Future

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Not to beat a dead horse here, but I've been reading regarding the proposed cuts to rads, and it's concerning. Given that the road is long getting there, what are realistic cuts to be expected? And when will the financial future of rads become more clear? I hear talk and news about all these proposed measures but when will they be taking effect?

They've been taking place for the past 3-5 years. I expect it all to stop around 250-300k.

Originally Posted by cowme

They've been taking place for the past 3-5 years. I expect it all to stop around 250-300k.

When you say you expect it to stop around 250-300k, is that for starting salaries or with a number of years of experience in the field?

Id guess Average across all radiologists. But fwiw, I think every specialty will drop to that point as the ceiling

Originally Posted by cowme

Id guess Average across all radiologists. But fwiw, I think every specialty will drop to that point as the ceiling

Interesting perspective. So then we should be expecting salaries of less than 200k to start, and all specialties to make about the same. That's kind of depressing.

I also don't understand why the market is so glutted. I am aware of all the non retiring older docs, the market crash, and the large # of positions. But doesn't anesthesia, IM/FM/psych/peds pump out a ton of residents and their job market is not as bad.

Is there just not as large a need for radiologists overall then?

Salary is driven by Medicare rates, not supply and demand. Rads still make more than most other docs despite being in relatively low demand. FP still makes nothing despite being in massive demand.

Originally Posted by cowme

Salary is driven by Medicare rates, not supply and demand. Rads still make more than most other docs despite being in relatively low demand. FP still makes nothing despite being in massive demand.

Problem is that rads residency is twice as long as FM, and it seems that jobs are non-existent, and the few that are available seem to pay just as badly as FM. I guess I can't figure out why that is? The non-existent job part that is.

Originally Posted by Medstudentquest

Problem is that rads residency is twice as long as FM, and it seems that jobs are non-existent, and the few that are available seem to pay just as badly as FM. I guess I can't figure out why that is? The non-existent job part that is.

If your reason for choosing radiology is salary, you'll be disappointed.

I would still choose radiology over FM if FM was reimbursed twice as well as radiology.

-

Originally Posted by Medstudentquest

Problem is that rads residency is twice as long as FM, and it seems that jobs are non-existent, and the few that are available seem to pay just as badly as FM. I guess I can't figure out why that is? The non-existent job part that is.

Well you can always see some acne patients for cash once the rads job market crashes.

Originally Posted by drizzt3117

Well you can always see some acne patients for cash once the rads job market crashes.

Fluoroscopy-guided pimple popping? Sounds reasonable.

Originally Posted by johnnydrama

Fluoroscopy-guided pimple popping? Sounds reasonable.

The OP finished a derm residency before applying rads.

Originally Posted by drizzt3117

Well you can always see some acne patients for cash once the rads job market crashes.

Ha! I actually hate acne and treating acne, one of my biggest pet peeves.

Originally Posted by Medstudentquest

Ha! I actually hate acne and treating acne, one of my biggest pet peeves.

There's always fluoro-guided breast implants

Originally Posted by Dumb

There's always fluoro-guided breast implants

This one I don't get, sorry.

Originally Posted by Medstudentquest

This one I don't get, sorry.

wasn't a joke...apparently that's an actual procedure being developed. i do wonder how much demand there is for this type of thing, including treatment for varicose veins, and if it'd be enough for a truly cash-based practice.

I am a radiologist, it is true. The golden years are over.

Furthermore, when I am oncall I am up more than the surgeons are.

We are working a lot more and getting paid a lot less.

Move on to another specialty.

Dermatology is the last great bastion of medicine.

Originally Posted by bobafart

I am a radiologist, it is true. The golden years are over.

Furthermore, when I am oncall I am up more than the surgeons are.

We are working a lot more and getting paid a lot less.

Move on to another specialty.

Dermatology is the last great bastion of medicine.

Interesting. How is rads still being compensated so much more than other specialties then? And what do you expect compensation to be in the upcoming future?
Derm is getting blasted big time, it's not what it used to be in many areas.

Also you've mentioned in other threads that you were an ER doc before. What made you switch, and why to rads vs. something else? It seems you are not happy with rads either? Just curious.

Originally Posted by Medstudentquest

What made you switch, and why to rads vs. something else? It seems you are not happy with rads either? Just curious.

I'd be curious myself. I was thinking EM for a long time and have a radiology rotation early in M4 to see how I feel there.

Originally Posted by exi

I'd be curious myself. I was thinking EM for a long time and have a radiology rotation early in M4 to see how I feel there.

I personally did not absolutely hate EM in med school, but absolutely hated it with fiery contempt during internship. Patients were so entitled and demanding, it was sickening. I know this is not special to EM but in part because there is no long term relationship with the patient, it's difficult as a provider to form a therapeutic bond and bring patients back to reality. To hear patients complain and scream that they had waited too long, the drunk come in and demand/complain about how they had not gotten their sandwich, or the ones who barely spoke English yet *demanded* another bag of saline because they *needed* it, as well as the referral from a NP for emergent admission for an appy because a young gal had abdominal pain, was just nauseating. Not to mention working having to work 12 hour shifts that start at 7-10pm, holidays, weekends, etc. even as an attending when I'm 50. Ugh. *Fiery contempt*

Originally Posted by bobafart

I am a radiologist, it is true. The golden years are over.

Furthermore, when I am oncall I am up more than the surgeons are.

We are working a lot more and getting paid a lot less.

Move on to another specialty.

Dermatology is the last great bastion of medicine.

Originally Posted by greg1184

This is the dude talking about how US-IMGs are not given preference over FMGs? Good grief. It was nearly impossible to even get a hold of the rads resident while on call, the attendings were nowhere to be seen. Surgeons though, were up and about regularly where I did internship!

Generally clinical rotations appear much more interesting than they are to medical students and radiology appears much less interesting.
You are MS4, go to IM or ER. You will be given a defined role to get H&P and even write some orders to be signed later by resident. You feel you are a doctor which is exciting only for a year or two. All of us had some dream of being a doctor since college or even for some since childhood and now all of a sudden your wishes come true. During your ER rotation you play a role of a doctor without seeing the big picture. On the other hand in radiology, you have to sit and even in some reading rooms there is not enough space for you without knowing what they are doing.

I do not understand why people get interested in ER. There is nothing interesting about it other than having relatively short residency and being paid well, esp pay per duration of training is really good. You have to deal with BS your whole life. It is practically a glorified triage nurse.
Step away form ER, my 2 cents.

Is Ortho next?

It's like some twisted divinity decided to smite all the people who worked their butts off on the Step 1 and M3 year.

It pays to be average, because of reversion to the mean.

Originally Posted by naus

Is Ortho next?

It's like some twisted divinity decided to smite all the people who worked their butts off on the Step 1 and M3 year.

It pays to be average, because of reversion to the mean.

If you think that way, you deserve to be disappointed, frankly.

Do the best you can and choose a specialty you will enjoy and where you will excel.

If you go into this chasing money, you will be disappointed. If you find something you like and then happen to make a decent living doing it, you will be happy.

Originally Posted by johnnydrama

If you think that way, you deserve to be disappointed, frankly.

Do the best you can and choose a specialty you will enjoy and where you will excel.

If you go into this chasing money, you will be disappointed. If you find something you like and then happen to make a decent living doing it, you will be happy.

Get off the high horse. Competitive specialties are competitive for a reason (mainly in the salary to hours worked ratio). It doesn't matter what I think, this is kind of the reality of what's going on, and I was merely commenting on the irony.

Originally Posted by naus

Is Ortho next?

Not sure why you're using the word "next" since ortho's pay has been *concurrently* declining at the same pace as rads (i.e., 10% decline year over year). That being said, the decline doesn't change the fact that ortho and rads are still the most highly compensated specialties on average. (I will add that it's unusual neurosurg and rad Onc weren't included in the medscape salary survey. I wonder if they just declined to respond, which would prolly be a good strategy for rads, too)

Originally Posted by Dumb

Not sure why you're using the word "next" since ortho's pay has been *concurrently* declining at the same pace as rads (i.e., 10% decline year over year). That being said, the decline doesn't change the fact that ortho and rads are still the most highly compensated specialties on average. (I will add that it's unusual neurosurg and rad Onc weren't included in the medscape salary survey. I wonder if they just declined to respond, which would prolly be a good strategy for rads, too)

I meant that at some point you just can't increase your volume or productivity anymore to offset the reimbursement cuts. I get the feeling that ortho is reaching that peak and will soon go the path of ENT in another 5 years. Still decent salary but no standout either. Probably still a little better than Gen Surg on an hours worked basis, but we're all regressing to the mean.

Ortho and Rads are such different specialties that you can not claim you are interested in both. The only common thing between them is money.If you choose your specialty solely based on money you will be miserable big time. Job security is important, income is very important but comparing two different fields that have 10 percent difference in salary is radiculous. The overlap between salary of different doctors in different practices of different specialties is huge. Choose what you like.

Originally Posted by shark2000

Ortho and Rads are such different specialties that you can not claim you are interested in both. The only common thing between them is money.If you choose your specialty solely based on money you will be miserable big time. Job security is important, income is very important but comparing two different fields that have 10 percent difference in salary is radiculous. The overlap between salary of different doctors in different practices of different specialties is huge. Choose what you like.

Lots of med schools don't have exposure to rads though for third year. That does make it challenging to decide. So a lot of people go with whatever reach they could get based on their Step 1 score or income goals.

Originally Posted by shark2000

Ortho and Rads are such different specialties that you can not claim you are interested in both.

This is really not true. I was choosing between ortho and rads. The pathology is amazing, and I loved sports medicine. I ultimately realized that I liked the "Science" aspect more than the treatment aspect, and didn't really love the OR, so I went with rads.

Originally Posted by cowme

This is really not true. I was choosing between ortho and rads. The pathology is amazing, and I loved sports medicine. I ultimately realized that I liked the "Science" aspect more than the treatment aspect, and didn't really love the OR, so I went with rads.

Exactly. Pathology, anatomy. It really comes down to whether you like the OR or not and that's actually kind of hard to figure out since there's a lot of novelty in the OR as an M3.

You should not look at the difference between fields on paper or in textbooks. In that sense, all of medicine have a lot of similarities. You have to take a look at day to day practice.
Yes, day to day practice of your field and in this regard ortho is a completely different world than radiology. If you are in doubt between them, you have not done your homework yet. Go and hang out with mostly pp practicing physicians for their entire schedule and not only the morning. Then you will find out the difference.
On the other hand, totally agree that as MS you do not have really good ways to know whether you like something or not. You will figure it out only when you do it yourself and that means when you are 2nd or 3rd year resident.

Originally Posted by shark2000

Generally clinical rotations appear much more interesting than they are to medical students and radiology appears much less interesting.
You are MS4, go to IM or ER. You will be given a defined role to get H&P and even write some orders to be signed later by resident. You feel you are a doctor which is exciting only for a year or two. All of us had some dream of being a doctor since college or even for some since childhood and now all of a sudden your wishes come true. During your ER rotation you play a role of a doctor without seeing the big picture. On the other hand in radiology, you have to sit and even in some reading rooms there is not enough space for you without knowing what they are doing.

I do not understand why people get interested in ER. There is nothing interesting about it other than having relatively short residency and being paid well, esp pay per duration of training is really good. You have to deal with BS your whole life. It is practically a glorified triage nurse.
Step away form ER, my 2 cents.

It's like you read my mind.

But as for the stuff about EM, I respectfully disagree. For someone who loathed rounding and didn't care for the OR, it was actually pretty great. And in comparison with Rads, they both have that whole "what exactly am I looking at, take care of it and move on" thing going on for it, which is what's leaving me torn between the two (besides Rads getting paid better while EM is more fun ).

Originally Posted by dostudent13

It's like you read my mind.

But as for the stuff about EM, I respectfully disagree. For someone who loathed rounding and didn't care for the OR, it was actually pretty great. And in comparison with Rads, they both have that whole "what exactly am I looking at, take care of it and move on" thing going on for it, which is what's leaving me torn between the two (besides Rads getting paid better while EM is more fun ).

EM may be more "fun" when you are 30, but when you are 50 and working holidays/night/weekends it sucks big time.

Originally Posted by Medstudentquest

EM may be more "fun" when you are 30, but when you are 50 and working holidays/night/weekends it sucks big time.

Yeah it does.. just like the radiologist at my base hospital hated it when she had to work two overnights in a row on a weekend a while back and then come in Monday morning. It happens. Everyone has to do it sometime, granted EM does it more often but hey, working 14 days a month with some of those being weekends or nights might be worth it..

Originally Posted by dostudent13

Yeah it does.. just like the radiologist at my base hospital hated it when she had to work two overnights in a row on a weekend a while back and then come in Monday morning. It happens. Everyone has to do it sometime, granted EM does it more often but hey, working 14 days a month with some of those being weekends or nights might be worth it..

Usually most attendings in rads don't go into the hospital, call is from home. EM is a different beast and has high burn out. But if you love EM, I say go for it!

Originally Posted by dostudent13

Yeah it does.. just like the radiologist at my base hospital hated it when she had to work two overnights in a row on a weekend a while back and then come in Monday morning. It happens. Everyone has to do it sometime, granted EM does it more often but hey, working 14 days a month with some of those being weekends or nights might be worth it..

1- Current trend in radiology is going towards taking in house call including evenings and overnights. More and more studies are ordered over night which justifies having an on site radiology for a shift overnight to read them and CLEAN the list. 20 years ago on average 2-3 CT scans were ordered a night, not it is much much more. So when it is 5 CTs you can do it from home, but when it is 30 CTs, 20 US and 50 XR, then it may justify having an in house radiologist.
2- It is not about hours of working. I'd rather work 12 hours reading CTs than doing an 6 hours ER shift. But agree that it is a personal preference. You may like ER shift more.
3- Everybody hates working nights and weekends esp after the age of 40.

why does it make a difference being in house if you have more studies? With a top end computer and internet connection and phone line, isn't that all you need?

It is more than just film reading.There should be somebody to control the department from quality to minor problems like contrast reactions,.... Minor procedures like joint aspiration, challenging LP, US with techs, talking with clinicians, emergent flouro procedures,....
While many can be done from home, if the volume is high enough you'd rather be in place in person.
It is like having an online university. Can be done over net and is being done, but high quality training is done in general not over net.

How much "break time" (not reading films, writing notes, or on work email) do radiologists get in say an hour? I remember shadowing an academic radiologist a couple of years ago, and he seemed to have quite a few minutes in an hour to take care of personal business. Is this the norm in radiology in general or are you working and mentally occupied for solid 60 minutes? In most other specialties I notice there is always some down time for joking around and just unwinding a little, i.e., you're not always "on." Or is radiology kind of like doing a full length Step 1 every day for the rest of your lives?

Originally Posted by naus

How much "break time" (not reading films, writing notes, or on work email) do radiologists get in say an hour? I remember shadowing a radiologist a couple of years ago, and he seemed to have quite a few minutes in an hour to take care of personal business. Is this the norm or are you working and mentally occupied for solid 60 minutes? In most other specialties I notice there is always some down time for joking around and just unwinding a little, i.e., you're not always "on." Or is radiology kind of like doing a full length Step 1 every day for the rest of your lives?

Also curious about this. How does the pace compare to a busy ED doc?

Academics isn't terrible. But in private practice, radiology is about as busy as ED. You'll be lucky to get 10 minutes for lunch at your desk in some groups. At least you get to sit in one place for the most time

Originally Posted by cowme

Academics isn't terrible. But in private practice, radiology is about as busy as ED. You'll be lucky to get 10 minutes for lunch at your desk in some groups. At least you get to sit in one place for the most time

Speaking of sitting in one place for a long time... Are standing (or adjustable) desks becoming popular at all with radiologists?

Combining the extra radiation with sitting all day seems like a good recipe for a short retirement.

A lot of places have adjustable tables.
extra-radiation other than IR is very minimal to negligible.
The break time is different depending on the setting of your practice. In academics there is lots of free time. In pp very little to no free time. Generally speaking, the free time in radiology is much less than many other fields. When you work, you really work.

Originally Posted by shark2000

A lot of places have adjustable tables.
extra-radiation other than IR is very minimal to negligible.
The break time is different depending on the setting of your practice. In academics there is lots of free time. In pp very little to no free time. Generally speaking, the free time in radiology is much less than many other fields. When you work, you really work.

Oh I know the radiation exposure is minimal (although I'd like to see some nice longitudinal studies on IR docs).

I was really just asking about standing desks.

Originally Posted by johnnydrama

Oh I know the radiation exposure is minimal (although I'd like to see some nice longitudinal studies on IR docs).

I was really just asking about standing desks.

at a hospital i was at recently there was a reading station that was up at a standing level and instead of a chair there was a treadmill. the radiologist was training for a marathon

Originally Posted by Deceptacon

at a hospital i was at recently there was a reading station that was up at a standing level and instead of a chair there was a treadmill. the radiologist was training for a marathon

I think that would be a great idea, but I have to assume that was noisy.

Come on. You can not concentrate or read a study while running on a treadmill. You have to scroll over 300 images for a CT. How can you do it when running.
On the other hand, I love the adjustable tables. You can read half a day standing and half a day sitting. You can change the level when sitting so you will be able to lie back or sit straight or ...
It is much more comfortable. I think even if your job does not provide you with one, it is worth buying one.
We have adjustable table in almost all of the department except for a few stations and I can really feel the difference when working for long hours.

Originally Posted by shark2000

Come on. You can not concentrate or read a study while running on a treadmill. You have to scroll over 300 images for a CT. How can you do it when running.
On the other hand, I love the adjustable tables. You can read half a day standing and half a day sitting. You can change the level when sitting so you will be able to lie back or sit straight or ...
It is much more comfortable. I think even if your job does not provide you with one, it is worth buying one.
We have adjustable table in almost all of the department except for a few stations and I can really feel the difference when working for long hours.

You wouldn't be running, walking could work through.