 22091.
AJR Am J Roentgenol. 1994 Feb;162(2):263-70. doi: 10.2214/ajr.162.2.8310907.
The American College of Radiology (ACR), the principal professional organization of United States radiologists, receives numerous requests for information on the characteristics of radiology groups. This report describes the basic characteristics of radiology groups in the United States. We defined radiology groups as any practice with two or more radiologists or radiation oncologists, including academic departments, units in multispecialty groups, and staff of government facilities.
To collect basic information on radiology groups, the ACR conducted a mail census of all identified radiology groups in the United States during late 1991 and early 1992. Follow-up was conducted by mail and telephone. To make the responses accurately representative of all radiology groups, we weighted the approximately 2000 responses to correspond to known control totals for the number of groups of each of seven size categories in each of the four census regions (Northeast, Midwest, South, and West). These control totals were obtained from the ACR's 1990 Manpower Survey, which showed a total of approximately 3200 radiology groups.
Approximately one fourth of all groups have two radiologists, one fourth have three or four radiologists, one fourth have five to seven radiologists, and one fourth have eight or more radiologists. Academic groups were relatively large; almost 50% had 11 or more radiologists. Nonmetropolitan areas had very few large groups, and metropolitan center cities had relatively few small groups. Ninety-two percent of all groups practiced at hospitals, and 73% of all groups practiced at nonhospital offices or centers. The median number of practice sites for all groups was three, including both hospital and nonhospital sites. Eighty-eight percent of all groups provided diagnostic radiology services, 23% provided radiation oncology, 12% offered both, and 11% were oncology-only groups. Relatively many academic groups (25%) were oncology-only groups; very few radiology groups (2%) in multispecialty practices were oncology-only groups. The diagnostic radiology techniques available from the largest percentages of groups were general radiography (plain film), sonography, mammography, and CT. One eighth of academic groups that provided diagnostic services did not report providing mammography, compared with only a few percent of all groups in the United States that provided diagnostic services.
Half of all groups have two to four radiologists, and this has not changed since at least 1986. A substantial percentage of groups that perform diagnostic radiology do not provide MR, interventional, or nuclear medicine services. This is particularly true of relatively small groups. These characteristics may become the source of some problems as managed care becomes more prominent and larger groups, offering a full range of services and practicing at several sites, are favored by managed care organizations that seek to contract with one group for all their radiology services.
美国放射学会（ACR）是美国放射科医生的主要专业组织，收到众多关于放射学团体特征的信息请求。本报告描述了美国放射学团体的基本特征。我们将放射学团体定义为有两名或更多放射科医生或放射肿瘤学家的任何执业机构，包括学术部门、多专科团体中的单位以及政府设施的工作人员。
为收集放射学团体的基本信息，ACR在1991年末和1992年初对美国所有已识别的放射学团体进行了邮件普查。通过邮件和电话进行随访。为使回复能准确代表所有放射学团体，我们对约2000份回复进行加权，以对应四个普查区域（东北部、中西部、南部和西部）中七个规模类别中每个类别的团体数量的已知控制总数。这些控制总数来自ACR的1990年人力调查，该调查显示共有约3200个放射学团体。
所有团体中约四分之一有两名放射科医生，四分之一有三或四名放射科医生，四分之一有五至七名放射科医生，四分之一有八名或更多放射科医生。学术团体相对较大；近50%有11名或更多放射科医生。非都市地区大型团体很少，而大都市中心城市小型团体相对较少。所有团体中有92%在医院执业，73%在非医院办公室或中心执业。所有团体的执业地点中位数为三个，包括医院和非医院地点。所有团体中有88%提供诊断放射学服务，23%提供放射肿瘤学服务，12%两者都提供，11%是仅提供肿瘤学服务的团体。相对较多的学术团体（25%）是仅提供肿瘤学服务的团体；多专科执业中很少有放射学团体（2%）是仅提供肿瘤学服务的团体。提供诊断放射学服务的团体中，占比最大的诊断放射学技术是普通放射摄影（平片）、超声、乳腺摄影和CT。提供诊断服务且不报告提供乳腺摄影的学术团体占八分之一，而在美国提供诊断服务的所有团体中这一比例仅为百分之几。
所有团体中有一半有两至四名放射科医生，至少自1986年以来这一情况未变。相当比例进行诊断放射学的团体不提供磁共振成像、介入或核医学服务。相对较小的团体尤其如此。随着管理式医疗变得更加突出，而寻求与一个团体签订所有放射学服务合同的管理式医疗组织更青睐提供全方位服务且在多个地点执业的大型团体，这些特征可能会引发一些问题。
