Am I missing something?

[RonaldColeman]

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I'm a 4th year med student desperately trying to make up my mind about a specialty. I've been talking to radiology residents and attendings who tell me that starting salary now for rads is around 400k in California--a state not known for its great reimbursement of physicians. These same doctors tell me that the typical work week is M-F with an occasional weekend. Does this sound too good to be true? Am I missing something here? I mean, that sounds better than derm, radonc, optho, etc. which are still more competitive than rads. Any input would be appreciated.

 

[f_w]

Do you like radiology ?

If yes, please apply. If no, please go away.

 

[Docxter]

Do you like radiology ?

If yes, please apply. If no, please go away.

I know for a fact that two people in my residency got PP jobs in California, starting at 230,000 and 250,000 respectively. They take call q6-7.

 

[trouta]

You shouldnt choose a specialty based on the schedule and the reimbursement. No matter how good they are if you dont like the day to day, the grind will get you down.

 

[fedor]

Ronald,

Reimbursements for radiology have been cut in recent years and will continue to be cut in the future. Many radiologists have been able to preserve income by reading faster and also working longer hours. The average work week for a radiologist is now over 55 hours. While a radiologist has a good lifestyle, it is nowhere near the cosy lifestyle rad-onc, derm, allergy/immunology, etc.

Your $400k figure for new rads in California sounds a bit excessive. Also, by the time you finish residency/fellowship, the job market for rads may be completely different. Go into the specialty you enjoy.

 

[RonaldColeman]

You shouldnt choose a specialty based on the schedule and the reimbursement. No matter how good they are if you dont like the day to day, the grind will get you down.

I agree with you. My biggest problem has been that I've liked most of my rotations (except OB/Gyn)! I would really be just as happy in radiology as I would in say ER. I'm one of those weirdos who has really enjoyed medical school...even 3rd year. At this point, I have basically decided that I'm gonna choose the specialty that has the best hrs and pay and allows me to match in Cali. I just don't know what other criteria to use. So in response to one of the previous posters, yes, my post was about hours and pay, but that is not the sole reason I would choose radiology.

 

[fedor]

I agree with you. My biggest problem has been that I've liked most of my rotations (except OB/Gyn)! I would really be just as happy in radiology as I would in say ER. I'm one of those weirdos who has really enjoyed medical school...even 3rd year. At this point, I have basically decided that I'm gonna choose the specialty that has the best hrs and pay and allows me to match in Cali. I just don't know what other criteria to use. So in response to one of the previous posters, yes, my post was about hours and pay, but that is not the sole reason I would choose radiology.

Find a couple of private practice radiologists to shadow so you can see the pace of private practice rads. It's night and day different from academic rads where you can leisurely peruse scans. Spend a whole day shadowing one or two PP rads and if you enjoy it, by all means continue to consider rads. I know many rads who entered PP and realized that it wasn't for them, then they went into academic rads where they made very little compared to PP. If you're so concerned about money, then be sure you know what you're getting into with PP (ie, you will be asked to leave by most groups if you read too slow, increasing hours every year, night call, etc.) since it's much different than academic rads.

 

[jmou123]

Find a couple of private practice radiologists to shadow so you can see the pace of private practice rads. It's night and day different from academic rads where you can leisurely peruse scans. Spend a whole day shadowing one or two PP rads and if you enjoy it, by all means continue to consider rads. I know many rads who entered PP and realized that it wasn't for them, then they went into academic rads where they made very little compared to PP. If you're so concerned about money, then be sure you know what you're getting into with PP (ie, you will be asked to leave by most groups if you read too slow, increasing hours every year, night call, etc.) since it's much different than academic rads.

Dont let these guys fool you, rads has some ridiculous jobs right now. From what I understand, radiology does have some decreasing reimbursements (all fields do), but this mainly applies to private practice. Most radiologists are employed by hospitals and the hospital will pay a salary to X number of people in a specific group. There are often incentives for productivity, etc. These people are not experiencing as many pay cuts because rads is one of the top money makers for hospitals. As far as increasing call/hours, this is also true. However, the total number of hours worked is still significantly less than most docs/surgs. With that in mind, it is typical for radiologist to have 10 weeks of vacation in a year. This type of vacation time with the current salaries is not offered in any other field. With all that being said, I agree that you must enjoy your field, otherwise you will hate your life.

 

[f_w]

> Most radiologists are employed by hospitals and the hospital
> will pay a salary to X number of people in a specific group.

What are you smoking. Radiologists in hospitals are only in the rarest cases employed by the hospital. The hospital bills its technical component of the fee, the radiology group bills the professional component, both entities are financially independent. (Sometimes there are small payments by the hospital to reimburse the group for expenses such as IT support or payments to the group for management services like providing a division chief for radiology)

> There are often incentives for productivity, etc.

Productivity bonuses are paid by the radiology group, and only from the revenue they get out of either professional fees (for hospital based work) or the global fees (for work done in offices owned by the group).

> rads is one of the top money makers for hospitals.

That is correct. Many community hospitals derive 50%-60% of their operating income from radiology services. But this is income for the hospital, not necessarily the radiologist.

> However, the total number of hours worked is still significantly
> less than most docs/surgs.

There are studies out there looking at the work hours. They tend to be better than surgeons and comparable to non-surgical specialties.

 

[Docxter]

Dont let these guys fool you, ....

Wow, it's interesting how much you don't know about how radiology practice, yet warn about misinformation by people who are actually in the know. But yes, jobs are good. Not as good as two years ago, but still very good.

From what I understand, radiology does have some decreasing reimbursements (all fields do), but this mainly applies to private practice.

Reimbursement decreases often apply across the board, not limited to private practices, acdemic institutions, etc.

Most radiologists are employed by hospitals and the hospital will pay a salary to X number of people in a specific group.

Wrong. Outside military and some of the VA hospitals, salaried employee radiologists are extremely rare. Hospitals contract with radiology physician groups, who have to provide certain services and coverage, and in turn the hospital takes the large chunk of technical fees for each study. This amount that the hospital takes is somewhere between 75% to 90% of the radiology examination reimbursement. Often, the radiologists take all or a just portion of the professional fees (10% - 25% of the reimbursement), depending on the contract. To translate, he who owns the equipment, makes the big bucks. A successful and high paying radiology group, is the one that owns the equipment. Same goes for every field. If you own the surgicenter, then you make big bucks. If you just have some priviledges, you won't make as much.

There are often incentives for productivity, etc.

Yes, but the incentives are within the radiology group, not from the hospital.

These people are not experiencing as many pay cuts because rads is one of the top money makers for hospitals.

To repeat, the vast majority don't get paid by the hospital.

As far as increasing call/hours, this is also true. However, the total number of hours worked is still significantly less than most docs/surgs.

Wrong again. Radiologists on average work more than most docs, and even some surgeons. Here's the official AMA stats on weekly hours:

Obstetrics and Gynecology 61
Anesthesiology 61
Urology 60.5
Surgery 60
Radiology (diagnostic) 58
Orthopedic Surgery 58
Internal medicine 57
Neurology 55.5
Pediatrics 54
Otolaryngology 53.5
Family Practice 52.5
Psychiatry 48
Ophthalmology 47
Emergency Medicine 46
Dermatology 45.5
Pathology 45.5