Burnout in Radiology: Key Risk Factors and Promising Solutions
Recognizing the daunting combination of increasing imaging volume and workforce shortages, these authors discuss key risk factors contributing to burnout and moral injury in radiology, and potential solutions to help preserve well-being among radiologists.
Burnout refers to the emotional, physical, and intellectual exhaustion caused by prolonged fatigue and/or stress. Physician burnout is a global issue impacting all medical specialties though the rate of burnout differs. Radiologist burnout typically falls in the middle-to-high end of all specialties with a 2024 poll finding that 44 percent of male radiologists and 65 percent of female radiologists experience burnout, though some studies have found that the overall percentage is greater than 80 percent.1-3
Additionally, interventional radiology is associated with a higher rate of burnout than diagnostic radiology, possibly due to longer work days and unpredictable emergency consults.4
Moral injury, a concept closely associated with burnout, is defined as the repeated psychological or spiritual harm that stems from events that conflict with one’s moral beliefs.5 In the context of diagnostic radiology, an example of moral injury is the perception that one is providing substandard care due to increasing demands and heavy workloads. In a national survey, 98 percent of both diagnostic and interventional radiologists experienced moral distress.6 Moral injury is distinct from burnout in that the issue originates within the environment rather than the individual, and is typically irreversible.7,8
Emphasis on physician wellness has been gaining traction in recent years and is correlated with reduced burnout and moral injury. Wellness refers to emotional, physical, and social well-being, which in turn impact quality of life. The importance of promoting physician wellness is not only for the physician’s well-being but also for optimizing patient care.9 While overall physician well-being has been increasing over the years, less than one-third of all physicians feel they are thriving in their careers. Radiologists perform at about average among specialties in terms of wellness.10
Risk Factors for Burnout in Radiology
Heavy workload. Due to an aging population, overuse of imaging, growing MRI orders, and the relatively unchanged number of residency positions, radiologists’ workloads are increasing.1 In a study conducted from 2009 to 2020, workload increased for diagnostic radiologists by a whopping 80 percent.11 A more demanding workload can increase levels of stress during the workday, fueling burnout and fatigue.
A 2024 poll found that 44 percent of male radiologists and 65 percent of female radiologists experience burnout though some studies have found that the overall percentage is greater than 80 percent. (Image courtesy of Adobe Stock.)
Long working hours. Unsurprisingly, higher average hours worked per week is correlated with higher rates of burnout. Among interventional radiologists, those who worked > 80 hours a week saw a sevenfold increase in burnout rate than those who worked < 80 hours a week.4 Interventional radiologists are also prone to working after-hours cases (i.e., for emergency procedures), which is a risk factor for burnout. Researchers have also noted similar associations between long working hours and burnout among diagnostic radiologists.12,13
Increased burnout risk for women. Females in radiology are also at increased risk for burnout, according to one poll.1 While this is a separate topic in and of itself, a brief review of the literature shows one explanation is that while more women are joining the workforce, their involvement in domestic work and child care remains largely unchanged.14
Isolation. One of the more unique factors associated with physician burnout in radiology is less contact with other people throughout the day, especially amongst diagnostic radiologists. Compounding this factor is the increased proportion of radiologists who are now working from home part- or full-time. While working remotely offers many benefits, including flexibility, increased productivity, and time saved from commuting, the upsides may be negated by reduced interaction with others and a sense of isolation.15
How Can Wellness Be Improved?
There are two main divisions of wellness we can look to for improving well-being: institutional and personal. Institutional wellness refers to the initiatives and programs offered by an institution to improve wellbeing. On the other hand, personal wellness starts with the individual and encompasses actions that one has control over to improve his or her well-being.
Can reading room assistants have an impact? One proposed intervention for lessening workload and mitigating long working hours is implementing reading room assistants to monitor calls and consults, which has already shown promising results in multiple studies.16,17 Having an assistant can streamline workflow and free up time for radiologists to finish their reads, thereby decreasing hours needed to work.
Team-building events and activities. To reduce feelings of isolation, one solution is for institutions to create social events and team-based activities for radiologists, which facilitates communication and provides the opportunity for networking and mentorship. Finally, wellness programs can be used as an adjunct to other interventions to improve wellness and alleviate burnout.17
Emphasizing ergonomics and good self-care. One’s environment plays a key role in wellness. Optimizing workplace ergonomics, such as by using a standing desk, can improve well-being.18 Other important personal wellness factors include getting adequate sleep, regular exercise, eating well, and having a good support system.
In Conclusion
Though radiology is generally considered a specialty with above-average satisfaction in work-life balance, there is still an average or higher-than-average rate of burnout in the field.1-3,19 There is also an increased incidence of moral injury, a distinct but related topic, in radiology. Connected to both of these terms is wellness, which typically varies indirectly with burnout and moral injury.
Accordingly, the relatively high rates of burnout and moral injury in radiology pose a significant threat to well-being. However, there are numerous strategies that can protect against and ameliorate burnout as well as improve wellness. These include both institutional as well as personal interventions. With the increasing acknowledgement of the importance of wellness in medicine and radiology, significant strides in improving burnout among radiologists seem more attainable than ever.
Dr. Makary is an associate professor of radiology at the Ohio State University Wexner Medical Center. He is a vascular and interventional radiologist.
Ms. Pfahl is a medical student at the Ohio State University College of Medicine.
References
1. Hudnall CE. Burnout fueling workforce woes. Bulletin. 2024. Available at: https://www.acr.org/Clinical-Resources/Publications-and-Research/ACR-Bulletin/Burnout-Fueling-Workforce-Woes . Published July 3, 2024. Accessed June 9, 2025.
2. Liu H, Ding N, Li X, et al. Artificial intelligence and radiologist burnout. JAMA Netw Open. 2024;7(11):e2448714.
3. Fawzy NA, Tahir MJ, Saeed A. Incidence and factors associated with burnout in radiologists: A systematic review. Eur J Radiol Open. 2023 Oct 23:11:100530. doi: 10.1016/j.ejro.2023.100530. eCollection 2023 Dec.
4. Bundy J, Hage AN, Srinivasa RN, et al. Burnout among interventional radiologists. J Vasc Interv Radiol. 2020:31(4):607-613.e1.
5. Hanneman K, Makary MS. Tackling moral distress in radiology: root causes and systemic solutions. Radiology. 2025;315(2):3250273. doi: 10.1148/radiol.250273.
6. Dave P, Brook OR, Brook A, Sarwar A, Siewert B. Moral distress in radiology: frequency, root causes, and countermeasures — results of a national survey. AJR Am J Roentgenol. 2023; 221(2):249-257.
7. Dean W, Talbot S, Dean A. Reframing clinician distress: moral injury not burnout. Fed Pract. 2019;36(9):400-402.
8. Henderson M. The effects of moral injury in radiology. RSNA News. Available at: https://www.rsna.org/news/2025/april/moral-injury-in-radiology . Published April 17, 2025. Accessed June 9, 2025.
9. Brady K, Trockel MT, Khan CT, et al. What do we mean by physician wellness? A systematic review of its definition and measurement. Acad Psychiatry. 2018;42(1):94-108.
10. Insights from 23,000+ physician wellness assessments. Champions of Wellness. 2025; Available from: https://www.championsofwellness.com/insights-from-23000-physician-wellness-assessments/. Accessed June 9, 2025.
11. Burns J, Chung Y, Rula EY, Duszak R, Rosenkrant AB. Evolving trainee participation in radiologists’ workload using a national Medicare-focused analysis from 2008 to 2020. J Am Coll Radiol. 2025;22(1): p. 98-107.
12. Harolds JA, Parikh JR, Bluth EI, Dutton SC, Recht MP. Burnout of radiologists: frequency, risk factors, and remedies: a report of the ACR Commission on Human Resources. J Am Coll Radiol. 2016; 13(4):411-416.
13. Huang HL, Chen RC, Teo I, et al. A survey of anxiety and burnout in the radiology workforce of a tertiary hospital during the COVID‐19 pandemic. J Med Imaging Radiat Oncol. 2021;65(2):139-145.
14. Artz B, Kaya I, Kaya O. Gender role perspectives and job burnout. Rev Econ Househ. 2022;20(2):447-470.
15. Oppenheimer D, Harvey JA. Remote radiology: point—enhance efficiency, promote work-life balance, and ameliorate staffing issues. AJR Am J Roentgenol. 2023;221(1):17-18.
16. Horowitz J, choe MJ, Dienes K, et al. Team approach to improving radiologist wellness: a case-based methodology. Curr Probl Diagn Radiol. 2022:51(5):806-812.
17. Buch KA, Daye D, Wood MJ, et al. Wellness program implementation in an academic radiology department: determination of need, organizational buy-in, and outcomes. J Am Coll Radiol. 2021:18(5):663-668.
18. Richardson M. Wellness in the radiology reading room: making your workstation a workout station. AJR Am J Roentgenol. 2014:203(3):627-9.
19. Wagner E. Physician job satisfaction. Med Prof Ref. 2023. Available at: https://www.empr.com/home/ppl/physician-job-satisfaction/#xd_co_f=MzQ0MjEzMzctNzJmMy00ZDQxLWFmZDYtNDY4NmI4MTg5MjUz~ . Published August 14, 2023. Accessed June 9, 2025.
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