Mammography lifestyle

[odyssey2]

Could anyone comment on the hours and call burden of a typical mammographer? How busy are the days? Is it the best lifestyle in radiology?

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[Neopolymath]

If you want to be a partner then you will still be in the call pool from what I have seen. Being a partner could have perks based on income, access to different retirement vehicles, and vacation.... Or it could not matter at all. I assume it varies on the type of group you join.

If you want to just do M-F 8-4 mammo then you probably are working as an employee of a bigger group.

 

[Cognovi]

Yea if you want to be a partner, you take as much general call as the rest of the rads. If you're okay to be employed, either in private or academic practice, then it's possible to do no call and otherwise the equivalent of 4 days a week 8-5 or 5 days a week 8-4.

 

[odyssey2]

Do you get as much vacation as other rads?

 

[.Asterion]

Do you get as much vacation as other rads?

No.

 

[vm26]

Could anyone comment on the hours and call burden of a typical mammographer? How busy are the days? Is it the best lifestyle in radiology?

Breast imaging is a hot field right now. By the time you graduate it may be a dead end field where mid-levels take care of screeners (with the help of AI), and also handle the procedures.

 

[Cognovi]

Breast imaging is a hot field right now. By the time you graduate it may be a dead end field where mid-levels take care of screeners (with the help of AI), and also handle the procedures.

The precedence of MQSA would empower the breast imager guild, with the help of powerful breast cancer patient groups, to lobby for legislative protection against midlevel incursion.

 

[Dave1980]

Could anyone comment on the hours and call burden of a typical mammographer? How busy are the days? Is it the best lifestyle in radiology?

mammo is hot for a reason. bc most people hate doing it.

the answer to your quesito will vary widely based on the practice and is basically meaningless bc it is so broad

 

[odyssey2]

mammo is hot for a reason. bc most people hate doing it.

the answer to your quesito will vary widely based on the practice and is basically meaningless bc it is so broad

Basically what I’m asking is, are there any jobs in radiology in general that are 40-45 hrs/week in desirable areas that pay 400+?

 

[Dave1980]

Basically what I’m asking is, are there any jobs in radiology in general that are 40-45 hrs/week in desirable areas that pay 400+?

depends on what you think is desirable but I think that is likely attainable. not sure if it will be in about 10 years from now when you look for a mammo job,

a traditional PP job will be unlikely to make you a full partner if you don't take night or weekend call. you would either be an employee for a PP (which kind of sucks) or an employee for an acacdemic center, cancer center, or large hospital system.

 

[Rad2013]

There are some mammo-only partnership positions with no general work and no general call.

 

[colbgw02]

I know of a breast imager early in her career that took a job getting roughly $25/screener. I would assume the rate goes up for diagnostics +/- ultrasound as well as MRI. Not sure if they did biopsies there. This was an outpatient women's imaging center, so no nights, no weekends, no holidays.

To keep it simple, 80 screeners a day, M-F, for 40 weeks a year would get you to $400K with plenty of time off. I think that's imminently doable. Of course, this imaging center just got bought by a local PP group, so womp womp.

 

[vm26]

The precedence of MQSA would empower the breast imager guild, with the help of powerful breast cancer patient groups, to lobby for legislative protection against midlevel incursion.

Wish I had your optimism. Despite the lobby/public opinion, there's constant push from organizations (backed by the Govt I suspect) to increase the screening age and change screeners to biennial.

Mid-levels have essentially replaced a chunk of ED physicians (by 2030 there will be about 10K extraneously ED physicians in part due to mid-level use/replacement). Replacing a general rad with a mid-level is pretty much impossible. Mammo/breast imaging, particularly screeners is conducive to mid-level replacement, particularly with AI (recently completed a CME which discussed the progress of AI with screeners).

Breast cancer pt groups are no match when it comes down to lobbying compared with Private Equity, large HC systems, and big tech (AI). No one knows who's reading their screeners and NPs can essentially introduce themselves as doctors when doing a procedure. Many patients don't even know what type of clinician they are seeing. They also probably don't even know that rads are physicians.

Finally, as long as we are in a fee-for-service HC system, there will be continued downward pressure on reimbursements particularly in radiology given increased utilization. CAD used to be a significant additional fee, now it's bundled (free). Nothing magical in breast imaging that protects them from larger economic forces.

 

[vm26]

I know of a breast imager early in her career that took a job getting roughly $25/screener. I would assume the rate goes up for diagnostics +/- ultrasound as well as MRI. Not sure if they did biopsies there. This was an outpatient women's imaging center, so no nights, no weekends, no holidays.

To keep it simple, 80 screeners a day, M-F, for 40 weeks a year would get you to $400K with plenty of time off. I think that's imminently doable. Of course, this imaging center just got bought by a local PP group, so womp womp.

I may be wrong but that does not seem like a good deal. Tomo screener is around 1.38 RVUs. Solid payor mix RVU reimbursement is around $50-60/RVU. CMS is around $35/RVU. Seems like she's working for a significant discount. Who's getting the rest of her professional fee? Private equity? This would be on top of the larger tech fee that the employer (owner of equipment) receives.

 

[maxxor]

I may be wrong but that does not seem like a good deal. Tomo screener is around 1.38 RVUs. Solid payor mix RVU reimbursement is around $50-60/RVU. CMS is around $35/RVU. Seems like she's working for a significant discount. Who's getting the rest of her professional fee? Private equity? This would be on top of the larger tech fee that the employer (owner of equipment) receives.

I wonder if this was before tomo boosted the wrvu for screeners.

 

[colbgw02]

I may be wrong but that does not seem like a good deal. Tomo screener is around 1.38 RVUs. Solid payor mix RVU reimbursement is around $50-60/RVU. CMS is around $35/RVU. Seems like she's working for a significant discount. Who's getting the rest of her professional fee? Private equity? This would be on top of the larger tech fee that the employer (owner of equipment) receives.

We're very quickly approaching the limit of my knowledge about this particular situation, but I do know that the imaging center was owned by a radiologist and now is owned by a radiologists-owned private practice. That is a lot of cheese to give up, but people seemed to think it was worth it to avoid all the hassles (and benefits) of entrepreneurship.

 

[vm26]

I wonder if this was before tomo boosted the wrvu for screeners.

Good point but tomo's been around for a while (last 7-10 yrs?).. Even a screener w/o tomo is ballpark around 1.0 RVU

 

[vm26]

We're very quickly approaching the limit of my knowledge about this particular situation, but I do know that the imaging center was owned by a radiologist and now is owned by a radiologists-owned private practice. That is a lot of cheese to give up, but people seemed to think it was worth it to avoid all the hassles (and benefits) of entrepreneurship.

No worries. Though I've been out of training for nearly a decade, I've actually pretty naive about the details of reimbursement. With that said there are only a few models of employment around. True private practice where you typically work at a reduced but still reasonably rate (like similar to that of an employee rate) for a period of 1-3 yrs. When you make partner you are basically a part-owner of a small business and get an even cut of profits, equal say in how things are run etc. Income goes up substantially. (some places it doubles if not more). I guess this is what you mean when you say entrepreneurship but its not like you are purchasing millions of dollars in equipment, office space, staff etc and setting up shop solo. Aside from predatory private groups, this is the traditional and most legit way.

Then you have pure employment models (academics, VA, HC systems). Basically you are a clock puncher for the most part. This has its pro's and con's. Finally you have a warped private practice model where you are actually an employee making money for your employer. They do this by skimming off your professional fees. Typically these types of practices are located in "highly desirable" coastal cities so filling these positions is usually not difficult. Private equity (eg. Rad Partners) would fall into this category. Essentially they offer true partners of a private practice 8-12x their annual income to sell their practice. This comes in a combo of cash and stocks. Then they advertise as a physician owned private practice with partnership which is a farce. One is an employee of a corporation and has zero say in how things are run. Plus one works at a discounted rated (eg. would have to read at 95th% to make around 50-55th% income). So key question to ask when interviewing anywhere: what is the income to RVU ratio?

 

[maxxor]

Good point but tomo's been around for a while (last 7-10 yrs?).. Even a screener w/o tomo is ballpark around 1.0 RVU

The complete mod-26 RVU for digital screening mammogram (77067) is 1.08 for 2021; however the wRVU is 0.76.

I specifically have never understood how people ever agreed to the administrators’ argument that wRVU is the amount you are entitled to, despite the entire -26 component being intended to reflect the professional fee.

If our imaginary mammographer was getting $25 a screener, she was getting Medicare rates for the wRVU, and ripped off relative to commercial rates.

 

[2brads]

Mammo is the biggest moneymaker there is. Avg pro fees for 2020 are $70-80 per bilateral mammo with tomo. Bilateral screener with tomo is worth almost 2 RVU, which is basically the same as a CT abdomen/pelvis with contrast (and worth more than a chest CT).

See: https://www.hologic.com/sites/default/files/content/Coding Guides/MISC-03286 Rev 010 Breast Imaging 2020 Rates_6797r5p.pdf

 

[2brads]

So if you make the avg of $70/screener and get 12 weeks off, you can generate $400k by reading 29 screeners per day. (I’m bad at math, but I think I did that correctly.)

 

[maxxor]

Mammo is the biggest moneymaker there is. Avg pro fees for 2020 are $70-80 per bilateral mammo with tomo. Bilateral screener with tomo is worth almost 2 RVU, which is basically the same as a CT abdomen/pelvis with contrast (and worth more than a chest CT).

See: https://www.hologic.com/sites/default/files/content/Coding Guides/MISC-03286 Rev 010 Breast Imaging 2020 Rates_6797r5p.pdf

Not to say mammo doesn’t generate disproportionate rvu relative to complexity of scan. However, It is rare for you to get the full rvu. More likely getting wrvu.

 

[vm26]

The complete mod-26 RVU for digital screening mammogram (77067) is 1.08 for 2021; however the wRVU is 0.76.

I specifically have never understood how people ever agreed to the administrators’ argument that wRVU is the amount you are entitled to, despite the entire -26 component being intended to reflect the professional fee.

If our imaginary mammographer was getting $25 a screener, she was getting Medicare rates for the wRVU, and ripped off relative to commercial rates.

Part of the problem is that many if not most physicians are relatively uneducated when it comes down to the economics of running a practice/getting compensated etc. They don't teach this isn med school or residency. Its really up to each rad/physician to get a concept of how much revenue their work is generating and how their compensation stacks up against this. It's mind boggling that P/E can pay what they do (40-50% discount on pro fees) successfully recruit and stay afloat.

 

[CorneliaSt]

mammo lifestyle is best in radiology. and one of the best lifestyles in medicine. if you enjoy it, it's amazing!

 

[Tiger100]

In most private practices, all partners irrelevant of their subspecialty participate in ER call.

 

[2brads]

But the amount of whining about call will vary by subspecialty.