Too many radiologists? Update.

In light of the growing concern that a large surplus of diagnostic radiologists is pending, the authors (a) reviewed the major projections of the surplus-shortage situation made during the past quarter century and (b) semiquantitatively analyzed factors widely expected to have a substantial effect on the future situation. Projections uniformly were seriously mistaken. Some factors expected to affect the future, such as the increasing percentage of women among radiologists, are foreseeable and have small effects. However, other factors, most notably new technology, cannot be predicted, although their effects may be very large. The authors conclude that the long-term future situation is not predictable. The authors also examined steps that might be taken to reduce the supply of radiologists if a large surplus were known to be pending and antitrust prohibitions against coordinated responses were eliminated. At first, there appear to be multiple actions possible that would reduce the number of graduates of residency programs while preserving, or even enhancing, quality and equity. Closer examination, however, shows that these actions are often conflicting, sometimes not actually desirable, and generally troubled by questions of effectiveness and feasibility of implementation. Thus, even with changes in the law, the authors find no ready solutions to a possible large oversupply of radiologists.