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Thank you Kim and Ratty.
Competitive Residencies
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I think Dr. Cuts list is pretty accurate although I would put radiology higher.
When you look at the hours put in by neurosurgeons and their comparative income they have to be down the list as far as an absolute per hour basis, although there are exceptions.
In reference to the reply by Dr Evil:
(Many neurosurgeons are paid $1500 a night just to take call from home and come in if they're needed. That's amazing to me.)
It is not unusual for radiologists doing locums to work 9-5 and get paid 2K per day.
I once made 14K in one 5 day week and worked about 50 hours.
When you look at the hours put in by neurosurgeons and their comparative income they have to be down the list as far as an absolute per hour basis, although there are exceptions.
In reference to the reply by Dr Evil:
(Many neurosurgeons are paid $1500 a night just to take call from home and come in if they're needed. That's amazing to me.)
It is not unusual for radiologists doing locums to work 9-5 and get paid 2K per day.
I once made 14K in one 5 day week and worked about 50 hours.
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posted by stinkytofu
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Interestingly, the Radiologists that I work with have a different view of the future of Radiology. The hospital I was working at is considering sending the images to Radiology Centers in a different state to be read. I think the name of this Radiology Center was Night Hawks, or something like that and they are creating centers all over the country. Anyway, according to them, this would eliminate the need for many of the full-time radiologists in the hospital. They would still need some for interventional procedures, emergencies, etc. and their lives would basically suck. It was their opinion that in 5-7 years, after hospitals and doctors got used to this idea, that it would be widely accepted. His opinion was these centers would hire the top Radiologists, be much more efficient and thus cutting down on the number of Radiologists needed, save the hospital tons of money, and make the call suck for the hospital-based Radiologists. I'm not sure if this will actually happen, but one of the interns (who is going into Rads) and I got into a discussion with him about it when we asked him to review a CT Scan with us on one of our patients.
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The bottom line here is that even if all the exams are sent to a centralized place the number of exams will stay the same, thus the number of radiologists needed will also generally be about the same. If you have Super-doc who is the best at reading CTs he may be able to read an extra one or two a day, but not many more, it wouldn't be worth it. A realistic scenario is that the night call may switch to many of these areas and some of these INC places will make big bucks consulting on difficult cases. A smaller version is already happening. Instead of having 3 rads at Small Town Hospital, and 7 rads at Large Town Hospital, there are now 10 rads at Large Town Hospital, and 3 of them cover the other place by telerad or by alternating driving there.
The AJR had an excellent article about the shortage of radiologists and they did not seem to think it was going to change any time soon
____________________________________________________
Interestingly, the Radiologists that I work with have a different view of the future of Radiology. The hospital I was working at is considering sending the images to Radiology Centers in a different state to be read. I think the name of this Radiology Center was Night Hawks, or something like that and they are creating centers all over the country. Anyway, according to them, this would eliminate the need for many of the full-time radiologists in the hospital. They would still need some for interventional procedures, emergencies, etc. and their lives would basically suck. It was their opinion that in 5-7 years, after hospitals and doctors got used to this idea, that it would be widely accepted. His opinion was these centers would hire the top Radiologists, be much more efficient and thus cutting down on the number of Radiologists needed, save the hospital tons of money, and make the call suck for the hospital-based Radiologists. I'm not sure if this will actually happen, but one of the interns (who is going into Rads) and I got into a discussion with him about it when we asked him to review a CT Scan with us on one of our patients.
___________________________________________________
The bottom line here is that even if all the exams are sent to a centralized place the number of exams will stay the same, thus the number of radiologists needed will also generally be about the same. If you have Super-doc who is the best at reading CTs he may be able to read an extra one or two a day, but not many more, it wouldn't be worth it. A realistic scenario is that the night call may switch to many of these areas and some of these INC places will make big bucks consulting on difficult cases. A smaller version is already happening. Instead of having 3 rads at Small Town Hospital, and 7 rads at Large Town Hospital, there are now 10 rads at Large Town Hospital, and 3 of them cover the other place by telerad or by alternating driving there.
The AJR had an excellent article about the shortage of radiologists and they did not seem to think it was going to change any time soon
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That's $280/hour! I think I'm gonna go read my Squire's now
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xraydoc:
Does teleradiology allow the radiologist to be literally anywhere in the world, as long as they have a license for the state they are consulting in? Also, do these centers have their radiologists come in to a main place, or do they read at home, etc?
How common is this, and where do you see it going in the next 5-7 years or so?
Does teleradiology allow the radiologist to be literally anywhere in the world, as long as they have a license for the state they are consulting in? Also, do these centers have their radiologists come in to a main place, or do they read at home, etc?
How common is this, and where do you see it going in the next 5-7 years or so?
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That is the general rule. As long as you have a local license you can read them anyplace. The rules do vary from place to place. Many hospitals have their own rules as well. There is one hospital here that states that attendings can live no more than 30 minutes from the hospital (probably pretty hard to enforce)
There are several companies that I know that are actively recruiting rads to read from home. I think the pay is generally on the non-partnership scale and some don't offer the extensive benefits that a private or academic group would offer. I think the stability of a job of that sort is a little scary as well. You are totally dependant on a corporation as opposed to a more stable healthcare entity that most likely will remain a presence in the same city for a long time in some form or another.
It is difficult to tell where this is all going. You have to remember there is fierce competition among groups for the work as well as for new radiologists. Most of the small to larger groups have talented fellowship trained radiologist in many of the specialities and are not about to let their studies be shunted to another place. The contracts with the hospitals are usually exclusive and the hospitals for the most part don't want to anger the group because of the tremendous amount of money and time it would take to find another group in its entirety.
I think that if the USA somehow goes to a national medical license that could expedite the trend toward centralization. This in some ways would be good for most radiologists who want to live in the metropolitan areas and want to do their subspeciality. If you extropolate this there may be say 25 -50 mega radiology groups in the country each with maybe 500-1000 rads working in 3-4 centers in each state with incredible sub-specialization. One or two radiologists would cover the procedures at each hospital, the others would read the studies and consult over virtual meeting places with docs from their sector of the country. I think this could happen in maybe 20 years or so.
But who knows what will happen!!
There are several companies that I know that are actively recruiting rads to read from home. I think the pay is generally on the non-partnership scale and some don't offer the extensive benefits that a private or academic group would offer. I think the stability of a job of that sort is a little scary as well. You are totally dependant on a corporation as opposed to a more stable healthcare entity that most likely will remain a presence in the same city for a long time in some form or another.
It is difficult to tell where this is all going. You have to remember there is fierce competition among groups for the work as well as for new radiologists. Most of the small to larger groups have talented fellowship trained radiologist in many of the specialities and are not about to let their studies be shunted to another place. The contracts with the hospitals are usually exclusive and the hospitals for the most part don't want to anger the group because of the tremendous amount of money and time it would take to find another group in its entirety.
I think that if the USA somehow goes to a national medical license that could expedite the trend toward centralization. This in some ways would be good for most radiologists who want to live in the metropolitan areas and want to do their subspeciality. If you extropolate this there may be say 25 -50 mega radiology groups in the country each with maybe 500-1000 rads working in 3-4 centers in each state with incredible sub-specialization. One or two radiologists would cover the procedures at each hospital, the others would read the studies and consult over virtual meeting places with docs from their sector of the country. I think this could happen in maybe 20 years or so.
But who knows what will happen!!
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In regards to Night Hawk... they have that in some hospitals up in Pennsylvania... as far as I understand it, when it is nighttime here, and all the FT rads go home, all the images are sent digitally to Australia, where their FT rads are just getting into the hospital. They will give a wet read and send that read back to the hospital, so whoever ordered that stat Xray or CT can get an idea of what's going on, and can wait until the morning comes to get a final read when the American rad comes back into work.
Q
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Roentgen
I was entertained by reading this thread- something I didn't realize until I was finishing medical school that's difficult to appreciate until you work in medicine for a while:
Radiology is not a black box. As a student, it seems like the pt goes down to the radiology suite, and then some time later out comes a diagnosis from the radiologist. This is the case for some simple problems- say appendicitis. Stroke. Kidey stone. You get the idea. Under that paradigm, Night Hawks (and outsourcing in general) works. And that's what they are there for!
However, in reality, radiologists are consultants in the hospital. Let's say I'm in primary care- "my 80 y/o pt s/p pneumonectomy for lung ca also has COPD; it seems like his cough is getting worse the past several times I've seen him. Has he got a new ca (can it be resected)? Is it bronchiolitis from his smoking (would be benefit from steroids)? Could you do hires CT of his chest to help me treat this guy?" Let's say I'm a pulmonologist- "can I biopsy this mass by bronch?" Surgeon- "am I going to be able to remove his colon ca or is it wrapped around his aorta?" Etc, etc. All of these referring physicians CONSULT the radiologist- they call him/her, they are asking tough questions of the radiologist-- over time they rely on the radiologist and develop a relationship of trust. Are these questions you (as a referring MD) would feel comfortable asking some guy in Australia or whatever?
Hospitals will always need radiologists. Not just for procedures. The provide a service- spend some time in the radiology suite and you'll see what it's about. And it's not all big bucks and golf- they work hard! More and more, radiologists are working in house at night. I would not choose the field for lifestyle. Rather, I would consider it if you like procedures, if you like consulting with other doctors, if you like solving problems and you like being on the cutting edge of technology.
Radiology is not a black box. As a student, it seems like the pt goes down to the radiology suite, and then some time later out comes a diagnosis from the radiologist. This is the case for some simple problems- say appendicitis. Stroke. Kidey stone. You get the idea. Under that paradigm, Night Hawks (and outsourcing in general) works. And that's what they are there for!
However, in reality, radiologists are consultants in the hospital. Let's say I'm in primary care- "my 80 y/o pt s/p pneumonectomy for lung ca also has COPD; it seems like his cough is getting worse the past several times I've seen him. Has he got a new ca (can it be resected)? Is it bronchiolitis from his smoking (would be benefit from steroids)? Could you do hires CT of his chest to help me treat this guy?" Let's say I'm a pulmonologist- "can I biopsy this mass by bronch?" Surgeon- "am I going to be able to remove his colon ca or is it wrapped around his aorta?" Etc, etc. All of these referring physicians CONSULT the radiologist- they call him/her, they are asking tough questions of the radiologist-- over time they rely on the radiologist and develop a relationship of trust. Are these questions you (as a referring MD) would feel comfortable asking some guy in Australia or whatever?
Hospitals will always need radiologists. Not just for procedures. The provide a service- spend some time in the radiology suite and you'll see what it's about. And it's not all big bucks and golf- they work hard! More and more, radiologists are working in house at night. I would not choose the field for lifestyle. Rather, I would consider it if you like procedures, if you like consulting with other doctors, if you like solving problems and you like being on the cutting edge of technology.
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Great post Roentgen ...
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