Top Problems in Radiology

A ranked assessment of the structural failures facing diagnostic radiology, ranked by patient reach and monetary cost, and sourced from peer-reviewed journals, medical societies, and federal data.

Methodology

Each problem is scored on two factors: patient impact and annual cost. Scores are based on peer-reviewed research, government data, and medical organizations. We lower scores when the evidence is indirect, uncertain, or doesn’t estimate a nationwide yearly impact. The total score (out of 100) determines the ranking.

No ranking is perfect. Research findings vary, data sources disagree, and some judgment is unavoidable. If you know of better evidence or a better way to score these problems, please fire away.

Patient Reach (P)

  • 50>100M directly affected
  • 4030M–100M directly affected
  • 3010M–30M or clear "1 in X" ratio
  • 20<10M or probabilistic/future harm
  • 10<5M or indirect impact

Monetary Cost (M)

  • 50>$10B direct annual cost
  • 40$1B–$10B direct annual cost
  • 30$400M–$1B
  • 20$200M–$400M
  • 10<$200M or indirect figure

References

  1. 01
    Medicare Physician Payment Has Plummeted Since 2001 American Medical Association · 2025
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    FIND: An Automated Follow-Up and Notification Dashboard for Radiology Findings Beesley et al. · Journal of Imaging Informatics in Medicine 2023
  5. 05
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    Radiologic Errors and Malpractice: A Blurry Distinction Berlin · American Journal of Roentgenology 2007
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    Fundamentals of Diagnostic Error in Imaging Itri et al. · RadioGraphics 2018
  11. 11
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    Perceptions of Prior Authorization Burden and Solutions Sahni et al. · Health Affairs Scholar 2024
  13. 13
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  15. 15
    Radiologist Workforce Projections 2024–2055 Nicola et al. · Neiman Health Policy Institute 2024
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  19. 19
    Projected Lifetime Cancer Risks From Current Computed Tomography Imaging Smith-Bindman et al. · JAMA Internal Medicine 2025
  20. 20
    Interpretive Error in Radiology Waite et al. · American Journal of Roentgenology 2017
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  25. 25
    Financial Burden of Cancer Care NCI Cancer Trends Progress Report