I'm thinking of starting a company where I buy an MRI machine that would just image outpatients. Do you know how much radiology groups charge for reading thoracic MRIs per MRI read?
Thanks for your input.
Thanks for your input.
Cost to read MRI thoracic spine
- Thread starter mpdoc2
- Start date
Your post implies you are not a radiologist. Then who are you?
A businessman? A family doctor? A spine surgeon ?A taxi driver who has heard that MRI is a good business? A PM&R? An IT guy? A medical student? A second hand car dealer? A real estate agent?
No man. Your question is ridiculous at best. Opening an MRI center is a complicated process and finding a radiologist to read your scans is the easiest part.
I am sure you are not the person that you claim. Most likely you are a premed student (or even a physician in another field) and want to ESTIMATE the salary of a radiologist by asking about pay/read. Or probably you already own the MRI center and you feel that you are paying the radiologist too much money.
A businessman? A family doctor? A spine surgeon ?A taxi driver who has heard that MRI is a good business? A PM&R? An IT guy? A medical student? A second hand car dealer? A real estate agent?
No man. Your question is ridiculous at best. Opening an MRI center is a complicated process and finding a radiologist to read your scans is the easiest part.
I am sure you are not the person that you claim. Most likely you are a premed student (or even a physician in another field) and want to ESTIMATE the salary of a radiologist by asking about pay/read. Or probably you already own the MRI center and you feel that you are paying the radiologist too much money.
I'm not a radiologist but I am a physician. My interest in opening such a center is purely business and will be the company owner (not physician of the center and so you can think of me as a businessman). I'm calculating whether opening an MRI center would be a good investment. This calculation includes the cost per read for a radiologist. Most of the patients will be post-non emergent accidents. There are obvious other costs including:
1. Rent for the center
2. Cost to acquire and install the MRI
3. Cost to maintain the MRI
4. Cost of an MRI tech
5. Cost of the receptionist
The most important thing that I do have is the patients that I can refer to such a center. But part of all this equation includes the cost per read for a radiologist and want a ball park number for this. Obviously I'm going to ask different radiology groups what they charge but I wanted a ballpark number because this is more of a thought at this point than a business plan. I already know how much radiologists make but I'm not interested in employing a radiologist because I don't have the volume to employ a full time radiologist.
- Joined
- Feb 24, 2005
- Messages
- 15,463
- Reaction score
- 1,908
Seems weird that you're asking about Thoracic MRs given that they are by far the minority spinal imaging behind lumbars and cervicals.
I'm assuming that's probably the most expensive because there's 12 of those so wanted to the high number for the cost per read 😛. If you have the numbers for the other ones please do tell.
Your post made me crack up a little, "what are you, a used car salesman". Honestly as an attending I've realized the best way to make money in medicine is to own a business...
- Joined
- Feb 24, 2005
- Messages
- 15,463
- Reaction score
- 1,908
We are paid similar to you. Look up the CPT code, use that to look up the RVU value which is split into technical and professional. Professional fee goes to the radiologist unless you are a predatory skimming owner.
How often do the owners skim on the professional fees? I'm not planning on doing this but I'm curious.
- Joined
- May 14, 2010
- Messages
- 1,189
- Reaction score
- 359
This doesn't answer how much radiology groups charge, but this is how much gets paid from government payers:
MRI Spine Thoracic W W/O Contrast 72157-26 (professional component)
Missouri HealthNet (Medicaid): $115.97
Medicare, depending on locality: $105.29-160.83
MRI Spine Thoracic W W/O Contrast 72157-26 (professional component)
Missouri HealthNet (Medicaid): $115.97
Medicare, depending on locality: $105.29-160.83
This is called self-referral. It is a common thing but is the major problem of today's medicine. It has been studied closely and has been shown that if you own an imaging center you order 2-3 times more studies compared to your colleagues who do not own an imaging center. And don't think you are different than anybody else. The moment that you receive the quarterly report of your business and see that you are not making the money that you expected, you will start to order more and more tests on the patients. This is the reason the government is taking over the control of medicine and many people believe in 10 years there won't be any real private practice medicine.
You can own your business and make money in medicine. You can open your imaging center or your lab and send everyone there. But don't crack up if people call you a used car salesman. A used car salesman is doing a more honest and more transparent business and is a better individual than a doctor who owns an MRI scanner and sends everyone and their mother for a spine MRI. Don't try to sell me the crap that you are different than other people. You will be at least as bad as them.
There is a PM&R group in my area who owns their MRI scanner. Guess what? Most of their MRIs are normal or have very subtle finding. " Mr. Jones. You came for right foot pain but do you also sometimes have left shoulder pain? What about wrist pain? What about low back pain? Oh, you have right ear pain. Let's do an MRI of your right ear and see what is wrong with your ear." IMO, a used car salesman with a shady business is a better person in society than these so called Doctors.
Again as stated, you can think of me as a businessman in this model and not the physician. I never claimed to be doing this for a noble cause as I'm doing this purely to increase my income. There are several other radiology centers nearby so there's definitely not a deficit; I'm thinking why not send patients to my own center as opposed to some other center.
- Joined
- Feb 24, 2005
- Messages
- 15,463
- Reaction score
- 1,908
Just don't break Stark laws.
Stark laws don't apply to radiology.
- Joined
- Oct 3, 2014
- Messages
- 390
- Reaction score
- 469
When you took the Hippocratic oath, you signed up for a "noble" cause and are held to a higher standard. That doesn't mean that others don't do this, but one can't pretend that it's not wrong. As a physician, you can't ethically just throw on the businessman hat since business principles and patient care can conflict. Only a short while ago, physicians didn't even advertise since it was a crass. The cow has left the barn on this one, since doctors now have little to no ethics and profiting off humans like so many animals is just considered "good business". At least pretend like you are about patient care.
Self-referral is also illegal (https://en.wikipedia.org/wiki/Stark_Law).
Self-referral is also illegal (https://en.wikipedia.org/wiki/Stark_Law).
- Joined
- Oct 3, 2014
- Messages
- 390
- Reaction score
- 469
I think you need to check again. It's a designated health service.
There's an exception for radiology in the Stark law. I know this by speaking with several healthcare attorneys regarding this issue. I'm actually fairly surprised as radiologists you're not already aware of this. In terms of ethics of self referral and nobility of "doctors", that unfortunately has long passed. Almost 80% of doctors I talk to are thinking of retiring as soon as they can because the money's going down.
- Joined
- Oct 3, 2014
- Messages
- 390
- Reaction score
- 469
Cool. Well if "80%" of people feel that way, then I guess I should too.
You need some better attorneys. The skill of your advisors is suspect since you're asking an anonymous forum about running an mri center. I guess you'll go to the businessmen and tell them that "radiologists" told you x and y.
You need some better attorneys. The skill of your advisors is suspect since you're asking an anonymous forum about running an mri center. I guess you'll go to the businessmen and tell them that "radiologists" told you x and y.
I have no doubt about the stark exemption for radiology. I've actually read the law myself regarding this. I'm not saying that you should retire; I'm just telling you of the fact that you think of physicians as not being in it for the money is naive. Lol as radiologists you don't even have to see patients 😛 so of all people who say they're doing it for the patients ...
- Joined
- Oct 3, 2014
- Messages
- 390
- Reaction score
- 469
It's not "naive", it's ethical. People who have done the wrong thing since the beginning of time have tried to make other feel foolish about adhering to ethics. It's still wrong. People say doctors are "bad businessmen"… it's not because doctors are stupid, it's because doctors adhere to a different set of principles than businessmen do.
Stark laws do limit your ability for self-referral. That's why they exist. Radiology, including MRI, is a designated health service. You may have some loophole or other, I'm not talking about that.
As a radiologist I see over a hundred patients a day. I won't perform or protocol a study on a patient that would physically harm them for my benefit (e.g. radiation). I won't perform a higher-reimbursement study on them that I know to have little medical value, and I will always recommend the appropriate study, even if it means that I would have to refer them away. This is not saintliness… this is just being a doctor. It's sad that we consider this saintliness now.
Your opinion on radiologists shows a level of intelligence commensurate with your other comments.
Stark laws do limit your ability for self-referral. That's why they exist. Radiology, including MRI, is a designated health service. You may have some loophole or other, I'm not talking about that.
As a radiologist I see over a hundred patients a day. I won't perform or protocol a study on a patient that would physically harm them for my benefit (e.g. radiation). I won't perform a higher-reimbursement study on them that I know to have little medical value, and I will always recommend the appropriate study, even if it means that I would have to refer them away. This is not saintliness… this is just being a doctor. It's sad that we consider this saintliness now.
Your opinion on radiologists shows a level of intelligence commensurate with your other comments.
- Joined
- Jan 26, 2009
- Messages
- 190
- Reaction score
- 30
Hold on there, troll... we do see patients. Many of us see 100 or more on a daily basis. Do we listen to heart and lung sounds and talk to families? No... our role is a little bit different. You know this. You're just trollin' though. Don't come on to the radiology forum and try to get people all worked up. We're not gonna bite.
And, good luck with your mega million dollar "business" idea. Buy an MRI and blamo, you're rich. I wish I had thought of that.
So you're saying your not doing it for the paycheck? I said it's naive to say physicians aren't doing the work for the money they bring home. (not as you put words in my mouth that it's naive to be ethical)
Nope not trolling. The fact that it upsets you that I'm interested in a MRI center venture doesn't equate with me being a troll. I'm sure you did think of the same but you don't have the patients to bring to your center.
- Joined
- Feb 24, 2005
- Messages
- 15,463
- Reaction score
- 1,908
I'm curious how many patients you have and what utilization rate you think you'll be able to generate.
Probably 4-5 MRIs per day. I won't be the only source of patients as my wife is part of a physician group who would be sending patients too. I'd probably hire a marketer/manager to gradually expand the business and give him a cut of the profits.
- Joined
- Feb 24, 2005
- Messages
- 15,463
- Reaction score
- 1,908
Based upon this response, my last words of wisdom would be find a business partner who understands the lingo and how the money flows.
Agreed.
- Joined
- Oct 3, 2014
- Messages
- 390
- Reaction score
- 469
No. I could be doing many other things with my time, and probably making more money at some of them. I'm in the bottom 25% of compensation for my field and experience, by choice. The service aspect of my job is important.
You initially made the comment that
To direct patients to your own facility is unethical, because, as Shark2000 pointed out above, your primary goal will be to keep the business running. It's great when business and patient care work in the same direction, but they don't always. And when they don't, the goal to increase income will win out… because you said this was the goal. This is what differentiates a doctor from a businessman, a doctor's first priority is to her or his patient's rather than herself or himself.
Last edited:
Most other things don't generate the same income as being a physician. There's nothing wrong with being a physician/businessman. It's when physicians became lazy and became employed as oppose to owners when our role went down the tubes. I know the real reason your irritated is that you've seen a trend across the country where physician groups are owning their own centers as opposed to sending the patients to radiology owned centers. Why don't you state what's really irritating you as opposed to calling me names like "troll" or "unethical".
Last edited:
As I said you are not the person that you claim to be.
You've already talked to business managers, talked to a lot of other people and you have investigate about stark law and etc and then the only thing that you couldn't find is about a radiology group who is willing to read for you??? Gimme a break.
I do 40% procedures and have more patient contact that you have. Stepping into the examination room and talking to the patient for 5 minutes and then writing an H&P for 15 minutes with all the made up info is not considered real patient contact to me. Anyway, it seems that seeing patient is so painful to you that you are jealous of radiologists not doing it.
I am not naive to say that physicians are not after money. But once you pass that line, you are not any different than a second hand car dealer or in the case of a physician who orders unnecessary tests to make profit out of his MRI center, is no different than a pickpocket in the street. So don't crack up if I call you a used call dealer since your practice is more similar to a pickpocket in downtown Manhattan.
One last thing. One who comes to a radiology forum and questions the practice of radiology is nothing but a jerk.
I never questioned the practice of radiology. And my questions were honest but the amount of antagonism and hypocrisy I got from some of the responders which had nothing to do with my original question irritated me. And half the time when I asked one of my radiology friends why they chose radiology, they said it's because they don't have to see patients. I'm not talking about IR guys (and even they never followup patients).
- Joined
- Oct 3, 2014
- Messages
- 390
- Reaction score
- 469
No. Older physicians worked longer hours and were hardly "lazier" than the current breed (radiology might be an exception to this).
There absolutely is something wrong with being a physician/businessman: the two are often ethically opposed. We all know which half of that Jekyll and Hyde wins out. And we know who ultimately loses (patients).
Clearly, your priority is money. It takes more than that to be a genuine doctor. A doctor's income is a recognition from society that you are sacrificing your life and relaxation for societal well-being, it's not a business strategy. You don't dedicate your life to learn about the human body to profit off sick people… at least that's how I was taught.
Our role went down the tubes when doctors decided to become businessmen and made all sorts of unhealthy alliances with business, all in the name of short term profit. Now the beast is out of doctors' control.
There absolutely is something wrong with being a physician/businessman: the two are often ethically opposed. We all know which half of that Jekyll and Hyde wins out. And we know who ultimately loses (patients).
Clearly, your priority is money. It takes more than that to be a genuine doctor. A doctor's income is a recognition from society that you are sacrificing your life and relaxation for societal well-being, it's not a business strategy. You don't dedicate your life to learn about the human body to profit off sick people… at least that's how I was taught.
Our role went down the tubes when doctors decided to become businessmen and made all sorts of unhealthy alliances with business, all in the name of short term profit. Now the beast is out of doctors' control.
Last edited:
Most of them these days follow up their patients very closely and have their own clinic, believe it or not.
As I mentioned before, if you practice similar to a pickpocket in downtown Manhattan (i.e. ordering unnecessary tests to make money out of your MRI scanner) you should expect all the antagonism.
I'm not planning on over imaging my patients. Most of the patients will be sent from my wife's colleagues.
Last edited:
Once your quarterly business report shows that your business is losing money or is not doing so well or your profit is less than what you want it to be, you will start to over image. This is the human nature.
Don't think making X amount of money will be enough for you. You will always look for more. The same reason that pushes you to open an imaging center now will push you to over image. Otherwise, as a physician you are making enough to have a comfortable life. But you are looking for more. Then you will continue to look for more in the future and this will go on and on. . . If you can not stop it now, you won't be able to stop it later.
Most people who over image patients justify their behavior by saying that they are not paid enough for their office visit and ordering MRI is a way to "get what their deserve" from the insurance company. You are not going to be any different.
and you know this because you know me i'm assuming.
- Joined
- Apr 11, 2009
- Messages
- 1,594
- Reaction score
- 1,658
For all who are curious, this guy is a RadOnc.
I can't believe how cheap your guys equipment is compared to ours. You can buy an 1.5 T MRI for 150k! The linacs we own cost 3mill to replace :/
BTW most radonc practices own their own imaging center and do everything from MRI to PET-CT.
Last edited:
- Joined
- Apr 11, 2009
- Messages
- 1,594
- Reaction score
- 1,658
I'm surprised you are getting into this, as the cuts that crippled radiology since 2007 disproportionately hit outpatient, free-standing imaging centers. Groups that didn't own equipment directly have done somewhat better than those that did. A lot of groups ended up selling the equipment to hospitals as they get reimbursed at a higher rate than the free-standing places do. Further, referrals are king, and if the hospital buys up all the primary care/specialty groups, they will direct all the ancillary testing to their imaging centers, and your centers are screwed.
My residency program has closed/sold at least 3 outpatient imaging centers because the economics just weren't working out.
Main reason I'm getting into it is because I have some extra cash and the overhead doesn't seem to be too much. Also I have a good referral base for the center. The biggest expense is the radiologist and hence my question on this forum 😛
Last edited:
- Joined
- Apr 11, 2009
- Messages
- 1,594
- Reaction score
- 1,658
.
- Joined
- Jun 12, 2007
- Messages
- 799
- Reaction score
- 90
Hey I want to open up a radiation treatment center and just wanted to know how much it would cost to hire the rad onc to draw the colored circles around the treatment area for me?
LOL, if you have the patient flow you should. Depending on location starting salary for a newly minted attending straight out of residency is between 350-600k. But that's a small part of the overall costs. Here are the major costs:
1. Linear accelerator: 3-6 million
2. Vault: 500 K.
3. CT Simulator: 300K.
4. Annual maintenance costs of machine and software: 300K.
The radonc is truly a minor cost compared to everything else. I'm not sure why everyone's so afraid of talking about numbers openly. It's not good for medical students, residents, or even attendings to always be in the dark about operating costs. I found a profound amount of ignorance regarding these things in residency and sometimes beyond. Look how many people I pissed off by asking a simple benign question about the cost to read an MRI of the thoracic spine. I'll bet you half the senior radiology residents don't even know how much medicare reimburses for this.
Electroshok, see how often they talk about the business aspect of radiology during your years of radiology residency. I'll guarantee you it probably won't add to any more than 2 hours, while money and finances will be a large part of your professional life. No wonder physicians are the only profession making less every year, year after year, and it's blasphemy to ask the government to match inflation to keep our incomes stable. The most financially successful people in Medicine that I've met were those who had a business acumen.
Last edited:
Don't worry about radiology residents and radiologists. At least their job is not boring.
The most financially successful people in Medicine that I've met with a few exceptions are bunch of jerks in fraudulent practices.
You talk about having a patient flow like that you find the patients yourself. Rad onc is a referral service itself. For example, breast cancers are diagnosed by radiologists and are then referred to surgeons and then referred to rad oncs. Or prostate cancer is diagnosed by urologist and then referred to rad onc for treatment. FYI, Urologists hire rad oncs in some practices.
One last thing. If knowing the professional fee for interpretation of a thoracic spine is a deciding factor to choose radiology for a medical student or a resident, it is better for them to choose a different field. This field is an amazing field (unlike rad onc) and it is better not to have people who choose it just for money.
I'm not worried about radiologist or radiology residents. I wonder about the direction of medicine as a whole but that's not specialty specific. Also I never said your field was boring. I also never stated that knowing the fee for one service should be the deciding factor for choosing a specialty, doing that is actually quite idiotic and I'm not sure where you got that from. However, not knowing about the business aspects of the practice your engaged in is also unwise. Finally my referral pattern is actually not related to my specialty at all and it's related to the personal relationships I've developed over the years. Finally, I'm glad you like your field as everyone should, and you've worked hard to get there. I'm not sure why I get a sense that you're upset about this thread.