Is it time to remove the "R" from ROAD to success?

[sirus_virus]

Liability and Lifestyle Issues Frustrate Radiologists

"Among 277 radiologists responding to a national salary survey conducted this past summer by LocumTenens.com, only 7% said they were not frustrated about practicing medicine in today's healthcare marketplace. The remaining respondents identified with a list of possible frustrations as follows"

"Medical liability issues - 24% - Lifestyle issues: Too much time at work - 22% - Administrative and business agendas interfere with clinical decisions - 16% - Reimbursement issues - 14%"

"Regarding physician salaries, the LocumTenens.com survey results indicate the average radiologist salary decreased by almost 7%, from $354,260 in 2005 to $330,100 in 2006. This year's survey results indicate that 40% of radiologists earn annual salaries of $300,000 or less, with 22% of those earning less than $225,000 per year. Slightly more than a fourth of respondents (27%) earn annual salaries of more than $400,000."

http://www.redorbit.com/news/health...trate_radiologists/index.html?source=r_health

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[notdeadyet]

"Medical liability issues - 24% - Lifestyle issues: Too much time at work - 22% - Administrative and business agendas interfere with clinical decisions - 16% - Reimbursement issues - 14%"

Go to any law firm or corporate office and ask about frustrations and you'll find a lot more than 22% respondents will say they spend too much time at work. And you won't find anywhere near 27% of them making $400K/yr.

I wouldn't count radiology down for the count just yet.

 

[sirus_virus]

Go to any law firm or corporate office and ask about frustrations and you'll find a lot more than 22% respondents will say they spend too much time at work. And you won't find anywhere near 27% of them making $400K/yr.

I wouldn't count radiology down for the count just yet.

7% salary decline in one year is some serious signs IMO. Meanwhile, while their pay is declining, their liability seems to be rising.

 

[Law2Doc]

I think the ROAD is a relic anyhow. Anesthesiology is reportedly (according to older docs I've spoken with) starting to make a comeback after a much bigger hit than rads a while back.

 

[Bertelman]

These surveys are entirely too subjective. Radiologists spending too much time at work...

 

[Critical Mass]

I'd like to see radiology fall out of the ROAD lifestyle specialties (perhaps replaced by EM). Make it easier to match for people who actually like the field rather than those who are just attracted by the salary and lifestyle.

 

[Long Dong]

The R.O. in the road stands for radiation oncology. Man do they make mad cheese and call, what call?

 

[Law2Doc]

The R.O. in the road stands for radiation oncology. Man do they make mad cheese and call, what call?

So I guess it's now the "RoD" to success. Catchy, albeit a bit phallic.

 

[45408]

The R.O. in the road stands for radiation oncology. Man do they make mad cheese and call, what call?

the call is for the emergency cancer patients that arrive via ambulance

 

[SoCuteMD]

(perhaps replaced by EM)

SHHHHHHHHHH! Let's keep it quiet until the 2009 match, mkay? Thanks!

 

[Biscuit799]

I'd like to see radiology fall out of the ROAD lifestyle specialties (perhaps replaced by EM). Make it easier to match for people who actually like the field rather than those who are just attracted by the salary and lifestyle.

I agree and feel that way about every specialty. I'm betting medicine would have a much better atmosphere if people would do what they loved instead of what gave the most time off.

BTW I love the new avatar, it's the best of everything!

 

[Tired]

The R.O. in the road stands for radiation oncology. Man do they make mad cheese and call, what call?

Did you just make that up? Because I've never heard that one before.

I do think they should pull Anesthesia out of the mix. It's just not that hard to get into anymore, and most of them do some kind of call or another.

Besides, ROD sounds a lot cooler than ROAD.

 

[Long Dong]

Did you just make that up? Because I've never heard that one before.

I do think they should pull Anesthesia out of the mix. It's just not that hard to get into anymore, and most of them do some kind of call or another.

Besides, ROD sounds a lot cooler than ROAD.

Some rad onc resident told me his life is "like budda bady" figured it should be part of the ROAD to happiness. Not really sure if others have thought of it as the road but I always have.

As for anesthesia it's not that hard to get in but as far I as know it is still a good life style. I friend of mine just finishing res got offered 350k starting, not sure what his hours are but that number sound pretty good. He even told me "what's the hardest part of gas? Trying to stay awake." So he said he reads the wall street journal or checks his stocks on his lap top during most surgs.

Yeah I like ROD, lets call it Hot rod. Cuz this is why it's hot, the others ain't cuz they not, this is why it's hot.

Or you can add path and call it DROP, and drop it like it's hot.

 

[Critical Mass]

I agree and feel that way about every specialty. I'm betting medicine would have a much better atmosphere if people would do what they loved instead of what gave the most time off.

BTW I love the new avatar, it's the best of everything!

Glad you like it.

I think that neurology is another one that sort of stands out as a specialty that people might be interested in if it didn't have an associated negative stigma. The lifestyle is probably similar to ROAD, yet people believe that it is low prestige (low pay?) relative to ROAD.

I hear more people say "hey stroke localization is kind of cool" than "whoa those skin diseases are interesting."

 

[-Goose-]

Glad you like it.

I think that neurology is another one that sort of stands out as a specialty that people might be interested in if it didn't have an associated negative stigma. The lifestyle is probably similar to ROAD, yet people believe that it is low prestige (low pay?) relative to ROAD.

I hear more people say "hey stroke localization is kind of cool" than "whoa those skin diseases are interesting."

Neurologists can make bank. My school's PD told us one of his recent neuro grads started at $400k... He said that she practiced saying "I will not work at your hospital (or whatever) for less than $400k" in the mirror before telling her future employer.

Granted, this was in a less-desirable area (although not BFE either).

Surprised me.

Also, I think that fellowship-trained EMG and sleep docs can make some respectable dough...

 

[Doctor Bagel]

Neurologists can make bank. My school's PD told us one of his recent neuro grads started at $400k... He said that she practiced saying "I will not work at your hospital (or whatever) for less than $400k" in the mirror before telling her future employer.

Granted, this was in a less-desirable area (although not BFE either).

Surprised me.

Really? That's cool -- I always heard their pay was sorta cr@ppy (well for physician pay).

So PM&R and Psych are also supposed to be pretty good in lifestyle if not so great in the pay.

 

[getunconcsious]

the call is for the emergency cancer patients that arrive via ambulance

Does anyone really initiate emergency radiation treatments for those that are emergent? I did a preceptorship in the MDACC ER and it was all neutropenic fever or the occasional rare blast crisis...or non-oncologic emergencies for which people abused the system knowing that MDACC has less wait time. But that's another story.

 

[Tired]

As for anesthesia it's not that hard to get in but as far I as know it is still a good life style. I friend of mine just finishing res got offered 350k starting, not sure what his hours are but that number sound pretty good. He even told me "what's the hardest part of gas? Trying to stay awake." So he said he reads the wall street journal or checks his stocks on his lap top during most surgs.

All I know is that when we (surgery) call, they come, which means someone is hauling their a$$ out of bed at 3am. Conversely, I can imagine the howls of laughter if we asked Derm to come visit us . . .

What do you think, "Ride the ROD to success!"

 

[Sol Rosenberg]

As for anesthesia it's not that hard to get in but as far I as know it is still a good life style. I friend of mine just finishing res got offered 350k starting, not sure what his hours are but that number sound pretty good. He even told me "what's the hardest part of gas? Trying to stay awake." So he said he reads the wall street journal or checks his stocks on his lap top during most surgs.

I think this has to end sometime soon (high pay for Anesthesiologists.) Some med schools are matching students to Anesthesiology by the dozens, and it's just not that competitive. My somewhat uninformed opinion (though based upon match lists, etc) is that supply will equal demand sooner rather than later.

I also agree with the posters that said to pick a specialty that you like, rather than solely on lifestyle. I've stared in disbelief at the salaries, match lists, average setp 1 scores for gas residencies, heard the stories (not too different from yours) about the lifestyle and thought, "What the heck," but then I realize that I'm a nontrad, switching to medicine because of dis-satisfaction with my jobs/career. If I wanted to fight to stay awake at work, I could just continue with my [very lucrative and lifestyle friendly] engineering career.

 

[yahoo123]

Thats what she said.

 

[yobynaes]

Thats what she said.

you sure it's not what he said?

 

[doctorp82]

Neurologists can make bank. My school's PD told us one of his recent neuro grads started at $400k... He said that she practiced saying "I will not work at your hospital (or whatever) for less than $400k" in the mirror before telling her future employer.

Granted, this was in a less-desirable area (although not BFE either).

Surprised me.

Also, I think that fellowship-trained EMG and sleep docs can make some respectable dough...

A neurologist who does movement disorders at our school said he gets offers for positions paying $250 - $400k regularly, and that at some point neuro will probably have some training in doing cathed procedures.

Ride RON to success?

 

[Law2Doc]

A neurologist who does movement disorders at our school said he gets offers for positions paying $250 - $400k regularly, and that at some point neuro will probably have some training in doing cathed procedures.

Ride RON to success?

Then if we add back Derm and Gas I guess you could

Ride RONDA to success.
(too bad there isn't a good H...)

 

[deleted77919]

Then if we add back Derm and Gas I guess you could

Ride RONDA to success.
(too bad there isn't a good H...)

Well, there's Heme-onc. But that job is way too depressing to be on this list.

 

[ColinHay]

what about Gas, Neuro, Op, derm

Ride my DONG, Cool!

 

[cfdavid]

I think this has to end sometime soon (high pay for Anesthesiologists.) Some med schools are matching students to Anesthesiology by the dozens, and it's just not that competitive. My somewhat uninformed opinion (though based upon match lists, etc) is that supply will equal demand sooner rather than later.

I also agree with the posters that said to pick a specialty that you like, rather than solely on lifestyle. I've stared in disbelief at the salaries, match lists, average setp 1 scores for gas residencies, heard the stories (not too different from yours) about the lifestyle and thought, "What the heck," but then I realize that I'm a nontrad, switching to medicine because of dis-satisfaction with my jobs/career. If I wanted to fight to stay awake at work, I could just continue with my [very lucrative and lifestyle friendly] engineering career.

We'll see. Regarding the compensation, a lot of anes people are pretty chill and often downplay the extent of their work. Also, most guys in the private sector are working pretty hard. In fact, there's a whole new crop of dudes/dudettes going into the field that really care about the future of anesthesiology, and are striving to add the most value possible in terms of total perioperative care. So, the field may evolve, but as attendings in the anes forum have stated, there will always be GOOD jobs in anesthesiology for those willing to hone their skills and work hard.

I think the gravy train days are over for most of medicine. We'll all be working harder for less, but it's all relative obviously. Being a fellow non-trad, I agree that it's best to choose a profession for the intrinsic rewards. Lifestyle and compensation SHOULD be factored in, but perhaps not at the #1 priorty.

Regarding anesthesiology, you guys should check out the sticky's over in their forum. They have great activity from attendings, and there are some very insightful posts regarding what they like about the profession. You'll see that the studs are having fun, and that it's a poorly understood field (even amongst most med students). It'll give you a feel for what the good ones think about during those periods of "downtime".

 

[cfdavid]

Well, there's Heme-onc. But that job is way too depressing to be on this list.

I've reflected on this too. But, it depends on how you look at it. These days what are admitedly horrible diagnoses have some pretty impressive (and optimistic) treatment options.

 

[mdterps83]

Not to rain on the good vibes in this thread (which I am sure I'm doing), is anyone else suspicious/tired of all of the word-of-mouth specialty discussion that we hear in medical school? It seems like everyone knows someone whose best-friends-neighbors-baby-daddy is making 400k doing family practice or someones uncle who says certain specialties will soon be forced to panhandle on the street. I'm not saying that you're lying or that your friends are lying or even that their advice is worthless, but c'mon people, lets not judge a whole field based on some hearsay or one person's experience. That said, the OP brings to the table a little bit of proof (or at least an opinion >1) and it resonates a little stronger with me and then what you heard on the floor.

 

[Critical Mass]

Not to rain on the good vibes in this thread (which I am sure I'm doing), is anyone else suspicious/tired of all of the word-of-mouth specialty discussion that we hear in medical school? It seems like everyone knows someone whose best-friends-neighbors-baby-daddy is making 400k doing family practice or someones uncle who says certain specialties will soon be forced to panhandle on the street. I'm not saying that you're lying or that your friends are lying or even that their advice is worthless, but c'mon people, lets not judge a whole field based on some hearsay or one person's experience. That said, the OP brings to the table a little bit of proof (or at least an opinion >1) and it resonates a little stronger with me and then what you heard on the floor.

You should read some of the threads in pre-allo...

 

[RokChalkJayhawk]

Radiologists have kind of screwed themselves by deciding to use the internet to review films. By doing so, they remove the need of having a radiologist in the hospital. Hospitals/insurers figured out pretty quickly if the doc doesn't have to be in the hospital, why do they even have to be in the country? All it takes is one U.S. certified radiologist to supervise the work of physicians from other countries who will often work for far less than 400k a year.

It will be interesting to see how this all plays out.

 

[DarksideAllstar]

Does anyone really initiate emergency radiation treatments for those that are emergent? I did a preceptorship in the MDACC ER and it was all neutropenic fever or the occasional rare blast crisis...or non-oncologic emergencies for which people abused the system knowing that MDACC has less wait time. But that's another story.

Yes. I rotated with a private practice radiation oncologist (city population approaching 2 million) who says that he gets called in for emergent planning about 6 times per year on patients with lesions causing spinal cord compression. They don't get called in as much for patients with SVC syndrome, however. The short answer is that they do get called in, but its rare.

 

[bulletproof]

Radiologists have kind of screwed themselves by deciding to use the internet to review films. By doing so, they remove the need of having a radiologist in the hospital. Hospitals/insurers figured out pretty quickly if the doc doesn't have to be in the hospital, why do they even have to be in the country? All it takes is one U.S. certified radiologist to supervise the work of physicians from other countries who will often work for far less than 400k a year.

It will be interesting to see how this all plays out.

Even so, the demand for U.S. trained radiologists will remain high. As long as medmal lawyers continue to strangulate medicine and propagate the culture of 'defensive medicine' the demand for studies will be high. Also bear in mind, that any study read overseas must be signed off on by a radiologist stateside. This is unlikely to change in the foreseable future as its kind of difficult to go sueing the telerad in Bombay for the missed subdural bleed etc.

Morover, Radiology is one of the more dynamic fields in medicine and is constantly evolving,developing newer modalities . As well as that they are involved in pioneering alot of interventional techniques ( albeit, many of which are subsequently poached by other specialities ie. cards)

Finally, as much as I would love to play into how great Anesthesia is, I really think that the field is currenlty in a terrible position. Just take a look at the anesthesia forum to see the abundance of threads discussing the decline of the field, the encroachment of midlevels, the rise of the DNAP. Yes, right now reimbursement is high, but is the government truly going to allow this to continue, particularly if anesthesia (as the AANA would have it defined) falls under the scope of 'Nursing practice'?

I think both are great fields, but I would be very cautious about entering into an anesthesiology residency at this time, particularly when attendings are telling residents that it is no longer enough to provide anesthesia, but that the role of the anesthesiologist must expand to that of 'peri-operative physician', that their future may be relagated to oversight of 4-7 CRNAs delivering an anesthetic as opposed to doing it themselves. As it stands already, there are 14 states participating in opt-out.

Say what you will about Radiology, but the speciality is doing its level best to prevent encroachment by RA, RPAs, and it is also evolving to the point where having well trained radiologists at ease with multiple modalities will be pivotal. The last two advents to advance anesthesiology were the mass spectrometer, and the pulse ox. Where to from here? Please, tell me I'm wrong.

 

[Bertelman]

Finally, as much as I would love to play into how great Anesthesia is, I really think that the field is currenlty in a terrible position. Just take a look at the anesthesia forum to see the abundance of threads discussing the decline of the field, the encroachment of midlevels, the rise of the DNAP. Yes, right now reimbursement is high, but is the government truly going to allow this to continue, particularly if anesthesia (as the AANA would have it defined) falls under the scope of 'Nursing practice'?

I wouldn't judge the future of the field based on an internet forum. There happen to be a few outspoken voices of late that have riled up the discussion. Nurse anesthetists have been around for some time. This isn't a new situation that we are addressing, and this most certainly isn't the first time a group has declared the death of the specialty. Somehow, it's still around.

 

[Law2Doc]

Radiologists have kind of screwed themselves by deciding to use the internet to review films. By doing so, they remove the need of having a radiologist in the hospital. Hospitals/insurers figured out pretty quickly if the doc doesn't have to be in the hospital, why do they even have to be in the country? All it takes is one U.S. certified radiologist to supervise the work of physicians from other countries who will often work for far less than 400k a year.

It will be interesting to see how this all plays out.

Nighthawk has existed for a while now and the demand for radiologists in the US has gone up, not down since then. The field has gotten more interventional, the technology continues to advance, requiring more and more expertise and specialization, and the legal issues continue to make having unlicensed people in foreign countries reading films infeasible. (Unless you are saying that some US certified idiot is willing to accept all liability for everyone on his staff in a foreign country -- which I don't see anyone rushing to do or any insurance company rushing to cover). So no, this field is probably not in any sort of jeopardy compared to the rest.

 

[bulletproof]

I wouldn't judge the future of the field based on an internet forum. There happen to be a few outspoken voices of late that have riled up the discussion. Nurse anesthetists have been around for some time. This isn't a new situation that we are addressing, and this most certainly isn't the first time a group has declared the death of the specialty. Somehow, it's still around.

I agree. I have been following the anesthesiology forums for greater than 4 years now, and this is not a new discussion. Indeed, the ideas borne out in the discussions on the forum were also being discussed at the two independent sites where I did my anesthesia rotations. It is being discussed over in the pain forums, where CRNAs are being welcomed by attending anesthesiolgist pain mngmt practitioners to attend workshops in Regional anesthesia. There are roadside billboards in some states declaring something to the effect "Ask your Nurse anesthestist about the anesthetic you'll be receiving". Along with the fervent efforts of the AANA to expand "nursing scope of practice" and "independent practice", there is also the governmental pressure to drive down costs, bearing in mind that 60% of U.S hospitalisations are either Medicaid/medicare. Logically, why would they not look for any conceiveable reason to drive down costs...ie at least up the current anesthesiologist: CRNA ratio from 1:4 to the 1:7 I've seen quoted. As it stands all CRNAs need is Physician oversight.....not anesthesiologist oversight.

My point is,it is what anesthesiologists have already conceeded that is alarming, and looking at all the indicators, it is my opinion that they will have to redefine what it is they do, and to make themselves more indispensible ( TEE cert, Pain, ICU ) to hospital admin. to remain vital

I am not advocating a "sky is falling" mentality, but it is prudent to be cognisant of these very real threats. They exist independent of the banter on an internet forum.

 

[getunconcsious]

Yes. I rotated with a private practice radiation oncologist (city population approaching 2 million) who says that he gets called in for emergent planning about 6 times per year on patients with lesions causing spinal cord compression. They don't get called in as much for patients with SVC syndrome, however. The short answer is that they do get called in, but its rare.

Well i suppose that makes sense.


In addition, we are the only ones representin for the silver state, yo!

 

[DarksideAllstar]

In addition, we are the only ones representin for the silver state, yo!

***makes hand gestures claiming Nevada***

I've got six more days and then I'll be reppin' the Golden State. Holla.

 

[Steiner]

How are you awake?

 

[DarksideAllstar]

How are you awake?

I was only out until 2 last night. You ready to PBZ?

 

[Steiner]

I was only out until 2 last night. You ready to PBZ?

I've been warming up for a couple weeks now.

 

[DarksideAllstar]

I've been warming up for a couple weeks now.

Nice. I shot my liver to **** on Monday. We did a couple of brewery tours for a friend of mine's birthday up in Marin County. Started at like 2pm, game over by 9. Best part was that at one of them (Lagunitas) the beer was completely free and they gave you probably at least 3-4 pints total.

 

[Long Dong]

Ride my DONG, Cool!

That's what I try to tell the ladies, but get slapped in face for.

 

[Steiner]

Nice. I shot my liver to **** on Monday. We did a couple of brewery tours for a friend of mine's birthday up in Marin County. Started at like 2pm, game over by 9. Best part was that at one of them (Lagunitas) the beer was completely free and they gave you probably at least 3-4 pints total.

Lagunitas makes good stuff. I have some of their IPA in my fridge right now.

 

[RokChalkJayhawk]

Nighthawk has existed for a while now and the demand for radiologists in the US has gone up, not down since then. The field has gotten more interventional, the technology continues to advance, requiring more and more expertise and specialization, and the legal issues continue to make having unlicensed people in foreign countries reading films infeasible. (Unless you are saying that some US certified idiot is willing to accept all liability for everyone on his staff in a foreign country -- which I don't see anyone rushing to do or any insurance company rushing to cover). So no, this field is probably not in any sort of jeopardy compared to the rest.

I think a diagnostic radiologist is in quite a bit more jeoparday than say a surgeon. It's always good to have your physical presence required.

 

[deleted77919]

I think a diagnostic radiologist is in quite a bit more jeoparday than say a surgeon. It's always good to have your physical presence required.

Can you say Davinci by remote control? Halfway across the state, or country, or planet. It is within the realm of concievability.

 

[Critical Mass]

If anything, I think that radiology is becoming more competative. I thus doubt that anybody is worrying that they are going to be passed over for Internet doctors.

 

[Law2Doc]

Can you say Davinci by remote control? Halfway across the state, or country, or planet. It is within the realm of concievability.

Exactly. There are already surgeons working from other rooms through robots. It's only a matter of time before they are working from other area codes. But again, that liability thing keeps us safe.

 

[RxnMan]

Exactly. There are already surgeons working from other rooms through robots. It's only a matter of time before they are working from other area codes. But again, that liability thing keeps us safe.

I've played around with DaVinci too, and yes, you can tie knots from across the room, the hall, or the country. But at $1 million a pop, are they worth it? You could employ one physician for 3-5 years for one of those machines.

 

[cfdavid]

I've played around with DaVinci too, and yes, you can tie knots from across the room, the hall, or the country. But at $1 million a pop, are they worth it? You could employ one physician for 3-5 years for one of those machines.

Over time, like all new technologies, the price will come down. Also, I guess it depends on what procedural advantages (i.e. precision etc.) could be offered to the patient. And how those advantages might be translated in terms of outcomes.

 

[Law2Doc]

Over time, like all new technologies, the price will come down.

Agreed. The first computers were multi-million dollar monstrosities -- who could have imagined that someday everyone would have one at home at a cost of about a grand. Or DVD players that debuted at about a grand and now you can get one for $60. In ten years we will all be doing our dishes with DaVinci's.