Covid19 effect on Radiology

[Timtom98]

Can anyone comment how this pandemic is affecting Radiology? Hearing a lot of private practices furloughed radiologists and stopped hiring since most their out patient centers are closed

Hospital contracts are still strong though

How screwed are current fellows and residents who skipped fellowship to enter a previously strong job market?

Is this the potential end of huge Radiology groups if they begin to fold and all the VC money dries up???

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[Radology]

Volumes down about 60-70% with no end in sight.

PE groups have slashed salaries across the board, private practice expects 20-40% pay cut this year.

The good job market is over, just like that. Next year is going to be ice cold out there. Even if the volume improves immediately (which I doubt it will), people are shaken and that is going to have ripple effects that outlast the pandemic. Radiologists on the brink of retirement will push it back to recoup their 401k losses.

i personally haven’t heard of any furloughs yet. At least not forced ones, a couple I’ve heard of with risk factors have requested to be furloughed until the pandemic passes

those of you that have locked down jobs are probably? fine; although you may have your start date delayed a couple months. It would be very poor form for a group to dump you now and would probably tarnish the groups reputation for years to come. Unfortunately, plenty of scummy groups out at there will do anything to make a buck and cutting unknown hires is just low hanging fruit

 

[yeet]

is this radiology specific or the entire medical field in general? Is radiology hurting more than other fields?

 

[Radology]

Outpatient specialties are hurting even more

optho Derm plastics etc are like 95% outpatient and can be deferred

ortho is probably getting crushed

trauma surgery volumes are all time low

radiology will always have a stream of ER inpatient and oncology studies. So we’re taking a big hit on outpatients, but there is a floor of that hit

 

[SeisK]

401k’s will recover much more rapidly than in ‘08. If you’re using that job market crisis to predict this one take everything with a large boulder of salt.

 

[Radology]

The 401ks are a very small (but real) factor in this. But they’re hardly the main factor.

The studies never just stopped coming in 2008. This is much, much worse

 

[Clean7795]

Where I am all specialties are being hurt badly with the exception of inpatient GIM.

Multiple outpatient specialties have no office hours at all. No income at all for many of them. I know a derm who has had to lay off his entire office.
All elective ORs cancelled. Even regular urgent surgeries are being put off and medically managed. Minimal work left for most of our surgeons.
ED volumes are down 50%-60% and we are working much quicker per patient to try and minimize exposure for everyone. We are not a hard hit area yet but are anticipating we will be.

Many specialties are reduced to practicing a bit of telemedicine here and there.

 

[SeisK]

The 401ks are a very small (but real) factor in this. But they’re hardly the main factor.

The studies never just stopped coming in 2008. This is much, much worse

Well the studies stopped coming because of a very temporary act of God here. When this ends, the economy will take a little bit of time to pick up momentum again, but it will take nowhere near as long as in ‘08 because in THAT circumstance, the underlying problem wasn’t a very temporary brick wall, but a sudden realization that everyone only had 2/3 the amount of savings as they thought. EVERYONE realized they had to make up for their losses, so while the patients kept coming (except in that early period in ‘08), radiology was 1) much more lifestyle friendly which permitted 2) older radiologists to stay in the market to recoup their ”losses” (not actually losses, they realized they never had it in the first place).

The losses here are much more temporary and will be quickly recouped when the economy resumes business as usual again, which it will much, MUCH more rapidly than in ‘08 because the fundamental problem that made people spend less (their 1/3 absent savings INDEPENDENT of economic function) simply isn’t present.

When the economy resumes function, 401k’s will regain their value (minus a 1-3 year upset in interest) in a way they simply could not in ‘08. There will be some loss which may cause some people to delay retirement, but I’ll appeal to #1 above: radiology is much less lifestyle friendly than it was in ‘08. Older folks will have to decide ”do I want to exhaust myself to recoup losses, or just downsize a little bit.”

I imagine the much less terrible fallout after this is over, coupled with the already way-too-hot job market, will yield a job market that is much less unfavorable / much more favorable than in the horrible years between ‘10-‘14.

 

[Radology]

You have no idea how the economy will respond to this.

A quick rebound is not guaranteed. Many Businesses will close, mortgages will default if this continues for a couple months. Unemployment will soar.

maybe this virus dies in the summer and all goes back to normal a couple months later. Maybe the abrupt halt of cash flow sets a chain of events that leads to a crisis worse than 2008. It is hardly a foregone conclusion one way or another.

 

[Lnsean]

Well the studies stopped coming because of a very temporary act of God here. When this ends, the economy will take a little bit of time to pick up momentum again, but it will take nowhere near as long as in ‘08 because in THAT circumstance, the underlying problem wasn’t a very temporary brick wall, but a sudden realization that everyone only had 2/3 the amount of savings as they thought. EVERYONE realized they had to make up for their losses, so while the patients kept coming (except in that early period in ‘08), radiology was 1) much more lifestyle friendly which permitted 2) older radiologists to stay in the market to recoup their ”losses” (not actually losses, they realized they never had it in the first place).

The losses here are much more temporary and will be quickly recouped when the economy resumes business as usual again, which it will much, MUCH more rapidly than in ‘08 because the fundamental problem that made people spend less (their 1/3 absent savings INDEPENDENT of economic function) simply isn’t present.

When the economy resumes function, 401k’s will regain their value (minus a 1-3 year upset in interest) in a way they simply could not in ‘08. There will be some loss which may cause some people to delay retirement, but I’ll appeal to #1 above: radiology is much less lifestyle friendly than it was in ‘08. Older folks will have to decide ”do I want to exhaust myself to recoup losses, or just downsize a little bit.”

I imagine the much less terrible fallout after this is over, coupled with the already way-too-hot job market, will yield a job market that is much less unfavorable / much more favorable than in the horrible years between ‘10-‘14.

What if none of this is happens and it takes much long and the economic effects on thousands of businesses are more dramatic? You're basically saying "trust me, I know it all."

Obviously I'm going to take the middle ground and say that it won't be as bad as people think but it's no rapid recovery either, probably a couple of years.

 

[SeisK]

What if none of this is happens and it takes much long and the economic effects on thousands of businesses are more dramatic? You're basically saying "trust me, I know it all."

Obviously I'm going to take the middle ground and say that it won't be as bad as people think but it's no rapid recovery either, probably a couple of years.

Nobody “knows it all,” but if you have to pick between two extremes, it seems much more likely to be on the softer side of things in terms of job security outcomes in the next few years after the dust has settled. I could be wrong, but I don’t think it’s wrong of me to speak as assuredly of my idea as Radology is of his. I just don’t like catastrophizing and scaring people unless I’m damn sure of a catastrophe, which no one is.

If you think I’m “basically saying“ ‘trust me, I know it all...’ maybe reread paying closer attention to the words I chose?

 

[Radology]

My guess about the economy recovery timeframe is as good as yours. Just throwing out a guess.

i can absolutely with 1000% certainty promise you the good job market is over.

ACR job postings went from 1200 to under 1000 just 3 weeks.

even if the market recovers instantaneously and the economy picks up by summer, groups are going to be very hesitant to commit to more hires 12 months down the road fresh off this crisis. I can absolutely guarantee you that. Everyone is taking a major financial hit this year, and their life savings have been cut in third, and they are going to be terrified of this virus coming back next winter.

the 2020-21 job market is going to be rough for non mammo non IR (who tend to always weather bad job markets). I hope I’m wrong and you can all quote this thread and laugh in my face. It could come right back and then some in 2 years, but I really think this year is gonna be awful timing for job seekers

 

[SeisK]

My guess about the economy recovery timeframe is as good as yours. Just throwing out a guess.

i can absolutely with 1000% certainty promise you the good job market is over.

ACR job postings went from 1200 to under 1000 just 3 weeks.

even if the market recovers instantaneously and the economy picks up by summer, groups are going to be very hesitant to commit to more hires 12 months down the road fresh off this crisis. I can absolutely guarantee you that. Everyone is taking a major financial hit this year, and their life savings have been cut in third, and they are going to be terrified of this virus coming back next winter.

the 2020-21 job market is going to be rough for non mammo non IR (who tend to always weather bad job markets). I hope I’m wrong and you can all quote this thread and laugh in my face. It could come right back and then some in 2 years, but I really think this year is gonna be awful timing for job seekers

I in no way disagree this year will be bad for job seekers or that the good job market has hit a brick wall like 90% of the rest of the global economy. If I had to sum up my argument in one go, it would be: the job market for radiology won’t be (most likely) a half decade of misery like it was after ‘08.

 

[zero0]

My guess about the economy recovery timeframe is as good as yours. Just throwing out a guess.

i can absolutely with 1000% certainty promise you the good job market is over.

ACR job postings went from 1200 to under 1000 just 3 weeks.

even if the market recovers instantaneously and the economy picks up by summer, groups are going to be very hesitant to commit to more hires 12 months down the road fresh off this crisis. I can absolutely guarantee you that. Everyone is taking a major financial hit this year, and their life savings have been cut in third, and they are going to be terrified of this virus coming back next winter.

the 2020-21 job market is going to be rough for non mammo non IR (who tend to always weather bad job markets). I hope I’m wrong and you can all quote this thread and laugh in my face. It could come right back and then some in 2 years, but I really think this year is gonna be awful timing for job seekers

Would it make sense to commit to an ESIR track then if we're already kind of thinking about IR to hedge our bets with the job market? I'll be starting residency this summer and will play it by ear, but I definitely don't want to have to worry about finding a job down the road. At what point do people even have to decide if they're doing ESIR and, if I do it, can I back out of fellowship last minute and just do DR? Sorry to derail, but just curious.

 

[Radology]

I would make no 5 year from now decisions based on current events

 

[Taurus]

I would not count on a V-shape recovery, especially with a clueless president who constantly lies, spreads false hope, and is more worried about his TV ratings than American lives. He has no idea what he's doing. As a result, more lives will be lost and the economic damage will be worse than necessary. It's could take years for full recovery.

 

[efle]

Why do economic downturns hit radiology so hard? Shouldn't all physicians have felt that 401k hit? But I only hear about these cyclical hot and cold job markets in Rads

 

[SeisK]

Why do economic downturns hit radiology so hard? Shouldn't all physicians have felt that 401k hit? But I only hear about these cyclical hot and cold job markets in Rads

Specialties that are very lifestyle friendly (path, derm, rads, radonc) have a lot of wiggle room to increase productivity before burnout becomes unbearable. When near-retirement folk have the freedom to increase productivity so much, they will to recover their retirement losses, preventing job openings. In less lifestyle friendly specialties, older folks are already so tired near retirement they’re okay just downsizing and taking the hit.

After ‘08, the path and radonc markets never recovered. Radiology did because reimbursements were cut so much and imaging volumes concomitantly increased that it’s really not a lifestyle specialty that it was back in ‘08. Unless older folks in radiology are set up like Kings in their groups where they make high salary with low productivity, they have much less wiggle room to increase productivity now than they did in previous market downturns. Derm also recovered rapidly because its inherently elective and low-acuity nature allows them to restrict training spots with impunity, and they have the economic wherewithal to minimize slot expansion in a way that radonc and path are... too selfish? To do.

 

[efle]

Specialties that are very lifestyle friendly (path, derm, rads, radonc) have a lot of wiggle room to increase productivity before burnout becomes unbearable. When near-retirement folk have the freedom to increase productivity so much, they will to recover their retirement losses, preventing job openings. In less lifestyle friendly specialties, older folks are already so tired near retirement they’re okay just downsizing and taking the hit.

After ‘08, the path and radonc markets never recovered. Radiology did because reimbursements were cut so much and imaging volumes concomitantly increased that it’s really not a lifestyle specialty that it was back in ‘08. Derm also did because it’s inherently elective and low-acuity nature allows them to restrict training spots with impunity, and they have the economic wherewithal to minimize slot expansion in a way that radonc and path are... too selfish? To do.

Ah, gotcha, so it's that a radiologist in their 60s-70s can keep working at a level an older surgeon cannot. Makes sense.

As a brief aside, what happened to Path? I'm familiar with RadOnc's downward spiral, was it the same story for Path where they rapidly expanded training slots beyond the number of interested US MD Seniors?

 

[SeisK]

Ah, gotcha, so it's that a radiologist in their 60s-70s can keep working at a level an older surgeon cannot. Makes sense.

As a brief aside, what happened to Path? I'm familiar with RadOnc's downward spiral, was it the same story for Path where they rapidly expanded training slots beyond the number of interested US MD Seniors?

Residency salary is funded by Medicare, so if you use residents to go through more work faster, your (the faculty) salary increases because they won’t see the money from their work. It’s my (and many, many others) prevailing opinion that older faculty realized they can use Medicare to subsidize resident labor, with the end result if lining their wallets. So a lot of departments increased residency training spots not because of a societal need, but because of a selfish scheme of making more cash for themselves.

 

[Butters Stotch]

Specialties that are very lifestyle friendly (path, derm, rads, radonc) have a lot of wiggle room to increase productivity before burnout becomes unbearable. When near-retirement folk have the freedom to increase productivity so much, they will to recover their retirement losses, preventing job openings. In less lifestyle friendly specialties, older folks are already so tired near retirement they’re okay just downsizing and taking the hit.

After ‘08, the path and radonc markets never recovered. Radiology did because reimbursements were cut so much and imaging volumes concomitantly increased that it’s really not a lifestyle specialty that it was back in ‘08. Unless older folks in radiology are set up like Kings in their groups where they make high salary with low productivity, they have much less wiggle room to increase productivity now than they did in previous market downturns. Derm also recovered rapidly because its inherently elective and low-acuity nature allows them to restrict training spots with impunity, and they have the economic wherewithal to minimize slot expansion in a way that radonc and path are... too selfish? To do.

To add on to this why were reimbursements cut back in ‘08? If the economy tanks either due to covid or sometime in the future which is envitable( say 15 years down the road?) will reimbursements continue to be slashed?

 

[Timtom98]

To add on to this why were reimbursements cut back in ‘08? If the economy tanks either due to covid or sometime in the future which is envitable( say 15 years down the road?) will reimbursements continue to be slashed?

deficit reduction act, i dont think it was just rads that got hit

 

[Radology]

DRA became law in 06, so it was just bad luck that it coincided with the impending crisis

 

[Tiger100]

The volumes that we saw in private practice between 2017-2019 won't be seen for the foreseeable future. As a result the job market will go down.

There are about 30K practicing radiologists out there. 5-10% decrease in volume (which is very likely) translates into decrease in demand by 2-3K of manpower. Than means turning a healthy job market into a bad market.

 

[Radology]

To be fair, the volumes were easily 5-10% above what staffing could handle before this.

and I’m sorry, but you have absolutely no idea what’s going to happen for the foreseeable future. I could just as easily say volumes could get worse. For instance, 12 months worth of screening mammograms will getting done in the 9 months after the country reopens. All the elective procedures and imaging that comes with them will be the same

fear and uncertainty will make next year’s job market Rough.

what happens beyond that is anyone’s guess. Personally, I think this heighened desire to not touch patients and treat them from the door will only continue the trend we had seen for the last two decades of increased imaging

 

[Tiger100]

To be fair, the volumes were easily 5-10% above what staffing could handle before this.

and I’m sorry, but you have absolutely no idea what’s going to happen for the foreseeable future. I could just as easily say volumes could get worse. For instance, 12 months worth of screening mammograms will getting done in the 9 months after the country reopens. All the elective procedures and imaging that comes with them will be the same

fear and uncertainty will make next year’s job market Rough.

what happens beyond that is anyone’s guess. Personally, I think this heighened desire to not touch patients and treat them from the door will only continue the trend we had seen for the last two decades of increased imaging

I agree that groups used to work hard and with fast pace but they at the end of the day they handled the volume or at least they "felt" that they were handling the volume. Otherwise, they would have hired more people. The same people are going to run the groups for the foreseeable future so the volume/radiologist is not going to change. In fact the opposite happens. Many will work harder the next 2-3 years to compensate for money lost in stock market and lower income this year.

There is also a lot of uncertainty about the future of healthcare in this country. Many believe that the current events will result in more and more centralization of healthcare. Whether it happens or not, the uncertainty that it creates will result in hesitation in hiring new associates. This happened in mid 90s and late 2000s.

Other than fields like ED or Pulmonary critical care, any field that has outpatient elective procedures will be hit.

Let's face it. A great portion of elective medical procedures (whether it is knee MRI or shoulder arthroplasty or spine surgery or hysterectomy or angiography for chronic chest pain or pain injection or even Mohs surgery) are not as necessary as doctors claim. They can easily be postponed or even canceled without any significant impact on patient's prognosis.