Rationale and Objectives
Occupational “horizontal segregation,” defined as disparity in the distribution of
responsibilities between genders, could discourage women from seeking careers in radiology,
as well as impact women within radiology in terms of compensation, promotion, and
career advancement. We aimed to explore the existence of horizontal workplace segregation
in radiology, as potentially manifested as intergender differences in the distribution
of clinical work effort among imaging modalities for radiologists.
Materials and Methods
Medicare-participating general radiologists, neuroradiologists, abdominal, cardiothoracic,
and musculoskeletal radiologists were identified from the 2016 Medicare Physician
and Other Supplier Public Use File. Work effort in radiography, ultrasound, CT, and
MRI was stratified by gender. Univariable and multivariable analyses were performed.
Results
22,445 radiologists were included (19.0% female; 19.6% in academic practices). At
univariable analysis, female (vs. male) generalists had lower work effort in MRI (10.2%
vs. 13.2%) (p < 0.001); abdominal radiologists had higher work effort in ultrasound (27.1% vs.
21.9%), with lower work effort in CT (53.7%. vs. 56.0%) and MRI (8.1%. vs. 9.4%) (p < 0.001); and musculoskeletal radiologists had higher work effort in radiography
(41.6% vs. 34.8%) and less in MRI (44.8% vs. 49.6%) (p = 0.007). In multivariable analyses, female gender was independently associated with
lower work effort in advanced imaging (CT and MRI) for generalists (coefficient, −0.020;
p < 0.001), abdominal radiologists (coefficient, −0.042; p < 0.001), and neuroradiologists (coefficient −0.010; p = 0.035).
Conclusion
Horizontal occupational segregation exists in radiology with female radiologists devoting
lower work effort to advanced imaging modalities. Further investigation is warranted
to better understand the sources and downstream implications of such variation.
Key Words
Abbreviations:
CT (computed tomorgraphy), MRI (magnetic resonance imaging), NITOS (Neiman imaging types of service), POSPUF (physician and other supplier public use file), wRVU (work relative value units)To read this article in full you will need to make a payment
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Article Info
Publication History
Published online: July 04, 2019
Accepted:
June 6,
2019
Received in revised form:
May 26,
2019
Received:
May 2,
2019
Identification
Copyright
© 2019 The Association of University Radiologists. Published by Elsevier Inc. All rights reserved.
