Abstract
A recent American Registry for Diagnostic Medical Sonography (ARDMS)/Inteleos study focusing on trends in sonographer retirement raises some interesting economic questions about the future of diagnostic medical sonography in clinical and academic workplaces (See Figure 1). With the ever-increasing utilization of ultrasound imaging across virtually all medical specialties, the demand for clinical practitioners with expertise in corresponding sonographic disciplines will continue to grow proportionately. However, this increase in demand is not currently being met by a concomitant increase in supply of appropriately trained and credentialed sonographers. Several factors contribute to this evolving shortage including the increase in the number of sonographic examinations being performed, the number of graduates from accredited sonography programs, and, as is the focus of this discussion, the exiting from the workplace of experienced sonographers in favor of early retirement. 1 This early retirement trend also impacts the realm of sonography education. As experienced, tenured educators opt to exit classrooms and clinical sites, the void is filled by a new generation of enthusiastic but less-experienced successors. This editorial offers some thoughts on how retired ultrasound professionals can continue to participate and offer their expertise and experience as both clinical and academic sonography domains transition to a new generation.
ARDMS/Inteleos retirement forecast based on current registrants.
Projected Sonographer Shortage
Diagnostic sonographic studies have always been a mainstay of the medical imaging armamentarium. Comprising nearly 45% of all medical imaging services performed in hospitals in the United States, sonography ranks as the leading application compared with utilization rates of other radiology-based imaging techniques, such as computed tomography (CT), magnetic resonance imaging (MRI), conventional radiography, and nuclear medicine. This statistic alone, which excludes utilization rates of other sonography-heavy disciplines, such as cardiology and vascular specialties that typically use experienced sonographers to perform their studies, clearly demonstrates the significant economic and clinical contribution that sonographers play in delivering health care across patient populations. 2 Historically, even when overall utilization of inpatient imaging studies in the radiology department decreased, such as during the COVID-19 pandemic of 2020 to 2021, the use of sonographic studies remained numerically constant, indicating a relative increase in demand.3,4 The upward trend in the number of sonographic studies performed in the decade 2011 to 2021 surpassed the labor force capacity available to conduct these exams. This mismatch between supply and demand of qualified sonographers is resulting in a work force shortage and portends a subsequent future strain on the provision of health care services. 5 Unfortunately, little, if any, empirical data are available for changes in work force trends within the academic sonography community. Of necessity, then, this discussion relies primarily on trends within the clinical realm, understanding that generalized data may possibly be extrapolated to the academic sonography domain as well.
Retirement Trends Among Sonographers
Sonographers are retiring at a slightly earlier age than individuals in the general population, as noted in Figure 1. In a recent study conducted by the ARDMS/Inteleos, in the decade 2014 through 2024, the average retirement age for sonographers was 60.8 years. In the general population, average retirement age during this same time period was 64 years for men and 62 years for women. 6 The ARDMS data also demonstrate that this trend is expected to continue through the next decade. A number of economic and personal factors are contributing to this trend across all occupations in the United States. Improvements in the provision of retirement income, the health and educational level of the workforce, the nature of jobs, and improved Social Security and Medicare benefits all provide incentives for the early exit from stressful, full-time positions. 7 Factors specific to allied health care professionals point to additional reasons for sonographers opting out of full-time employment and include burnout, occupational stress, workplace bullying, increased workload, and understaffing. 8 Most recently, COVID-19 introduced social and job-related factors that exacerbated the risk of burnout and the decision of many health care providers to exit the workplace. 9 The net result of these myriad contributing factors is a reduction in the supply of experienced ultrasound practitioners and instructors required to meet the increasing demand for both clinical and educational sonographic services.
Postcareer Opportunities
The data presented in this recent ARDMS/Inteleos study demonstrates the unfortunate trend that sonographers with tremendous expertise are exiting the profession early, taking with them decades of knowledge and experience that could potentially have great import on the continued evolution and growth of the discipline. The survey shows that over the last decade, the average amount of time a sonographer has under his/her belt at retirement is over 25 years (See Figure 2). This level of experience is projected to increase to almost 29 years as retirement trends continue over the next decade.
ARDMS/Inteleos years of certification forecast based on current registrants.
It is certainly understandable that, after years of service in the health care industry, most individuals look forward to enjoying their next life phase away from the day-to-day stresses and responsibilities associated with active participation in the sonographic work force. However, some individuals may wish to continue to share their invaluable experiences and hard-earned wisdom with those who come after. There are a variety of options that can continue to support our profession in a postcareer, or “moving-on” phase, of the typical career trajectory. Most of these center around volunteer activities that foster the education, professional growth, development, and mentoring of both sonography students and active practitioners. These opportunities include but are not limited to:
Volunteering to do case reviews with students in educational and clinical settings.
Volunteering or attending student scan labs as a “value added” partner.
Mentoring students in case studies, class projects, and career path direction.
Organizing or participating in activities in state and local ultrasound groups.
Participating in credentialing and certification processes by writing test questions and/or serving on examination advisory committees.
Monitoring social media or list serves and answering clinical, task-related, or professional development questions.
Participating in professional society committees and activities (e.g., SDMS).
Conclusion
Early retirement plays a role in the increasing shortage of clinical and academic sonography professionals at a time when demand for skilled and experienced practitioners is increasing across the board. This trend is projected to continue over the next decade, raising concerns about ease of access to imaging services, quality of patient care, and the stability and continuity of accredited ultrasound educational opportunities. While the exit of seasoned and experienced practitioners certainly is well-earned and should be expected after, in many cases, decades of dedicated service, unique opportunities at this “moving-on” phase in the typical career trajectory allow individuals to continue to make valuable contributions to a vocation that has served many of us “old-timers” well.
Footnotes
Acknowledgements
The author and JDMS editor-in-chief thank Inteleos, specifically Jessica Herchenroeder, PMP, PMI-ACP, CSPO, CX-PRO, Director of Engagement, for providing this important trend data.