Shifting Procedural Burden: A Nine-Year Analysis of Radiologist-Performed Paracentesis and Thoracentesis in the United States

BACKGROUND: Paracentesis and thoracentesis are essential procedures increasingly performed by radiologists. Prior national studies demonstrated rising radiologist involvement, but contemporary, practice-level data are limited. METHODS: We performed a multicenter retrospective review of internal billing data from 92 U.S. practice sites (2014-2022). Annual totals and per-radiologist averages for paracentesis and thoracentesis were calculated. Results were compared to publicly available Medicare Physician & Other Practitioners datasets (2017-2022), capturing national volumes across all specialties. RESULTS: From 2014 to 2022, radiologists in the dataset performed 93,037 paracenteses and 50,357 thoracenteses. Annual paracentesis volume increased from 3105 (2014) to 16,891 (2022), while thoracentesis rose from 1943 (2014) to 9712 (2022). Yearly average procedures per radiologist increased substantially (paracenteses: 38.3 → 66.8; thoracenteses: 25.9 → 43.4) as did yearly average procedures per site 280.4 (2014) to 436.1 (2022). National Medicare totals remained stable or declined slightly from 2017 to 2022. CONCLUSION: Radiologists now perform the majority of paracentesis and thoracentesis procedures in the United States, despite stable national volumes. This shift underscores the need for strategic workforce planning, training emphasis in radiology residency, and health policy adjustments to support the expanding procedural role of radiologists. SUMMARY SENTENCE: Radiologists now perform a majority of paracentesis and thoracentesis procedures in the United States, reflecting a major shift in procedural burden with implications for workforce planning, training, and health policy.