Radiology vs Hospitalist?

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i would personally opt for hospitalist.

i actually enjoy seeing patients (gasp). plus there's more demand and thus more geographical flexibility. the 1 on 1 off or 2 on 2 off is pretty standard these days from what i understand. i could definitely see myself being a hospitalist for a couple years and then getting a fellowship in GI or cards. or just remaining a hospitalist until retirement. also i suck at reading images.
 
Leonidis I said:
i would personally opt for hospitalist.

i actually enjoy seeing patients (gasp). plus there's more demand and thus more geographical flexibility. the 1 on 1 off or 2 on 2 off is pretty standard these days from what i understand. i could definitely see myself being a hospitalist for a couple years and then getting a fellowship in GI or cards. or just remaining a hospitalist until retirement. also i suck at reading images.
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A few things:

Radiologists also see patients when doing procedures. They obviously don't see them in the same capacity or duration as a hospitalist, but do see them nonetheless. Some posters make it seem like all internists do is talk with patients all day. The majority of their day is spent on the phone or writing notes...Not sitting with patients.

A hospitalist gets more scheduled time off. A radiologist has more vacation time.

You suck at reading images? Good. Otherwise, what would be the purpose of doing a four year residency to learn to read images? 😛
 
I think it's possible in either of those fields but more likely as a hospitalist. As Leonidis said, most are working 1 on 1 off or 2 and 2. So there's your >10 weeks right there. Personally, I think it would become mind numbly boring but if you're just looking for a "job" then this would fit the bill.

Another thing to consider is that you could do Locums work in pretty much any specialty and have all the vacation you wanted.

Survivor DO
 
tco said:
A few things:

Radiologists also see patients when doing procedures. They obviously don't see them in the same capacity or duration as a hospitalist, but do see them nonetheless. Some posters make it seem like all internists do is talk with patients all day. The majority of their day is spent on the phone or writing notes...Not sitting with patients.

A hospitalist gets more scheduled time off. A radiologist has more vacation time.

You suck at reading images? Good. Otherwise, what would be the purpose of doing a four year residency to learn to read images? 😛
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Every specialty (except maybe psych) will have more time documenting, calling consults, talking to insurance, etc than actually sitting and talking to the patients.
 
survivordo said:
I think it's possible in either of those fields but more likely as a hospitalist. As Leonidis said, most are working 1 on 1 off or 2 and 2. So there's your >10 weeks right there. Personally, I think it would become mind numbly boring but if you're just looking for a "job" then this would fit the bill.

Another thing to consider is that you could do Locums work in pretty much any specialty and have all the vacation you wanted.

Survivor DO
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Agreed. Easier as hospitalist. You are very interchangeable in that job - which means easy to replace or have more vacation time.

Note on comment above: Hospitalist really DO document much more than almost anyone. They are like professional writers.
 
link2swim06 said:
Every specialty (except maybe psych) will have more time documenting, calling consults, talking to insurance, etc than actually sitting and talking to the patients.
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That's exactly my point. Thanks.

I will never have to call a consult or talk to insurance companies. I will, however, have to discuss treatment options and plans with physicians that have ordered procedures of which they know very little about, which can be just as frustrating.
 
Kal EI said:
Agreed. Easier as hospitalist. You are very interchangeable in that job - which means easy to replace or have more vacation time.

Note on comment above: Hospitalist really DO document much more than almost anyone. They are like professional writers.
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I wonder if documentation is a plus or a minus? I've read some hospitalist notes, and they are certainly more voluminous than other specialties. But I would not call it high quality writing. If you get paid $150/hr to write something noncreative and dull, I don't think it's a bad way to spend your day. I am more turned off by those calls/consults and family/social issues when the patient cannot be really helped. I've seen some of that and I don't know if I'd ever get competent at that.
I heard that radiologists can do knee and spine injections, even get into pain. That and everything else seems to me like much more direct patient care. You have to do 6yrs instead of 3, but it seems once you get a job you get all the stability that you want? Just because IM is 3yrs of residency and week on/off right now, what makes you think that they will still be in demand 5-10yrs from now? There are more IM residencies opening up, they are not retiring, and nurses get to contribute more to IM work, hence the supply of hospitalists might exceed the demand. I'd like to have a lot of vacation but also stay employed. It would be nice if I could have it all after 3yrs of residency.
 
tco said:
A few things:

Radiologists also see patients when doing procedures. They obviously don't see them in the same capacity or duration as a hospitalist, but do see them nonetheless. Some posters make it seem like all internists do is talk with patients all day. The majority of their day is spent on the phone or writing notes...Not sitting with patients.

A hospitalist gets more scheduled time off. A radiologist has more vacation time.

You suck at reading images? Good. Otherwise, what would be the purpose of doing a four year residency to learn to read images? 😛
Click to expand...

Uh unless you're a diagnostic radiologist who sits in your dark reading room all day with 4 screens...which is most of them. This isn't a negative if you like it but the fact is that many (if not most) radiologists have essentially no patient contact.
 
Kal EI said:
Agreed. Easier as hospitalist. You are very interchangeable in that job - which means easy to replace or have more vacation time.

Note on comment above: Hospitalist really DO document much more than almost anyone. They are like professional writers.
Click to expand...

I am concerned about that "interchangeable". Demand is good now, but what if there is oversaturation in the next few years? Then I'll have trouble finding a job unless I am one of those people with "outstanding personality".
 
calvnandhobbs68 said:
Uh unless you're a diagnostic radiologist who sits in your dark reading room all day with 4 screens...which is most of them. This isn't a negative if you like it but the fact is that many (if not most) radiologists have essentially no patient contact.
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I understand this. Some might even sit in their vacation house and do their reads over the internet. I think it's awesome if your skills are so unique that you don't need any patient contact or social skills. But still, they have opportunities to be even more "valuable" in the hospital by doing those MSK procedures or other procedures. I am concerned that if my employment rests on being able to talk to families and to ask other doctors for consults, then I might eventually end up with no job at all.
 
yesno said:
I wonder if documentation is a plus or a minus? I've read some hospitalist notes, and they are certainly more voluminous than other specialties. But I would not call it high quality writing. If you get paid $150/hr to write something noncreative and dull, I don't think it's a bad way to spend your day. I am more turned off by those calls/consults and family/social issues when the patient cannot be really helped. I've seen some of that and I don't know if I'd ever get competent at that.
I heard that radiologists can do knee and spine injections, even get into pain. That and everything else seems to me like much more direct patient care. You have to do 6yrs instead of 3, but it seems once you get a job you get all the stability that you want? Just because IM is 3yrs of residency and week on/off right now, what makes you think that they will still be in demand 5-10yrs from now? There are more IM residencies opening up, they are not retiring, and nurses get to contribute more to IM work, hence the supply of hospitalists might exceed the demand. I'd like to have a lot of vacation but also stay employed. It would be nice if I could have it all after 3yrs of residency.
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Because we're just hitting the tip of the iceberg in terms of baby boomers getting old enough to get sick enough to be inpatient...which means more patients and more hospitalists.

What do you mean by nurses get to contribute to IM work? Nurses essentially can't do anything on a gen med floor without orders. Ever notice how the residents are constantly getting paged about how orders have to be put in for this or that? Ever seen a nurse write a progress note? Me neither. Like 90% of inpatient IM is ordering and documentation.
 
Yesno, if you're wondering if hospitalists will become an over-saturated field - Most likely not b/c too many people still want to do IM subspecialties.
 
calvnandhobbs68 said:
Uh unless you're a diagnostic radiologist who sits in your dark reading room all day with 4 screens...which is most of them. This isn't a negative if you like it but the fact is that many (if not most) radiologists have essentially no patient contact.
Click to expand...

Last week I was with a radiologist who was doing just that. I lost my marbles after 1 hour in that bat cave. Talking into a dictaphone and listening to his own voice over the speakers.

I know another who works in his basement. Pulls down $500k/yr, hates it, but gets ~12 weeks vacation.
 
CDI said:
Last week I was with a radiologist who was doing just that. I lost my marbles after 1 hour in that bat cave. Talking into a dictaphone and listening to his own voice over the speakers.

I know another who works in his basement. Pulls down $500k/yr, hates it, but gets ~12 weeks vacation.
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That's not even worth it then.

If you could make 300K doing something you like wouldn't that make a ton more sense?
 
A radiologist once said me, i find my job to be nice, cause although i make very difficult and often bad outcome diagnosis, i am not the one to tell the patients the news.

Though i have to say that intervention Rads is very cool and rewarding.
 
CDI said:
Last week I was with a radiologist who was doing just that. I lost my marbles after 1 hour in that bat cave. Talking into a dictaphone and listening to his own voice over the speakers.

I know another who works in his basement. Pulls down $500k/yr, hates it, but gets ~12 weeks vacation.
Click to expand...

Those rooms are so dark and their chairs are always so nice...I'd probably just fall asleep after an hour.
 
You could try Locums with most specialties going to the boondocks for half the year and chilling the rest. EM could possible be scheduled with microblocks of days off for mini get-a-ways.
 
DrBowtie said:
You would think that from observing as a medical student, but when actually working your mind goes a million miles an hour. Medicine after rounds, you're just on autopilot.
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I'm no longer a med student, and have worked in a hospital abroad, and I agree when working the ICU or ER. Its more of the setting that's too comfortable and sleep inducing.
 
CDI said:
I'm no longer a med student, and have worked in a hospital abroad, and I agree when working the ICU or ER. Its more of the setting that's too comfortable and sleep inducing.
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I guess what I'm saying is to the observer, radiology is a sleep inducing environment because you're not the one actively interpreting. While actually doing radiology, its hard to be sleepy scrolling and cranking through cases. Too much of a mental workout to get sleepy.
 
DrBowtie said:
I guess what I'm saying is to the observer, radiology is a sleep inducing environment because you're not the one actively interpreting. While actually doing radiology, its hard to be sleepy scrolling and cranking through cases. Too much of a mental workout to get sleepy.
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I could definitely see that.
 
yesno said:
I wonder if documentation is a plus or a minus? I've read some hospitalist notes, and they are certainly more voluminous than other specialties. But I would not call it high quality writing. If you get paid $150/hr to write something noncreative and dull, I don't think it's a bad way to spend your day. I am more turned off by those calls/consults and family/social issues when the patient cannot be really helped. I've seen some of that and I don't know if I'd ever get competent at that.
I heard that radiologists can do knee and spine injections, even get into pain. That and everything else seems to me like much more direct patient care. You have to do 6yrs instead of 3, but it seems once you get a job you get all the stability that you want? Just because IM is 3yrs of residency and week on/off right now, what makes you think that they will still be in demand 5-10yrs from now? There are more IM residencies opening up, they are not retiring, and nurses get to contribute more to IM work, hence the supply of hospitalists might exceed the demand. I'd like to have a lot of vacation but also stay employed. It would be nice if I could have it all after 3yrs of residency.
Click to expand...

I agree with this point, but I think that radiology is a bit more of a risky path as far as job security. Honestly, with some hospitals "outsourcing" their images to private radiology groups, and the advancement of computer programs, at least diagnostic radiology is a dying field in my opinion. I think it is a valuable position and I haven't ever met a radiologist I didn't like, but we are only a few years away from an iPhone app that can dx an image.
 
DrNightMoves said:
I agree with this point, but I think that radiology is a bit more of a risky path as far as job security. Honestly, with some hospitals "outsourcing" their images to private radiology groups, and the advancement of computer programs, at least diagnostic radiology is a dying field in my opinion. I think it is a valuable position and I haven't ever met a radiologist I didn't like, but we are only a few years away from an iPhone app that can dx an image.
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Lol. Just curious how far along in your training are you?
 
Beware of the difference between vacation and time off. Hospitalists and dedicated overnight radiologists get a lot of the latter, but that's not the same as the former. Really getting away from it all can be difficult to do with the 1 on/1 off formula, particularly if that week on is overnight and you need a day or two to recover. In radiology, most people who work that schedule don't last more than 2 years.
 
DrNightMoves said:
I agree with this point, but I think that radiology is a bit more of a risky path as far as job security. Honestly, with some hospitals "outsourcing" their images to private radiology groups, and the advancement of computer programs, at least diagnostic radiology is a dying field in my opinion. I think it is a valuable position and I haven't ever met a radiologist I didn't like, but we are only a few years away from an iPhone app that can dx an image.
Click to expand...

Yeah, that would never happen.
 
Thank you! I still cannot decide. Now I need to ask for an elective for next month. 3rd year obviously. And I don't know if it should be ER, Anesthesia, or Radiology? I do have some interest in ER and Anesthesia but don't think i'm fit to do those specialties, especially not ER. I am afraid if I do radiology early in 3rd year, I will not learn much medicine, that is how to interact with doctors and patients, might be a waste of my month... On the other hand if I fall in love with radiology, it's better to figure out my specialty early than to wait until 4th year. I feel anesthesia or ER would be a great rotation to do even if I am not interested in those specialties, because intubations or sutures or chest pain workups are so essential for a medical student. Some doctors never learn to do intubations or sutures🙁
 
yesno said:
btw very interesting. how much do professors of radiology make at most unis? how about professors of IM? anesthesia? Like if you are 50% research and 50% clinical?
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With the dismal job prospects and the singularity looming on the horizon, professors of radiology at large academic institutions are lucky to bring in $115k. Maybe a little more with research.
 
IJL said:
Gas and rads >>>> EM

JMO.
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Why so? In terms of training that's 5(fellowship almost mandatory) vs 6(also compulsory) vs 3yrs. And EM get paid at least as much per hour as those other 2 specialties. And it seems they intubate and sedate without much help from anesthesia.. And they do ultrasound, and they even do cool workups for eye and ortho problems that hospitalists don't get. My only problem is that I am not good at all this "dealing with multiple patients quickly". But if I forgot about EM, I wonder if anesthesia or radiology would be more useful for my elective right now? Either one, I could do at a chill smaller hospital, and I would take a university based elective later on in the year(but by then I'd be pushing 4th year). I know both courses have a lot of use in my curriculum, but I would definitely postpone them until next year if I knew that I wanted to do something else.
 
A lot of groups already interpret their own images and only use consults when needed. If reading images gets easier to do, as technology advances, it makes sense to wonder if fewer rad consults will be needed.
Outsourcing is probably not a real problem, but it is something to think about

Im just playing devils advocate here against the point above about hospitalist job security.



IJL said:
Did you even read any of those articles?
Click to expand...

No what are they about?
 
DrNightMoves said:
A lot of groups already interpret their own images and only use consults when needed.
Click to expand...

What groups are you referring to? Family medicine docs reading chest xr and fractures?
 
yehhhboiii said:
there's already a few apps that can read ecgs
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Even the best computer-aided diagnoses are reviewed by a physician. The liability is too great to ever rely entirely on a piece of software.
 
circulus vitios said:
Even the best computer-aided diagnoses are reviewed by a physician. The liability is too great to ever rely entirely on a piece of software.
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Yeah, we were looking at mammograms the other day and the computer-aided stuff just sucks. Can't take into account things like position, etc. The radiologist just ignored the suggestions for the most part.
 
DrNightMoves said:
A lot of groups already interpret their own images and only use consults when needed. If reading images gets easier to do, as technology advances, it makes sense to wonder if fewer rad consults will be needed.
Outsourcing is probably not a real problem, but it is something to think about

Im just playing devils advocate here against the point above about hospitalist job security.





No what are they about?
Click to expand...

What a joke. Clinicians love to say they can read images, but always check the final read before making a treatment decision. There's a reason for that...
 
yesno said:
I wonder if documentation is a plus or a minus? I've read some hospitalist notes, and they are certainly more voluminous than other specialties. But I would not call it high quality writing. If you get paid $150/hr to write something noncreative and dull, I don't think it's a bad way to spend your day. I am more turned off by those calls/consults and family/social issues when the patient cannot be really helped. I've seen some of that and I don't know if I'd ever get competent at that.
I heard that radiologists can do knee and spine injections, even get into pain. That and everything else seems to me like much more direct patient care. You have to do 6yrs instead of 3, but it seems once you get a job you get all the stability that you want? Just because IM is 3yrs of residency and week on/off right now, what makes you think that they will still be in demand 5-10yrs from now? There are more IM residencies opening up, they are not retiring, and nurses get to contribute more to IM work, hence the supply of hospitalists might exceed the demand. I'd like to have a lot of vacation but also stay employed. It would be nice if I could have it all after 3yrs of residency.
Click to expand...

They write those notes more because of billing purposes. You get paid extra for the complexity when adding extra diagnoses and what not.

I really do hate these kind of questions. If you want a job with that kind of vacation time, they are both realistic but don't expect to make the cash and it may be difficult to find people who want you around. 8 weeks a year was offered by a radiology group I know.

Just go into what you enjoy more. I'm in my prelim medicine year now before going into radiology and every day is a reminder why I would rather not be a hospitalist. I enjoy patient interaction when it is a nice patient, but when you throw in the ones that aren't nice, the families, the isolation precautions, rounding on 20+ patients at times and having to travel all over the hospital, it just isn't worth it to me. Everybody is different, but I couldn't personally take it. I like knowing where I'm going to be and having the problems in front of me. Solve a problem and move on. Slightly less hospital bureaucracy as well.
 
DrNightMoves said:
Old article, but it references a study which concluded that between 62-88% of radiologic readings in a nonhospital setting were performed by non-radiologist physicians. That study was from 1993 though.

http://www.ajronline.org/doi/full/10.2214/ajr.179.4.1790843
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I realize that you know the article is old, but I feel like it needs to be explicitly stated that very few things that were true about radiology in 1993 are still true. This is no exception.

For perspective, in 1993, there was probably one CT scanner in the hospital. Most of them would have been gen2 units, while maybe a few of the big universities had a gen3 scanner. It likely spent most of its time doing head CTs, which took an hour at a time. The scanner didn't operate past 5pm, which meant that if the patient wasn't on the table by 4pm, they waited until the morning.

Nowadays, patients get brain MRs out of the ED when they're head CT, head CTA, and neck CTA are all negative. Suffice it to say that quite a bit has changed regarding the availability, frequency, and complexity of medical imaging. If some family docs want to shoot, interpret, bill for, and assume liability for a CXR, then rock on, but that has no relevance to the utility of radiologists - not in 1993 and certainly not twenty years later.
 
tco said:
What a joke. Clinicians love to say they can read images, but always check the final read before making a treatment decision. There's a reason for that...
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The truth of the matter is that someone who dabbles in something is never going to be as good as the someone who devotes all of his time to something. A surgeon might spend 5% of his time looking at images, and while he might log enough time to get reasonably competent at looking at his specific focus of anatomy after a number of YEARS, he's never going to catch up to the number of hours logged by the guy who did four years of residency plus a fellowship spending 10 hours a day doing nothing but looking at images. its really no different than the guy who dabbles at procedures so he thinks he can do surgery. You need to log a certain critical volume to have expertise in pretty much any skillset, and I don't think this is any different. Attendings like to wow med students with their ability to read the patients' imaging on rounds, but most of the time their ability to know what they are looking at is only marginally better than the students they are teaching. It's not a whole lot different than people who have a little exposure to the legal system and think they know as much as their lawyer. They usually don't have a clue what they don't know. But I suspect if programs feel a need to have four years of residency after intern year, plus a fellowship, to do the job, it's not something you can pick up in an hour or two each week. And probably malpractice to try.
 
IJL said:
With the dismal job prospects and the singularity looming on the horizon, professors of radiology at large academic institutions are lucky to bring in $115k. Maybe a little more with research.
Click to expand...

Lol. UTSW publicly lists salaries. Many rads teeter on the edge of 400k.

If you like patients, go into IR.

Don't like the lifestyle of IR, but like patients? Do mammo, where you work 9-5 5 days a week with no call, and spend all day interacting with women and working up potential cancers while consulting them.

Only like a little bit of patient contact? Do body or msk, where you'll have a smattering of biopsies, arthrograms, etc intermixed between reading cases.

Don't like patients at all? Go into nighthawk or do an emergency radiology gig.

The options are basically endless. Radiology is a remarkably flexible field.

Oh and you want 10 weeks of vacation a year? Try nighthawk, and get 26-36 weeks of vacation a year. I know hospitalists have 1 on 1 off opportunities too, but they can't do it in their basement with the football game on in the background.
 
Last edited by a moderator:
cowme said:
Lol. UTSW publicly lists salaries. Many rads teeter on the edge of 400k.

If you like patients, go into IR.

Don't like the lifestyle of IR, but like patients? Do mammo, where you work 9-5 5 days a week with no call, and spend all day interacting with women and working up potential cancers while consulting them.

Only like a little bit of patient contact? Do body or msk, where you'll have a smattering of biopsies, arthrograms, etc intermixed between reading cases.

Don't like patients at all? Go into nighthawk or do an emergency radiology gig.

The options are basically endless. Radiology is a remarkably flexible field.

Oh and you want 10 weeks of vacation a year? Try nighthawk, and get 26-36 weeks of vacation a year. I know hospitalists have 1 on 1 off opportunities too, but they can't do it in their basement with the football game on in the background.
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I read numerous threads about how teleradiology is dying. If I could have that job, I would definitely work and live on a resort. I would think any negatives are nothing compared to living 52wks/yr somewhere that people only dream of going on vacation 4wks/yr.
Also I do not have any idea what mammo and msk people do. I read about msk doing joint injections and that's interesting. But I have no idea what they do really. The only exposure to radiology that I've had so far is some IR and body/ed radiology.
 
yesno said:
I read numerous threads about how teleradiology is dying. If I could have that job, I would definitely work and live on a resort. I would think any negatives are nothing compared to living 52wks/yr somewhere that people only dream of going on vacation 4wks/yr.
Also I do not have any idea what mammo and msk people do. I read about msk doing joint injections and that's interesting. But I have no idea what they do really. The only exposure to radiology that I've had so far is some IR and body/ed radiology.
Click to expand...

Do a radiology elective in 4th year, ask for one week of mammo + MSK each.
 
Law2Doc said:
The truth of the matter is that someone who dabbles in something is never going to be as good as the someone who devotes all of his time to something. A surgeon might spend 5% of his time looking at images, and while he might log enough time to get reasonably competent at looking at his specific focus of anatomy after a number of YEARS, he's never going to catch up to the number of hours logged by the guy who did four years of residency plus a fellowship spending 10 hours a day doing nothing but looking at images. its really no different than the guy who dabbles at procedures so he thinks he can do surgery. You need to log a certain critical volume to have expertise in pretty much any skillset, and I don't think this is any different. Attendings like to wow med students with their ability to read the patients' imaging on rounds, but most of the time their ability to know what they are looking at is only marginally better than the students they are teaching. It's not a whole lot different than people who have a little exposure to the legal system and think they know as much as their lawyer. They usually don't have a clue what they don't know. But I suspect if programs feel a need to have four years of residency after intern year, plus a fellowship, to do the job, it's not something you can pick up in an hour or two each week. And probably malpractice to try.
Click to expand...

Thank you for this nugget of common wisdom so easily forgotten. 😀
After having experienced both radiology and pathology...it is quite amazing just how vast the knowledge in each field is. The path residents once told me that they like how their field has a paucity of "amateur pathologists" - rarely ever does a surgeon or internist come down to the path lab to read and interpret slides
 
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