teleradiology

Trying to understand how vRad (or similar telerads shops) work. My understanding is you eat what you kill (pay per scan) model. But is the work synchronous or can routine cases be read at any time (asynchronously)? And can you work however much you want or is there some minimum?

So what's the deal with these? I've been highly successful in private practice and, even, some academic practice for 25+ yrs. Yet these companies will send these esoteric "sample bread and butter cases" which seem like la de da, no problem, do them every day. Then they say "so sorry we have...