Derm vs rads?

[ItAintEasyBeingCheesy]

To radiologists, if you could do it all over again and given the option, would you pick derm or stick with radiology? Strictly from a lifestyle/money perspective?

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[Womb Raider]

To radiologists, if you could do it all over again and given the option, would you pick derm or stick with radiology? Strictly from a lifestyle/money perspective?

What do you mean strictly from a lifestyle/money perspective? Should my interest in the field be irrelevant? Would I want to look at moles all day? Never. The answer is absolutely not.

 

[Clean7795]

I would pick radiology over derm every time, based on interest mainly.

From a strictly money perspective, the floor is lower in derm but ceiling is higher (cosmetics).
From a strictly lifestyle perspective, derm is generally better because it is outpatient only type work. Both are busy at work (i.e. fully booked/double booked clinic vs reading imaging nonstop), but derm has no real call or overnight work.

There are certain radiology perks, like work from home and not dealing with "high maintenance" patients that are common in cosmetics.

IMO the fields are so different from day-to-day practice that it makes more sense to pick based on interest.

 

[TxC]

The skin can be pretty gross. Computers aren't really gross at all.

 

[brownman23]

Call is much easier with Derm, especially with some EMR's ability to upload pictures onto a patient's electronic chart. If I liked both fields equally, I would pick Derm for the chiller lifestyle.

However, I like the subject matter of Radiology much better.

 

[Neopolymath]

Derm can wave the middle finger at insurance and corporate medicine if it really wants to. Saying no to insurance is never happening in rads and you can't hang a shingle.

Otherwise I think the workload is similar in private practice. Pick which day to day when you are 45 sounds better. It is a shorter residency though...

 

[odyssey2]

I'm a first year rads resident so take what I say with a grain of salt but I also was deciding between these two and here's my two cents:
In general, derm is going to have a better lifestyle just in terms of having less call, but there are still cush lifestyle practices and certain fields in radiology (mammo especially) that can approach or match the derm schedule. There's generally less acuity in derm with the only common deadly ailment being skin cancer, and even that is mostly treatable, while all the emergencies and trainwrecks in the hospital will be seen by rads. This also means more interesting cases and a much more vast variety of pathologies will be seen by rads.

A lot of your day in derm in PP is going to be acne/psoriasis/warts and you're going to be prescribing different creams and doing small procedures. Visits are generally short and to the point but you do get your fair share of demanding/emotional/difficult patients, which is obviously not going to be a problem in most fields of radiology. Derm clinic tends to have a light atmosphere since most of what you're dealing with is benign and treatable. But you'll also get more grateful and appreciative patients, while the referring docs you work with in rads are definitely not going to give you that kind of ego stroking. Derm is busy clinic, rads is busy computer work churning through scans. Derm can be socially exhausting, esp for introverts, while rads can be isolating in certain settings.

Derm residency is shorter but I know plenty of residents who complain about how rough their clinic is. Radiology residency call can be very rough and will have longer residency hours on average, but the hours are still a lot more benign than IM or surgery. Both specialties require a lot of outside studying and have difficult board exams. Derm attracts very Type A personalities and despite the chill lifestyle there are more than a few malignant training programs (the one at my TY was notoriously awful). Rads people tend to be more chill and abusive programs tend to be few and far between.

As said above, the avg salary in rads is slightly higher but the ceiling is higher in derm. Your application need to be pristine, with good research and ECs, to be able to match derm, rads is getting more competitive but in general good scores and grades will get you in (test scores especially).

 

[qxrt]

I recommend choosing based on what interests you more. Working in a clinic every day seeing patients is a very different job from sitting at a computer in a dark room reading exams. It is hard to imagine that anyone has the same level of interest in both.

Both dermatology and radiology have options for busy practices or laid back lifestyles. You can work like a dog and make a lot of money or take a relaxing job in either.

True that radiology has night and weekend call, but jobs without call exist (primarily outpatient jobs), and while dermatology makes more money/hour worked, radiology probably makes more money overall and is much easier to moonlight in.

I would 100% choose radiology again and have never even considered dermatology because I have no interest in the subject nor clinic. I get bored with monotony, and radiology is unique in that there aren't many (if any) other fields that require both the combination of breadth and depth of knowledge in medicine.

 

[Taurus]

The upside to radiology is greater than many think. Radiology is a 24/7 field. Every minute of every day is an opportunity to increase your income. No other field including derm can do that. In the evenings, weekends, holidays, and vacation time, you can either sign up for telerads or do locums to supplement your regular radiology job. Your ceiling in radiology depends on how much you want to hustle. The trick is to find the most lucrative opportunities and pace yourself so you don’t burn out.

 

[Cognovi]

The upside to radiology is greater than many think. Radiology is a 24/7 field. Every minute of every day is an opportunity to increase your income. No other field including derm can do that. In the evenings, weekends, holidays, and vacation time, you can either sign up for telerads or do locums to supplement your regular radiology job. Your ceiling in radiology depends on how much you want to hustle. The trick is to find the most lucrative opportunities and pace yourself so you don’t burn out.

Speaking to this, one of my attendings from training who does academic emergency radiology and moonlights in spare time just got a Lamborghini. This guy hustles. One time he was moonlighting early morning like 4AM for a community hospital, read a study on this patient, patient gets transferred to the tertiary care center, this guy comes in for his day job, does the second opinion read of the outside study... that he read a few hours ago.

 

[odyssey2]

Speaking to this, one of my attendings from training who does academic emergency radiology and moonlights in spare time just got a Lamborghini. This guy hustles. One time he was moonlighting early morning like 4AM for a community hospital, read a study on this patient, patient gets transferred to the tertiary care center, this guy comes in for his day job, does the second opinion read of the outside study... that he read a few hours ago.

You gotta werk for the Lambo in rads

 

[voxveritatisetlucis]

You gotta werk for the Lambo in rads

Is this really true though? Assuming median radiologist is about 500k then obviously half will be making more. Used/preowned super cars are very easy to find in the range of 120-200 on sites like carfax. Assuming one had no debt, isn’t this like somebody making 90k spending 35k on a car which seems pretty common

 

[odyssey2]

Is this really true though? Assuming median radiologist is about 500k then obviously half will be making more. Used/preowned super cars are very easy to find in the range of 120-200 on sites like carfax. Assuming one had no debt, isn’t this like somebody making 90k spending 35k on a car which seems pretty common

I was jk. If you really prioritized Lambos you could get them. Just saying in general the really high paying rads work very hard for it.

 

[doctalaughs]

Dermatologist here.

Both great fields. Good income per time.

Many friends are radiologists and many do really well. I think their work is more intense than mine though. At this point in my career (15 years out) I can “turn my mind off” for some parts of the day. You learn to interact with different kinds of patients automatically and of course there are always a few interesting things every day— but for most skin exams, biopsies, bread/butter stuff I can go on autopilot and make all the right decisions.

I’ve heard you always have to concentrate in radiology. Not to say I can go to sleep - but I really I don’t need a super high level of focus to get through a day, which occasionally be boring but really is a blessing (ie I’m not stressed at 4pm after seeing 40 patients at the end of my day).

 

[2brads]

Derm lifestyle is probably better, generally speaking. Unless you find an outpt-only gig, but those may pay less.

You can make more money in derm probably, but you’ll work for it and you have to be good at running a business. You can do very well in rads just being a cog in a wheel if you don’t want to be bothered with the business side of things. I agree with above that the floor for rads is higher than derm.

Just have to decide if you want to look at naked wrinkly people all day or look through them.

 

[vm26]

Derm lifestyle is probably better, generally speaking. Unless you find an outpt-only gig, but those may pay less.

You can make more money in derm probably, but you’ll work for it and you have to be good at running a business. You can do very well in rads just being a cog in a wheel if you don’t want to be bothered with the business side of things. I agree with above that the floor for rads is higher than derm.

Just have to decide if you want to look at naked wrinkly people all day or look through them.

Agree...I am also hearing that derm is getting infiltrated by P/E so the gravy train may not last, use of mid-levels make this much easier than in rads given supply/demand...As stated, much easier to be a cog in the wheel in rads. The big money in derm is in cosmetics, cash only business where one sells products etc...I would imagine that these days this is pretty tough to break into particularly in desirable wealthy areas. One also needs to have the temperament/financial savyness to be a small business owner making all sorts of decisions, while on top of being a FT physician (at least initially)

 

[2brads]

Agree...I am also hearing that derm is getting infiltrated by P/E so the gravy train may not last, use of mid-levels make this much easier than in rads given supply/demand...As stated, much easier to be a cog in the wheel in rads. The big money in derm is in cosmetics, cash only business where one sells products etc...I would imagine that these days this is pretty tough to break into particularly in desirable wealthy areas. One also needs to have the temperament/financial savyness to be a small business owner making all sorts of decisions, while on top of being a FT physician (at least initially)

Also, cosmetic derm is more susceptible to the macroeconomic trends. You lose your job and you can skip Botox for a bit. You’re less likely to skip imaging if you need it.

 

[sloh]

@SeisK created an awesome thread on the threat (not really a threat) of AI to rads.

We need a thread on why AI WILL NOT replace radiologists in the next several decades. I’ll start.

This post is made by a recent study here that delineates 1/6 medical students interested in radiology decide not to after learning about AI minimally from other attendings (almost certainly in specialties that do not generate radiology reports), and it’s something that keeps coming up, at first...

forums.studentdoctor.net

"This post is made by a recent study here that delineates 1/6 medical students interested in radiology decide not to after learning about AI minimally from other attendings (almost certainly in specialties that do not generate radiology reports), and it’s something that keeps coming up, at first amusingly, but now it’s slowly become annoying.

Radiology is the best specialty. We deal with essentially no crap that other specialties have to on a day to day basis, we’re extraordinarily efficient, we deal with ALL the type of things you learn about in med school (even those pesky lysosomal storage diseases you were told never mattered), you are directly exposed to the applications of the coolest modern physical and technological sciences, and you’re paid appropriately for it unlike a large swath of the rest of medicine.

My motivation in this is, well, I’m a jealous guy. I want all the smart, driven, charismatic people to come to my specialty and in their (necessarily) naive state as young influenceable medical students I think a bunch of smooth-brained window-lickers (with the utmost respect) are dissuading them from this thing. So I want to start a thread on why this is so horribly mistaken.

—-

This is a post I made on auntminnie on a related thread, which I think really drives the point home. I’d love to hear other’s thoughts (doesn’t matter how thought out or not). This comes from a background in not a small amount of literature review, and clinical trial research.

“
We don’t really have successful models that can predict the future well in economic terms, and when that happens emotions run rife and dominate the conversation.

You have computer scientists and software developers that immediately show their futorology bias by repeatedly spouting “radiologists will be obsolete” even today, despite what little AI has been implemented probably isn’t saving anyone any time, and the only RoI comes in the form of higher quality reads.

You have radiologists on the other hand, who possibly in an ego-defense kind of way, state “AI will only assist us not replace us” when assisting you is tantamount to replacing you. If I need five radiologists instead of ten to get through a list in a day, I’ve replaced five with the implementation.

But the fact of the matter is, actual clinical implementation of algorithms and reproducibility studies have not matched trial studies in accuracy, and will continue to not do so for the next several decades at least, for many reasons:

I’ll start with the obvious: no radiologist is being replaced until radiologist+AI is better than radiologist in a large scale, heterogenous population. I’ll go more into that below. Starting with that:

1. Edge cases are not a negligible proportion of our studies. Even if they were, there are no studies or software present that assess the accuracy of an AI in determining edge-scenarios, so how am I going to know “you don’t need to look at this study” even if AI surpasses my ability? This is why AI that is a “normal identifier” is far away. Far away. FAR. AWAY.
2. Training datasets are not generalizable because of subtle differences in the scanners underlying the data acquisition, and heterogenous datasets are proprietary making it extremely difficult sometimes to acquire larger datasets to train your algorithms. There are some efforts to overcome this, but five large homogenous datasets do not a heterogenous sample make.
3. The Black Box problem. This is tied to problem 2. There’s often something else consistently on the image that may demonstrate why something is going to happen that’s coincidentally tied to the pathology, that we can’t identify. “Who cares if the diagnoses are accurate?” I do MFer, because if in a multivariate analysis we account for this hidden “black box variable” and find the machine is now worse than humans, I’m not going to use the thing. I have no idea if there are black box variables in your algorithm to even begin knowing how to set up a multivariate analysis in its elimination. This right here is almost certainly why clinical implementation of extremely promising algorithms have been milquetoast. Frankly, there’s s*** I can’t see that the thing is using to cheat. When you employ the algorithm in another population that doesn’t have that hidden variable, it fails. Two ways of getting around this are localizers to help the radiologist figure out what the AI is seeing, and testing the algorithm on an extremely heterogenous population (lots of different types of patients, lots of different types of scanners, lots of different types of clinical settings in acquisitions).
4. AI is exceptionally vulnerable to artifacts that are trivial to us.
5. AI does not reproduce human-level sensitivity or specificity on cross-sectional imaging, which is likely our most important work as it’s here we often truly make diagnoses, whereas in planar imaging we only provide descriptions that lean in favor of diagnoses.

Additionally, here are the bigger deals:
6. Greater accuracy doesn’t save anyone any time. Or at least it morally shouldn’t. AI+Radiologist surpassing radiologist performance assumes the radiologist hasn’t changed their behavior in the presence of AI, unless the software has accounted for that behavior in its pre-release trial. A radiologist going through studies quicker because they have AI on board isn’t reproducing the study conditions, so its conclusions can’t be guaranteed to extrapolate, and the person suffering that decision is the patient. Because of this, AI doesn’t actually yield a RoI for the radiology practice when used. Then again, there are a lot of dubious radiologist practices out there, and they’re becoming dubiouser with private equity expansion.

Finally:
7. No prospective trials. This is a big deal, probably the biggest. Nothing, I mean nothing in any field of medicine becomes or supplants the standard of care until you have a large, national-scale, large AND SUFFICIENTLY HETEROGENOUS sample population randomized clinical trial demonstrating the new method surpasses the old in terms of morbidity and mortality years down the line—NOT FOR MODALITIES AS A WHOLE, but for the thousands of specific pathologies picked up on that modality. There is a lot of groundwork to be done before you’ll let the experimental arm be put at risk of the study going wrong. You do this by performing quite exhaustive retrospective studies analyzing variables important to the outcome, and for AI that’s a lot of variables. Additionally and most importantly, this is also overcome by making the experimental population arm be “existing standard + new intervention,” which I’ll again remind you doesn’t replace a single radiologist. After this case is met can you maybe attempt to use the “new intervention” alone without the existing standard. Even a single such Phase 3 trial takes YEARS, and a simple search of clinicaltrials.gov will show that there is not even a phase 1 trial of ANY imaging modality AI versus radiologist. The FDA will NEVER clear these devices as standard of care until a Phase 3 looks gorgeous and published on the front page of NEJM, and right now we don’t even know yet how to set up an appropriately sampled population for such a phase 3 as, again, generalizability is an enormous issue (you’d have to sure any new variant of image acquisition is covered). Keep in mind though that while this is the biggest deal, it is the BIGGEST deal. Once an AI has overcome this hurdle for a specific pathology, the radiologist has lost. If AI says “acute interstitial edematous pancreatitis” and AI > AI + Radiologist for this pathology, that’s what goes in the report even if you don’t see it.

And again, I’ll remind you. You set up clinical trails NOT FOR MODALITIES AS A WHOLE. But for specific pathologies. You need a phase 1 for acute interstitial edematous pancreatitis, acute necrotizing pancreatitis, chronic pancreatitis, pancreatic adenocarcinoma… and so on. For the thousands of such diagnoses a radiologist is required to identify and describe. That’s a lot of work for a small group of software devs who don’t know what pancreatitis is.

Given the above, and probably because private equity would prefer modest short term return than huge long term return, the AI software we do see is relatively small, sold to radiologists rather than providers directly, and is always advertised as an adjunct to the standard of care rather than any kind of replacement for it lest they suffer the FDA and litigation’s wrath.

And I’ll remind everyone finally that all of this will reduce the need for radiologists, but still will not replace them. I see the future of radiology one that is much more data / mathematics / physical science driven as the number and complexity of imaging modalities grows and as the importance of AI grows. We have to become experts on it. We have to become as familiar with the language of AI implementation into healthcare as the oncologist is with their various chemotherapies, and the subtleties of using them depending on the context of what cancer. We really should be the experts and keepers of this, and become as familiar with it as the computer scientists themselves. For the benefit of our patients. Learn it, not because you fear it (if you’re new you don’t have much to fear) but because you want to employ it to save your patient’s lives.

 

[MouseChair]

Rads over derm for sure for ME. I like the diversity of pathology, knowing something about every organ system, surgical techniques, medical stuff. Rads is just inherently more interesting for me

The massive advantage of derm is two things: 1) it’s a shorter residency. The extra years start adding up and you can only tolerate being a trainee for so long. You can leave after just 4 years with derm whereas with rads it’s 6 as fellowship pretty much required. Sometimes 7.

And 2, if you are entrepreneurial, running a practice can be rewarding financially, way more than rads. Like cosmetic/cash only stuff, ancillary services like med spas and what not

They won’t ever have to take call like we do… I assume most things can wait till Monday morning or to be seen in clinic. Call is pretty brutal in rads as I am sure you know

 

[Tiger100]

To radiologists, if you could do it all over again and given the option, would you pick derm or stick with radiology? Strictly from a lifestyle/money perspective?

Strictly from lifestyle/money perspective:
Nothing in medicine beats Derm with a huge margin.

I am not going to give you a big lecture about the importance of doing what you enjoy to do.
But remember this:
When you start working you care about Money>= Your interest >> lifestyle.
After 10 years of practice and saving north of 2 mil you care about lifestyle >>>>> Money>= Your interest.

 

[odyssey2]

Strictly from lifestyle/money perspective:
Nothing in medicine beats Derm with a huge margin.

I am not going to give you a big lecture about the importance of doing what you enjoy to do.
But remember this:
When you start working you care about Money>= Your interest >> lifestyle.
After 10 years of practice and saving north of 2 mil you care about lifestyle >>>>> Money>= Your interest.

So would you have chosen derm over rads knowing what you know now? And don’t fields like breast radiology have hours similar to derm?

 

[SeisK]

Strictly from lifestyle/money perspective:
Nothing in medicine beats Derm with a huge margin.

I am not going to give you a big lecture about the importance of doing what you enjoy to do.
But remember this:
When you start working you care about Money>= Your interest >> lifestyle.
After 10 years of practice and saving north of 2 mil you care about lifestyle >>>>> Money>= Your interest.

I don’t know the difference is as stark as you make it seem. There is a difference - we often/sometimes have nights (it depends on the gig), they don’t, we probably work a few more hours in the week than they do, but we have much more vacation time, we aren’t beholden to a fixed clinic schedule, and our median pay is higher. Both specialties work at a fast pace.

 

[Tiger100]

So would you have chosen derm over rads knowing what you know now? And don’t fields like breast radiology have hours similar to derm?

Since I hate Derm, it is out of question for me. YMMV.

No. In order to get paid partner's salary, you have to take call in most groups.

And the flexibility of Derm is a lot more than breast radiology. In Breast radiology you are part of a bigger group unlike Derm that you can open your solo shop.

 

[Tiger100]

I don’t know the difference is as stark as you make it seem. There is a difference - we often/sometimes have nights (it depends on the gig), they don’t, we probably work a few more hours in the week than they do, but we have much more vacation time, we aren’t beholden to a fixed clinic schedule, and our median pay is higher. Both specialties work at a fast pace.

Most radiologists take weekend calls.

In private practice, most radiologists work more (a lot more) than derm.

Vacation time is good but you really don't need 10 weeks if you have kids.

The potential pay for Derm is higher than radiology.

 

[Dantes]

Interesting, as an outsider I assumed that rads lifestyle might be better due to not having to deal with an inbox, prior auths, other paperwork. How many hours/week and how much call/night burden is there as an attending generally?

 

[jambro]

Is derm really that flexible if you have to cancel clinic or plan out your off days x months in advance? I feel like some sort of telerad employed position would be the most flexible in all of medicine

 

[DarkHorizon]

Is this really true though? Assuming median radiologist is about 500k then obviously half will be making more. Used/preowned super cars are very easy to find in the range of 120-200 on sites like carfax. Assuming one had no debt, isn’t this like somebody making 90k spending 35k on a car which seems pretty common

Buying a lambo or any 150k+ car is a bad decision making only 500k. Assuming one has a family and other expenditures.

 

[letmebe]

Do derm if you can get into it. Yes, skin pathology is quite gross, but gross is better than gambling your life away with every scan you read. Also, you can always employ midlevels in derm. Can do pharma related stuff to supplement your income in derm but not rads. And on top of that, it’s a shorter path overall (approx .5 million opportunity cost).

 

[doctalaughs]

As a dermatologist/owner in private practice the perspective from my side:

1) I can work as little or much as I want, but it will directly determine how much money I make.
2) generally I need to plan my schedule out 4-6 months and I do not cancel unless it’s an emergency (yes, I technically can - but you lose patients and reputation if you do).

In exchange though, I never work a single holiday, night or weekend. Generally my hours are extremely predictable (8 to 330 or 4). I never carry a pager. I never miss a family event and can easily take as little as 4 weeks as much as 12 off per year, depending on if I’m good with the corresponding money flow. The paperwork and insurance hassle isn’t bad with a well run practice (scribes, clerical staff to do pre-auths etc). Money is fine, and can exceed expectations if you are a founding partner in a bigger practice (for a derm that’s like 15+ for true private; fake partner in PE doesn’t count).

 

[forchinet121]

As a dermatologist/owner in private practice the perspective from my side:

1) I can work as little or much as I want, but it will directly determine how much money I make.
2) generally I need to plan my schedule out 4-6 months and I do not cancel unless it’s an emergency (yes, I technically can - but you lose patients and reputation if you do).

In exchange though, I never work a single holiday, night or weekend. Generally my hours are extremely predictable (8 to 330 or 4). I never carry a pager. I never miss a family event and can easily take as little as 4 weeks as much as 12 off per year, depending on if I’m good with the corresponding money flow. The paperwork and insurance hassle isn’t bad with a well run practice (scribes, clerical staff to do pre-auths etc). Money is fine, and can exceed expectations if you are a founding partner in a bigger practice (for a derm that’s like 15+ for true private; fake partner in PE doesn’t count).

What do you consider “fine” money?

 

[Kuratz]

Currently looking at a few Rads jobs where partners make excellent money and ~10 weeks vacation, in a nice part of the country. Most have a hybrid model where some shifts can be from home. Alternatively I know of some tele gigs making still plenty of money with the flexibility to live exactly where you’d like with no commute etc. Are there better gigs than Rads (possibly including Derm)? Yes. But most people drawn to Rads aren’t going to enjoy seeing 40+ people in a busy skin clinic. I couldn’t be a Derm, just not my cup of tea even if it does come out ahead in terms of $/lifestyle. The work for rads is very pleasant and interesting and I know I will enjoy this long term. The ability to work remote is such a huge intangible that shouldn’t be ignored. If an area is saturated with Docs then I can take a tele job and work hard. With clinical fields? No guarantee you get to live there.

 

[letmebe]

This whole idea of work from home in rads, I would bet that 80% of rads still report to a physical location 80% of the time. From what I’ve seen, WFH is granted to a few shifts in the month. My knowledge is limited to my local area, but still I don’t think anyone who responded on here is working from home >50% of the time. It’s definitely available, but probably highlighted as a benefit more than it’s actually utilized by a large margin.

 

[SeisK]

This whole idea of work from home in rads, I would bet that 80% of rads still report to a physical location 80% of the time. From what I’ve seen, WFH is granted to a few shifts in the month. My knowledge is limited to my local area, but still I don’t think anyone who responded on here is working from home >50% of the time. It’s definitely available, but probably highlighted as a benefit more than it’s actually utilized by a large margin.

Half of the recent grads from my residency are doing remote tele gigs for physician-owned private practices and academic powerhouses. If you want to do mostly/all remote work, you can, although it’ll probably cost your salary:annual RVU ratio.

 

[Neopolymath]

Currently looking at a few Rads jobs where partners make excellent money and ~10 weeks vacation, in a nice part of the country. Most have a hybrid model where some shifts can be from home. Alternatively I know of some tele gigs making still plenty of money with the flexibility to live exactly where you’d like with no commute etc. Are there better gigs than Rads (possibly including Derm)? Yes. But most people drawn to Rads aren’t going to enjoy seeing 40+ people in a busy skin clinic. I couldn’t be a Derm, just not my cup of tea even if it does come out ahead in terms of $/lifestyle. The work for rads is very pleasant and interesting and I know I will enjoy this long term. The ability to work remote is such a huge intangible that shouldn’t be ignored. If an area is saturated with Docs then I can take a tele job and work hard. With clinical fields? No guarantee you get to live there.

Part of why I picked rads is that in the worst case scenario I do tele and don't have to uproot my family in the event an in-person group sells out or goes to ****.

What other field can deal with onerous (probably illegal?) non-competes with the same ease?

 

[sloh]

What’s the most you can make with tele-rads?

 

[Steve_Zissou]

What’s the most you can make with tele-rads?

Doc at my prelim reads for a PP group in a state on the opposite coast. He does their nights one week on, two off, makes ~$500,000. Totally tele.

 

[Steve_Zissou]

He sometimes works locums shifts at the hospital my prelim is at, which is how I’ve gotten to know him.

 

[voxveritatisetlucis]

what are the chances that this reliance on remote work leads to hospitals outsourcing the work to counties where radiologists get paid nothing

 

[Steve_Zissou]

what are the chances that this reliance on remote work leads to hospitals outsourcing the work to counties where radiologists get paid nothing

I would imagine that it would be quite the liability issue/legal battle.

 

[RageQuitter34]

Doc at my prelim reads for a PP group in a state on the opposite coast. He does their nights one week on, two off, makes ~$500,000. Totally tele.

Around how many hours are they working for that week?

 

[guytakingboards]

what are the chances that this reliance on remote work leads to hospitals outsourcing the work to counties where radiologists get paid nothing

That'd be a huge paradigm shift, not one that I imagine any entity other than the hospitals' bottom line would think is a good thing.

It's not currently legal to provide final interpretations without being US-licensed. I think you *could* get prelims from an out-of-country rad but the financials don't necessarily make sense if they need to be over-read by a US rad anyway.

 

[SeisK]

That'd be a huge paradigm shift, not one that I imagine any entity other than the hospitals' bottom line would think is a good thing.

It's not currently legal to provide final interpretations without being US-licensed. I think you *could* get prelims from an out-of-country rad but the financials don't necessarily make sense if they need to be over-read by a US rad anyway.

Lots of insurances also advertise that “blah blah percent of our in-network physicians are US board certified,” making retention of contracts a really thorny issue if all of a sudden a vast base of your patients now no longer have high-percentage US board certified care.

 

[Steve_Zissou]

Around how many hours are they working for that week?

9 hour shifts 7 days in a row. He said it's work from the time you start till the time you stop, but he gets two weeks off after and has more time than he knows how to fill so he works locus for extra cash.

 

[2brads]

The problem with most tele-only positions is the hours usually suck. 7 on 7 off sounds good, but giving up 50% of your holidays/weekends is a major bummer in my opinion. Almost no one is doing 100% WFH during normal business hours.

As far as remote tele from another country, it's legal, but you can't bill medicare for final reads performed by ANY radiologist offshore. Even if you ship off US grads with ABR certs, they must be on American soil when the final read is signed. "Best case" scenario time-wise is having a rad who lives in Guam reading for an East Coast practice. Good luck finding a rad who wants to live in Guam though.

 

[doctalaughs]

What do you consider “fine” money?

“Fine” is 400-500 (what you typically make as an employee or pre-partner full time).

“Exceeds my expectations” is 600-900 typical partner in a practice that is doing well (ie grown to multiple locations and 10+ providers with ancillary revenue streams etc.)

 

[Taurus]

Good luck finding a rad who wants to live in Guam though.

You don’t have to go that extreme. Many groups have tried to do reads from Hawaii and have failed because they’re fun places to visit but not to live.

 

[2brads]

You don’t have to go that extreme. Many groups have tried to do reads from Hawaii and have failed because they’re fun places to visit but not to live.

I said "best case". As far as Hawaii is concerned, a 6 hour time shift isn't enough to appropriately cover overnight hours without someone working at crappy times.

 

[Tiger100]

Very few fields in medicine even get close to derm when it comes to money/lifestyle.

True that spine surgeons can make 1mil+ but their lifestyle sucks.
True that Rheumatologists can work 8-4 outpatient but their job market and the money are not that good.
True that radiologists can make more than derm but the lifestyle is OK at best.

 

[forchinet121]

Very few fields in medicine even get close to derm when it comes to money/lifestyle.

True that spine surgeons can make 1mil+ but their lifestyle sucks.
True that Rheumatologists can work 8-4 outpatient but their job market and the money are not that good.
True that radiologists can make more than derm but the lifestyle is OK at best.

I’m not sure that’s true, derm is a serious grind, just like anything else, it just depends on what you enjoy. It’s not like derm is 3 days a week making 1 mil, they have to put in serious hours for their coin just like everyone else

 

[Ho0v-man]

Both are great financially. Do the one you like because they’re very different and I can’t imagine liking both.