MS3 here seriously considering Radiology with the hope of building a Radiology practice down the road. I have some questions for y'all. With all of this talk about the terrible job market and so forth, how difficult is it to create your own job/start a private radiology practice? Is this a risk that most people just don't want to take, and therefore decide that becoming an employee as the better/safer option?
Creating your own Job
- Thread starter Delque
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Well, for one thing, starting one's own practice and becoming an employee aren't really the only two choices. Many radiologists still take the traditional partnership-track jobs, whereby they may temporarily be considered employees. But eventually they'll become full partners, who - depending on the legal structure of the practice - take on a lot of risk. To answer your question, though...
Risk is a big part, but that's not really the whole story. Running a private practice is a lot of work and takes a fair amount of business acumen. Starting one takes even more of both, and those are things that many physicians - not just radiologists - are becoming increasingly less interested in. It's also a question of market saturation, meaning there really aren't any markets out there with a radiology demand but no supply. There are probably some exceptions to that, as in maybe a hospital in an oil-boom town in North Dakota is expanding and would love to have a small private practice take on its new radiology contract. But, exceptions notwithstanding, starting a new practice means pushing other radiologists out, so it's a zero-sum game for the profession. And frankly, it's one of the most loathsome aspects of teleradiology firms. To wit, they undercut and push out the local group, and all too often quality suffers.
Risk is a big part, but that's not really the whole story. Running a private practice is a lot of work and takes a fair amount of business acumen. Starting one takes even more of both, and those are things that many physicians - not just radiologists - are becoming increasingly less interested in. It's also a question of market saturation, meaning there really aren't any markets out there with a radiology demand but no supply. There are probably some exceptions to that, as in maybe a hospital in an oil-boom town in North Dakota is expanding and would love to have a small private practice take on its new radiology contract. But, exceptions notwithstanding, starting a new practice means pushing other radiologists out, so it's a zero-sum game for the profession. And frankly, it's one of the most loathsome aspects of teleradiology firms. To wit, they undercut and push out the local group, and all too often quality suffers.
Thanks for reply, this makes a lot of since. So basically try to conger up as much business skills that I can in residency and try to avoid burnout so that I still have the energy to start a practice when the time comes. Do you feel that an MBA would be helpful or would that be a waist of time?
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My personal opinion is that residency is not a good time to try to cultivate anything academic other than radiology skills. That's not to say you shouldn't and can't have a life outside of residency, just that you don't want it to become a distraction. If one follows the 10,000-hours rule, then you won't really be an "expert" at radiology until you've been an attending for a number of years (and no, I'm not counting all hours at work because not that much is spent actually interpreting images). Besides, I don't really know how much knowledge you can gain about running a private practice group in residency, particularly if you're training at a university program. Better to follow a more traditional entrepreneurial model and work in private practice for awhile, become proficient at radiology, learn the business side of things from a practical approach, and then set out on your own if you still have the itch.
As to the MBA, I honestly don't know. I think it could help, but maybe not as much as you think. I mean, I'm not sure there is a higher success rate for small-business start-ups if the owner has an MBA. If anything, a PP group may value an MBA because they'll view you as someone willing to take on an executive role in the running of the practice.
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How do you offer your services, though? It seems like a race to the bottom because the large groups can undercut a solo guy on salary or by offering 24/7 coverage.
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I've heard of some mammo solo practitioners.
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Solo practice is rare and essentially limited to outpatient imaging, like the aforementioned breast clinics. I've also known multi-specialty outpatient clinics to hire a single radiologist, but that's also rare. I sort of assumed the OP was talking about forming his own, new group.
It depends on the location. In either coasts or desirable areas in midwest --> Practically impossible.
Starting a solo practice in a remote town hours and hours away from the nearest big hospital --> Easily doable and can be very profitable.
But it is not specific to radiology. In some of these remote areas, family doctors do sigmoidoscopy, minor surgeries, delivery and .... and make a bank.
Starting a solo practice in a remote town hours and hours away from the nearest big hospital --> Easily doable and can be very profitable.
But it is not specific to radiology. In some of these remote areas, family doctors do sigmoidoscopy, minor surgeries, delivery and .... and make a bank.
Is the rural radiologist becoming harder with teleradiology?
Is the rural radiologists becoming harder with teleradiology?
Not really. Esp if you offer some other services like IR (even light IR, not necessarily high end), mammo, high quality US service and close relation with other people in the hospital.
Though I don't ignore that teleradiology has also replaced some good groups, most of the time the problem is two sided and the quality of the existing group is not good. If you offer a comprehensive radiology service, esp IR and mammo but also tumor boards, biopsies, drains, LPs, good ultrasound service and not just relying on techs, close relation with hospital admins and clinicians and also very importantly work with the hospital to grow a business (Starting a body MRI service. Starting a head and neck imaging service, ....), it is very hard to replace you.
If there is teleradiology take-over in some rural areas, it is mostly because of the quality. Unfortunately, many/most rural practices have very high turn over of radiologists (people who just get a job till something opens up in their desirable location). As a result, nobody really puts energy and time into their work (Oh, I am here for a year or two.) Or they can not provide a comprehensive service year round (Our neuroradiologist just left a month ago, now we are looking for one. So we can do myelograms only on Thursdays ). I don't blame if the hospital goes for teleradiology in these settings.
