{
  "source": "Cooked Index — occupational AI risk register",
  "page": "https://cookedindex.com/jobs/radiologists/",
  "methodology": "https://cookedindex.com/methodology",
  "notice": "Verdicts are re-examined as evidence accumulates. Re-fetch before relying on this; the page above always carries the current score.",
  "scored_at": "2026-08-11",
  "model": "claude-opus-5",
  "occupation": {
    "title": "Radiologists",
    "soc_code": "29-1224",
    "category": "Healthcare",
    "us_employment": 26770,
    "median_annual_wage": 420860
  },
  "verdict": "EXPOSED",
  "risk_resistance": 56,
  "contested": false,
  "near_boundary": false,
  "dimensions": {
    "task_resistance": 8,
    "embodiment": 8,
    "liability_shield": 18,
    "trust_premium": 7,
    "judgment_accountability": 15
  },
  "reasoning": {
    "task_resistance": "An 8 reflects that the highest-volume portion of the workday — screening mammography reads, chest CT nodule detection, plain-film fracture triage, bone-age and cardiothoracic ratio measurement — is exactly where FDA-cleared CAD and triage algorithms already operate at scale, but it stays above the 6 line because worklists still contain multi-phase abdominal CTs where the finding only makes sense against three years of priors and a surgical note, plus fluoroscopy, biopsies, drain placements and tumour boards that no model touches.",
    "embodiment": "Most of the day is a dark reading room and a PACS workstation, which anchors this low, but the 8 accounts for the interventional and procedural share of a general radiologist's practice — CT- and ultrasound-guided core biopsies, thoracentesis, paracentesis, lumbar punctures, fluoroscopic barium studies, arthrograms — performed on a live patient in a controlled suite rather than the field.",
    "liability_shield": "An 18 is earned by state medical licensure plus ABR board certification, hospital credentialing and privileging per procedure, and the fact that the dictated report carries the radiologist's electronic signature and is the discoverable document in missed-cancer litigation — the discount from 20 is that most reads are one node in a care chain where the ordering clinician and referring physician also carry duty, so radiology malpractice exposure is real but rarely sole.",
    "trust_premium": "Patients typically never learn the radiologist's name and reads are routinely batched, load-balanced overnight, or sent to teleradiology, which caps this well under 13; the 7 comes from the referrer relationship rather than the patient one — orthopaedists and oncologists develop preferences for specific readers and phone them directly, and that repeat curbside traffic is not interchangeable.",
    "judgment_accountability": "A 15 fits calls where the imaging is genuinely equivocal and the recommendation has consequences: BI-RADS 3 versus 4 on an indeterminate mass, whether a subtle hyperdensity on a stroke code is haemorrhage or artefact within the thrombolysis window, calling an unexpected pulmonary embolism at 3am and escalating it, or recommending against biopsy on a lesion the surgeon wants sampled — ACR appropriateness criteria and structured reporting templates constrain the wording but not the decision."
  },
  "rationale": "Image interpretation is the single most attacked task in medicine by AI, and detection models already match or beat human sensitivity on narrow tasks like lung nodules, fractures, and mammographic screening — but the modal radiologist also compares priors across years, resolves ambiguous findings against clinical history, dictates actionable reports, fields curbside consults from surgeons and oncologists, and performs image-guided procedures. What holds is the signature: a licensed, board-certified human owns the report and the malpractice exposure, and no vendor currently accepts autonomous diagnostic liability. Expect volume per radiologist to rise sharply while the interpretive commodity tier compresses.",
  "outlook": "By 2035 radiologists read far more studies each with AI pre-reads doing first pass, and hiring growth slows while procedural and subspecialty consultative work becomes the durable core of the job.",
  "what_would_raise_it": {
    "levers": [
      {
        "dimension": "liability_shield",
        "change": "FDA continuing to clear all diagnostic imaging AI only as CADe/CADx adjuncts requiring a licensed interpreting physician's signature, plus CMS conditions of participation and state medical practice acts keeping the final report attributable to a board-certified radiologist. A concrete watchpoint: whether any AI vendor's product labeling ever permits autonomous reporting without physician review (as happened with IDx-DR in ophthalmology), and whether malpractice carriers (e.g. The Doctors Company, MedPro) write policies that price autonomous AI reads at all.",
        "plausibility": "already happening",
        "would_add": 2
      },
      {
        "dimension": "judgment_accountability",
        "change": "If the routine screening tier is largely pre-read by AI, the residual role concentrates in discrepancy resolution, indeterminate findings, tumor board participation, and signing off on AI outputs the radiologist did not generate — i.e. owning calls where the model and the clinical picture disagree. ACR's Assess-AI registry and 'AI QA' program formalizing radiologist responsibility for model drift and error adjudication would make this an explicit accountable duty rather than an informal one.",
        "plausibility": "plausible",
        "would_add": 4
      },
      {
        "dimension": "task_resistance",
        "change": "Genuine two-tier structure: plain-film and screening-mammography volume is the commodity tier; the judgment tier is multiphase CT/MR, oncologic staging with prior comparison across years, and interventional/image-guided procedures (biopsies, drains, ablations, IR). If fellowship-trained IR and body/neuro subspecialty work becomes the dominant share of the job as commodity reads compress, measured task resistance rises without any new law. Watch subspecialty fellowship match data and the IR/DR residency split.",
        "plausibility": "already happening",
        "would_add": 4
      },
      {
        "dimension": "embodiment",
        "change": "Same shift toward image-guided intervention — fluoroscopy, CT-guided biopsy, vascular access, ablation — is unpredictable-environment physical work. Only applies to the IR-heavy portion of the SOC code, not to teleradiology.",
        "plausibility": "plausible",
        "would_add": 3
      }
    ],
    "ceiling_note": "Trust premium has no realistic route: patients almost never choose their radiologist, rarely learn the name on the report, and the buyer is the hospital or payer optimizing cost per read — the same economics that made teleradiology outsourcing viable. The liability shield is already near ceiling and is the load-bearing dimension; if autonomous-read labeling and carrier coverage ever arrive, the whole 56 falls fast rather than degrading gradually."
  },
  "adjudication": null,
  "employment_history": {
    "points": [
      {
        "y": 2021,
        "emp": 29530,
        "wage": 239200
      },
      {
        "y": 2022,
        "emp": 29250,
        "wage": 239200
      },
      {
        "y": 2023,
        "emp": 31960,
        "wage": 239200
      },
      {
        "y": 2024,
        "emp": 26290,
        "wage": 239200
      },
      {
        "y": 2025,
        "emp": 26770,
        "wage": 420860
      }
    ],
    "from": 2021,
    "to": 2025,
    "change_pct": -9.3,
    "comparable_from": 2021,
    "spans_soc_revision": false
  },
  "pivots": [
    {
      "slug": "anesthesiologists",
      "title": "Anesthesiologists",
      "verdict": "SAFE",
      "risk_resistance": 89,
      "median_wage": 391490,
      "overlap": 84,
      "skills_to_close": [
        "Operations Analysis",
        "Management of Financial Resources",
        "Operations Monitoring"
      ]
    }
  ],
  "license": "https://cookedindex.com/terms"
}