Perspective: AI productivity will not benefit employed radiologists

Abstract

Debates about AI in radiology typically ask whether it will augment or replace radiologists. It is less common to ask who profits from improved productivity. AI systems already interpret high-volume studies, such as screening mammograms, at expert-level accuracy: a recent Swedish trial showed AI safely reduced radiologist workloads by 44 %. Economist James Bessen shows that automation tends to shift value from labour to capital. Following Bessen, we predict that the potential labour savings of AI will primarily benefit employers, investors, and AI vendors, not salaried radiologists. Radiologists should be aware of this trend and where appropriate adopt strategies to navigate AI disruption, such as gaining equity in their practice, specialising in areas resistant to automation, or transitioning to alternative career paths. • Radiology is the main focus of medical AI, yet few debates focus on who benefits. • AI raises imaging output which could reduce the value of radiologists’ labour. • Most productivity gains will go to employers, vendors, and private-equity firms. • History shows automation boosts efficiency while reducing labour’s share of income. • As AI redefines roles, radiologists should seek equity, specialise, or pivot.

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