BENGALURU: Even as the healthcare sector in India continues to grow at a brisk pace, the number of radiologists the country produces has not kept up, as the ratio of radiologists to patients is alarmingly low in India - with just one radiologist available for every 100,000 patients, starkly below the global average. This shortage is profoundly felt in rural areas as access to diagnostic services is critical for timely healthcare.
Industry data suggests that for every 100 diagnostic scans conducted daily, there is only one radiologist available to interpret the results. This scarcity significantly hampers timely reporting of emergency cases, directly impacting patient mortality and delaying crucial treatments and surgeries due to the inability to diagnose conditions accurately.
“Although the use of AI-based technology is improving the turnaround times for radiology reports in Tier I and II cities, the shortage is still a concern. Radiologists are available on-demand in private hospitals in well-developed cities, but the situation continues to be severe in Tier II and III cities,” said Dr Jagadish Hiremath, chairman at Aasra Hospitals, adding that this affects patients with emergency cases and there is certainly a greater need for measures to be taken to address this crisis immediately.
“The distribution of radiologists is heavily skewed towards metropolitan and Tier-I cities, a trend influenced by more attractive financial rewards and better working conditions,” said Kalyan Sivasailam, Founder and CEO of 5C network, a digital diagnostics startup.
The pool of radiologists can be increased by expanding the scope for post graduation courses and creating more opportunities for medical students to specialise in radiology. “Radiology has been the top most subject in the medical field for the last over four decades. But the number of PG seats in radiology in many states is not proportional to the demand which is why there are less number of radiologists, who require specialised training and equipment to perform their duties effectively. The cost of training, maintaining equipment and ensuring compliance with regulations can contribute to the overall expense of employing a radiologist,” said Dr Manas Ranjan Kar, senior interventional radiologist at Apollo Hospital, Bhubaneswar.
One major factor that dissuades students from choosing this field is the high level of competition to secure a spot in radiology residency programmes, which can be challenging. The extensive training and long working hours required in radiology is also daunting for doctors. “The field of radiology is not less appealing. The current shortage of radiologists is due to the unavailability of seats for radiology courses,” said Dr Hiremath.
“Several students on completion of their course are shifting to other countries for higher studies and specialisation. Thus, we may have to appoint people with specialisation in other subjects to meet the demand,” said Dr Amel Antony, senior consultant radiologist at Lisie Hospital, Kochi.
Radiologists face several challenges, including heavy workloads, long hours and high levels of stress. They need to update their skills and knowledge to keep up with rapid advancements in technology.
“There is a fear factor as well. Students are reluctant to choose the course as the laws are strict. Even if there is a minor clinical mistake, the license will be cancelled and the radiologist will be punished. People from the younger generation, thus, are reluctant to choose the field, especially ultrasound,” added Dr Antony.
As there is a shortage, the workload on available radiologists keeps growing. “Enhancing working conditions for radiologists, such as reducing long working hours and providing a better work-life balance, can make the field more attractive. Besides increasing awareness about the importance of radiology in healthcare and promoting the field among medical students, investment in advanced technology and tele-radiology services can help improve efficiency and help reduce the burden on practicing radiologists,” Dr Kar added.
The high expenses linked with hiring radiologists render their services inaccessible to numerous diagnostic facilities and hospitals, particularly those serving disadvantaged communities, according Sivasailam.
“Hiring a radiologist is more expensive compared to other specialties, with costs rising 7-10% annually. For instance, a fresh graduate radiologist can cost a hospital around `2.5 lakh per month, with interventional radiology and neuroradiology being the most in-demand subspecialties,” said Dr Hiremath. Sivasailam added that telemedicine and other technology could play a significant role in bridging the gap, especially in remote areas. “In regions, where the scarcity of radiologists is pronounced, leveraging technological advancements becomes imperative. Teleradiology, with its incorporation of artificial intelligence (AI) for pre-processing of reports, before it is reviewed by a radiologist, holds immense promise. This approach substantially decreases diagnosis time, empowering radiologists to manage cases more efficiently despite the shortage,” he added.
Stressing on the consequences of delayed diagnoses owing to shortage of radiologists, particularly in the context of time-sensitive ailments, Sivasailam said the ramifications of delayed diagnoses are grave, ranging from loss of limbs or life, owing to postponement of critical surgical interventions to miscommunications that can erode the trust between patients, their families and healthcare providers. “In critical conditions like stroke and internal bleeds, every second is critical and in such situations, a timely diagnosis can mark the difference between life and death.”
While India is an ideal destination for medical tourism, as the cost of advanced medical treatments is comparatively very less than other developed countries, the stark shortage of radiologists will have critical implications on the accessibility and affordability of healthcare, particularly rural and economically disadvantaged communities.
(With inputs from Anna Jose @Kochi and Hemant Kumar Raut @Bhubaneshwar)