Rads on the path to path?

[Artefact]

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Hey - I'm beginning Med 3 and am interested in radiology and pathology. I'm doing elective rotations in both, but so far I've only had experience with pathology.

Radiology had always seemed to be a better choice from a purely practical perspective - based on a good job market, good salary, and a seemingly greater potential for growth - but I recently read a survey recently that suggests that the radiology job market right now is just as bad as the pathology job market, and that radiology salaries are/will be dropping very soon (but salary is less important to me than job market, really)

Assuming that I like Rads and Path equally, are there practical reasons that I should consider one over the other? Are there reasons that I should think that one or another will pull out of it's current job difficulties sooner?

 

[Substance]

Hey - I'm beginning Med 3 and am interested in radiology and pathology. I'm doing elective rotations in both, but so far I've only had experience with pathology.

Radiology had always seemed to be a better choice from a purely practical perspective - based on a good job market, good salary, and a seemingly greater potential for growth - but I recently read a survey recently that suggests that the radiology job market right now is just as bad as the pathology job market, and that radiology salaries are/will be dropping very soon (but salary is less important to me than job market, really)

Assuming that I like Rads and Path equally, are there practical reasons that I should consider one over the other? Are there reasons that I should think that one or another will pull out of it's current job difficulties sooner?

In Canada if you want a good lifestyle, do path. If you want good income, but a slightly worse lifestyle, do rads.

I'd do rads over path any day of the week. Rads is on the forefront of technology, while path is stuck in the past.

Imaging is in more demand than biopsy reading. It's easier to get scanned than to do a resection, thus the volumes are higher.

Path is just a losing proposition I would say. In the US, there are too many of them, the pay is pretty bad, and the professional stature is low. What other field allows itself to be employed, at a discount, by other physician colleagues?

Go rads.

 

[Artefact]

In Canada if you want a good lifestyle, do path. If you want good income, but a slightly worse lifestyle, do rads.

I'd do rads over path any day of the week. Rads is on the forefront of technology, while path is stuck in the past.

Imaging is in more demand than biopsy reading. It's easier to get scanned than to do a resection, thus the volumes are higher.

Path is just a losing proposition I would say. In the US, there are too many of them, the pay is pretty bad, and the professional stature is low. What other field allows itself to be employed, at a discount, by other physician colleagues?

Go rads.

Do no clinicians own their own imaging equipment and collect TC on images and pay a radiologist the PC to read them out? That seems to be what's happening at urology/GI practices with pathology and radiation oncology, at least.

 

[shark2000]

In the last 6 years, there has been 18 cuts to imaging. Nothing else in the history of medicine faced such cuts.
Despite all these, still we make more than most doctors. Don't forget that some high paid fields like ophtho or OB went really really down financial wise after cuts that were not even comparable to half of what we had.

Overall, we survived these 18 cuts. Very few fields could handle all these cuts. Despite all what people say, still most graduates find good jobs.

The field is really dynamic. Much much more than any other field. For example US. OB took away some part of it, Vascular surgery took some part of it, but still US is one of the busiest departments in the hospital. Look at IR. Most of arterial work was taken away, but the filed is still one of the highest in demand. CT surgey for example could not tolerate it, but we could.

Breast cancer screening is one of the smallest things that a radiologist does. But don't forget that GI docs practically made one of highest paid fields just out of colon cancer screening. Or non-invasive cardiologists made one of high paid fields just by adding a small proportion of imaging to their practice.

The dynamic part of our field is the result of many factors. Probably a combination of technology, innovation and most importantly not dealing with single modality and single disease entity. Yes, we are pleurotential doctors.

 

[radman123]

Do no clinicians own their own imaging equipment and collect TC on images and pay a radiologist the PC to read them out? That seems to be what's happening at urology/GI practices with pathology and radiation oncology, at least.

No one knows what the market will be like in many years when current med students are done with training. My experience is that popular locations are ALWAYS tough not only to find jobs but to get a fair deal in a stable group.

It is certain that radiology reimbursement will stay the same (best case) to worst. You may never come close to published averages for the specialty which includes partners and other experienced radiologists. Unless you have resources, you will have high debt that will limit you in many ways when you are done.

It is certain that lifestyle will stay the same to worst. Do not let anyone fool you into thinking this is a lifestyle field unless working busy weekends, holiday, evenings, and nights in some places is lifestyle. There is no lunch break. The pace during the day is non stop. It is mentally exhausting to read images all day.

Radiology has become a commodity. Lowest bidder wins. No loyalty. No more gold watches. Just consolidations and private groups going away.

We toil in anonymity to the patient and have the toughest customers in the hospital- other physicians.

Our training is one of the longest 6-7 years with current associate pay not to far off from those who had half the residency training.

 

[shark2000]

Do no clinicians own their own imaging equipment and collect TC on images and pay a radiologist the PC to read them out? That seems to be what's happening at urology/GI practices with pathology and radiation oncology, at least.

Yes and no.

Probably 60 percent of imaging come from PCPs. That is the winning card that pathology does not have.
Another 20 percent come from doctors who do not have the volume they need. For example, oncologist ordering brain MRI or even urologists ordering CT abdomen.

But 20 percent of imaging come from clinicians owning equipment. The most notorious ones are orthopods owning MRI. Some oncologists own PET.

Overall, after recent cuts, clinicians are not a threat at all. The threat is from hospitals. Similar to what happened to cardiology. These days equipment is nit profitable unless you do high high volume. Not a bad trend for radiology, since you can not buy an MRI as a physical medicine doctor to do 4 MRs a day and still make money. You need to do a lot of MR from head to toe to liver to brain to make a profit.

 

[Enkidu]

Yes and no.

Probably 60 percent of imaging come from PCPs. That is the winning card that pathology does not have.
Another 20 percent come from doctors who do not have the volume they need. For example, oncologist ordering brain MRI or even urologists ordering CT abdomen.

But 20 percent of imaging come from clinicians owning equipment. The most notorious ones are orthopods owning MRI. Some oncologists own PET.

Overall, after recent cuts, clinicians are not a threat at all. The threat is from hospitals. Similar to what happened to cardiology. These days equipment is nit profitable unless you do high high volume. Not a bad trend for radiology, since you can not buy an MRI as a physical medicine doctor to do 4 MRs a day and still make money. You need to do a lot of MR from head to toe to liver to brain to make a profit.

So do you think that the rads job market will recover before the path market?

 

[cowme]

The path market will never recover unless they can find a way to increase their volume.

 

[tco]

The path market will never recover unless they can find a way to increase their volume.

Decrease residency spots.

 

[meister]

It'll be interesting to see just how far CMS is willing to go to decimate imaging costs. And by interesting, I mean terrifying.