Sick Money

[PublicHealth]

Why do radiologists make so much money?

---

Members don't see this ad.

 

[Resident Alien]

why are you wasting so much time?

 

[PublicHealth]

why are you wasting so much time?

You suck.

It only took me five seconds to type the question.

 

[skypilot]

Why do radiologists make so much money?

The reason they make so much money is the volume of readings they can do in a day and the price they can charge.

Lets say they read 150 xrays per day and charge $100 per read. That is $15,000 in one day.

Computerization has made the reading quicker and the undersupply of radiologists keeps the price up. Everyone wants an MRI, CAT scan or Xray these days so there is plenty of volume.

 

[nuclearrabbit77]

The reason they make so much money is the volume of readings they can do in a day and the price they can charge.

Lets say they read 150 xrays per day and charge $100 per read. That is $15,000 in one day.

Computerization has made the reading quicker and the undersupply of radiologists keeps the price up. Everyone wants an MRI, CAT scan or Xray these days so there is plenty of volume.

there are alot of other professions that make more or equal to radiologists.
do a google on physician salaries. neurosurgeons, orthopaedics, cardiology to name a few do comparable or better.

radiologists log in way above average in the number of hours of work/wk. although we don't bring our work back home ^^

 

[PublicHealth]

The reason they make so much money is the volume of readings they can do in a day and the price they can charge.

Lets say they read 150 xrays per day and charge $100 per read. That is $15,000 in one day.

Computerization has made the reading quicker and the undersupply of radiologists keeps the price up. Everyone wants an MRI, CAT scan or Xray these days so there is plenty of volume.

To what extent will outsourcing affect radiologist income?

 

[f_w]

troll-o-meter


0-------------------------------100
...................................X.........

 

[physiclas87]

Radiologists don't make sick money, considering the time it takes to train. Sick money is made by those who did fellowships, so after college, it takes 10 years to train a radiologist. 10 years!

 

[jmou123]

I am curious about the number of hours worked per week in private practice vs. academic. I have seen many posts stating that radiologists work more hrs/wk than most other fields. I guess I have been in contact with a different group at my medical school. Most of the rads guys I have met, get there at 8 and leave by 5. That is better than most surgery fields and about the same as most medicine fields. They also have ridiculous amounts of vacation time. As far as pay goes, I have been told that the ave is around 350K. What is surprising is the ceiling for rads. I have heard as much as 7 figures.

I dont know much about outsourcing and would be interested to hear some feedback. I heard that it is pretty limited due to the fact that the radiologist in another country has to have completed a US residency.

 

[f_w]

Don't look at your academic medical school rads as a model for the profession. They have residents/fellows to insulate them from after hours work and the way most academic departments are structured, they rarely have to stay beyond 5pm. People in private practice make good money, but they work for it, in most cases much harder than your typical academic rad.

 

[zzz1]

Radiologists don't make sick money, considering the time it takes to train. Sick money is made by those who did fellowships, so after college, it takes 10 years to train a radiologist. 10 years!

Do you have to complete a fellowship in order to make sick money? Can you make sick money (350k plus) with just a radiology residency in a relatively large metro city? What about rural areas?

How competitive is mammo fellowship? Supply and demand of mammo-trained rad doctors?

 

[fedor]

How competitive is mammo fellowship? Supply and demand of mammo-trained rad doctors?

Mammo is not competitive.

Few radiologists want to do mammography because of the malpractice issues and low reimbursement.

 

[fedor]

Do you have to complete a fellowship in order to make sick money? Can you make sick money (350k plus) with just a radiology residency in a relatively large metro city? What about rural areas?

There are a lot of radiologists who want to work in large metro areas (NYC, Cali, etc.) thus the majority of new hires are fellowship trained. Groups in big cities can choose among the pack.

A few of the recent postings for jobs in NYC itself were around 180k for first year with partner in 2 years. The outlandish offers are in rural or semirural areas. Also, some of the very high offers you see really are too good to be true. Either the group will boot you before you make partner or you may have a ridiculous buy in.

 

[fedor]

Why do radiologists make so much money?

Why don't you ask all the specialists why they make so much money? There's no better way to make friends than to imply someone is overpaid.

http://www.allied-physicians.com/salary_surveys/physician-salaries.htm

You see that many specialists make as much or more than the average for experienced radiologists ($354k)

Gas: Pain Management - $370k
Cards Invasive - $395k
Cards Interventional - $468k
Cards Noninvasive - $403k
Gastro - $349k
Oph Retina - $469k
Ortho Foot/Ankle - $392k
Ortho Hand - $459k
Ortho Hip - $491k
Ortho Spine - $670k
Ortho Sports - $479k
ENT - $311k
Path - $321k
Rad Onc - $385k
CT Surg - $515k
Neurosurg - $541k
Plastics - $412k
Urology - $358k

If money is what you're after, take a look at pathology (the best $/hours combo in medicine). They're salivating over dermatopath salaries in the path forum now.

http://forums.studentdoctor.net/showthread.php?t=244855

 

[zzz1]

Also, some of the very high offers you see really are too good to be true. Either the group will boot you before you make partner or you may have a ridiculous buy in.[/QUOTE]

I can't believe this would really happen, I mean, don't you sign a contract at the beginning? If they fire you, can't you sue them back? I just wonder if this kind of things really happen or is it just more of an urban legend? I mean it sounds like used car sales or something. Any examples of such outlandish offers?

 

[f_w]

None of the ridiculous offers are true salaries. Most are 'draws' meaning someone gives you a credit for your first years income but you have to cover it with your own collections. Can be a good deal if you are busy, but if it doesn't work out you 'own your soul to the company store'.

Incomes at the 3 year mark are good, but they are not much different from many other procedural specialties. Also, if you buy into an equipemnt owning group, there is a certain enterpreneurial risk involved. It is not huge, but if you look at 'average 3 year income', you don't know how many of these people had to make a considerable investment to get into the position to make this income (this ain't pediatrics. an exam table, some teddy-bears and an otoscope doesn't make an office in radiology).

The main difference in rads these days is that you can expect to make almost partner level incomes in your first year. This is not like a surgical practice where you often spend the first 3 years slaving away for a pitance to benefit your senior partners. Rads groups outside of metro areas have to offer equitable deals to new employees if they want to have a shot at hiring someone.

No, it is not 'sick money' (and just ignore Dr Cuts posts on this issue. He mistakes the flyers the recruiters send him for reality. Upon further investigation, most of the offers clogging up my mailbox turn out to be real dogs)

 

[zzz1]

No, it is not 'sick money' (and just ignore Dr Cuts posts on this issue. He mistakes the flyers the recruiters send him for reality. Upon further investigation, most of the offers clogging up my mailbox turn out to be real dogs)

Thanks for the insight. Though I still wonder why the recruiting groups and recruiters do this kind of things, they are dealing with rad residents who can read after all. It's not like they are dealing with dumb high school drop outs. Why can't they just be straightforward with their offers?

Also, another question about the politics of a rad group,

Is there age discrimination in rad groups? The rad group covering my hospital seems to have no one above the age of 55. I am just wondering if the politics of private rad practice groups forced them to retire by 55, because they "read slower" when older or what? I can't imagine it's all because they are rich and playing golf. What's the typical and maximum upper-limit age of a real world practicing radiologist? Can they practice into their 60's or even 70's like some FP's?

In general, what's the organizational politics like within a typical rad group?

 

[f_w]

Though I still wonder why the recruiting groups and recruiters do this kind of things,

Because they get paid whenever they can fill a position. And this is no chump change either, it is a percentage of the salary. The recruiter gets paid once the new doc starts, that is all he cares about. Whether that person will be happy or blow the group apart doesnt' concern the recruiter.

they are dealing with rad residents who can read after all. It's not like they are dealing with dumb high school drop outs.

Actually, once you wave enough money at people, greed takes over and in some, the ability to think rationally drops to the level of a high-school drop out.

Why can't they just be straightforward with their offers?

Why can't the angler be straightforward with the fish ?

Is there age discrimination in rad groups? The rad group covering my hospital seems to have no one above the age of 55.

In many rads groups the reverse is true, nobody younger than 55.

It might just be a function of when the group formed, or they might have had a couple of guys who founded it in the 70s stayed until retirement and all left at one time.

I am just wondering if the politics of private rad practice groups forced them to retire by 55, because they "read slower" when older or what?

Often, not allways, the older guys are the most productive. Maybe not by practice income because they read all the low-cash plainfilm and mammo work. But an older partner who can plow through an alternator full of screening mammos without complaining (and without getting sued) is worth his often considerable weight in gold.

I can't imagine it's all because they are rich and playing golf. What's the typical and maximum upper-limit age of a real world practicing radiologist? Can they practice into their 60's or even 70's like some FP's?

Many are maybe not rich, but at age 55 and after the kids are through college realized that a 2 day a week per-diem gig will pay the bills and leave them enough time for golf (without call responsibilities and group or hospital politics).

Some of the most brilliant academic rads I have met practice(d) into their 70s and up. I also know some semi-retired PP rads who will come in on a per-diem basis to help out at their old group. (As long as you have one 20/25 eye and one opposable thumb, you can practice radiology )

In general, what's the organizational politics like within a typical rad group?

Thats a loaded question.....

 

[fedor]

Thats a loaded question.....

...and the most interesting question I have heard in a while. I would love to see someone try to tackle it.

 

[stephew]

consider reading the book http://www.amazon.com/gp/product/09...103-7821199-1686251?n=507846&s=books&v=glance for a bile tinged answer to the question. but if you can sift through the cynicism, you can learn a lot of the real world functions involved in the OP's question. Note: its way out of date but the lessons are still worth the time.

 

[skypilot]

My mom is 74 and still practicing Radiology so it is possible. My uncle practiced till 68. I think Radiologists get better as they get older. At some point in your career you will have seen everything.

 

[f_w]

I think Radiologists get better as they get older.

Some do, and that are the ones to look up to.

While I was reading out with one of the senior volunteer faculty during residency (80 and still going), a medstudent asked him how he picked up that nodule (that me, the resident had missed). His answer was that during the first 40.000 or so, he would have probably missed it....

Some are bad, but they where probably bad throughout their career.

 

[zzz1]

My mom is 74 and still practicing Radiology so it is possible. My uncle practiced till 68. I think Radiologists get better as they get older. At some point in your career you will have seen everything.

It's good to know there are older radiologist out there. I just want to comment on something I've read numerous times. It's that radiologists tend to get sued more than most doc's. I heard it's due to the fact that lawyers usually sue everyone on the chart when something goes wrong and that invariably involves the rad doc.

Now as related to the rad group politics issue, how many times does a radiologist has to get sued before he becomes un-hire-able? Or is there a major distinction between being sued and being found guilty of negliency or something?

It's just that in the corporate world which I came from, it seems the minute a reputation develops about someone, it sticks with him forever. It's kind of like the "TPS report" in the movie Office Space if you know what I am talking about. Little is based on fact or merit, much on gossip and opinions.

So if you do the math, by the time a radiologist practice into his or her 70's, how many times would they have been sued? How much would their malpractice policy cost? What about a younger rad, how does it impact a younger rad if he or she has been sued before when they job search again? Or does it not matter in today's hot job market. Hospitals, groups will take anyone with a pulse?

 

[zzz1]

another question,


I thought radiologist used to all be hospital employees a long time ago, right? What's the percentage of rads going into private groups vs. direct hospital hire positions these days? What are the advantage or disadvantage to each? Can anyone share some opinions?

 

[f_w]

I heard it's due to the fact that lawyers usually sue everyone on the chart when something goes wrong and that invariably involves the rad doc

There is a single reason: Mammography. It is responsible for 60% of malpractice volume in radiology.

The problem in rads is that the answer is allways on the film. A finding on physical exam you missed is difficult to proove later on in court (if you didn't document it, its not there). In radiology, some jack#)( surgeon expert witness for the other side can allways point out that 'shadow' on the 'mammagram' which turned out to be cancer later on.

Malpractice premiums vary by state, so you can't make general assumptions. Radiology is usually in the upper third but not one of the outliers like NS. Just to give you an idea about one of the states I happen to know the ballpark premiums for:

Neurosurgery $145.000
OB-Gyn (>25 deliveries/year) $110.000
Radiology $45.000
Internist $14.000

Or is there a major distinction between being sued and being found guilty of negliency or something?

Getting sued comes in many flavors. People get 'named' in suits all the time, 90% of the suits are either dropped or don't make it to trial for some other reason (mostly because they are bogus). Your name only goes into the national practicioner database if you you pay out a settlement or loose on trial. An NPDB entry doesn't make you unhireable, it just drives up your malpractice premium.
Most radiologists I know of go through their life without ever getting named. The 'average' comes from states like Florida, West Virginia or Mississipi where docs get named and sued numerous times during their career.

I thought radiologist used to all be hospital employees a long time ago, right?

About 90 years ago, yes, they where hospital employees.

Today, only a small percentage are employed by hospitals. Most are with single specialty radiology groups, others work for multispecialty groups, others are independent (run their own corporation, often outsourcing the billing part to a commercial provider). Some are hospital employees in the sense that they work for the veterans administration or the indian health service or the military. In the real world of community hospitals, they are typically partners in a single-specialty radiology group.

 

[fedor]

The problem in rads is that the answer is allways on the film. A finding on physical exam you missed is difficult to proove later on in court (if you didn't document it, its not there). In radiology, some jack#)( surgeon expert witness for the other side can allways point out that 'shadow' on the 'mammagram' which turned out to be cancer later on.

So you're saying that most expert witnesses for the plaintiff won't even be radiologists? How hard would it be for the defense to drum up radiologists as expert witnesses? When I'm a radiologist, I wouldn't mind doing some pro-bono expert testimony to help out fellow rads.

 

[f_w]

So you're saying that most expert witnesses for the plaintiff won't even be radiologists? How hard would it be for the defense to drum up radiologists as expert witnesses? When I'm a radiologist, I wouldn't mind doing some pro-bono expert testimony to help out fellow rads.

A good number aren't. The 12 village idiots on the jury won't understand the difference between a 'cancer specialist' with '35 years experience in treating breast cancer' and a board certified radiologist.

Organized radiology is trying to lobby to make sure that only experts act as expert witnesses. But the process is controlled by the trial lawyers, quality is a remote concept to them.

You are actually more credible as an expert witness if you charge a reasonable fee. If you do it for free, it means you have a motivation to be anything but an impartial witness to the case. (actually, the strongest expert witnesses are the ones working for both, defendants and plaintiffs. It makes it harder for the plaintiffs shyster to paint you as a partisan crusader who believes that no radiologist could ever do any harm. There are cases where a unforgivable f#)(( up by a radiologist causes the patient irreparable harm. You have to be ready to testify for the plaintiff in such a case if you want to have credibility.)

 

[jmou123]

So I am curious as to how the whole process works with hospitals and private practice. It appears to me that the bulk of radiological tests are done on hospital patients. I have also heard that the radiology dept. and the Neonatal ICU are the two largest money makers for hospitals. If that is the case, how can a private practice radiologist survive. I assume that a group of radiologists in PP are not doing alot of imaging on sick patients. It seems that they would be doing fractures and 'outpatient' type tests. In the hospital there are rads tests flying all over the place. I thought that the hospitals are willing to pay huge due to the revenue that a rads dept can generate. So I guess what I am asking is, do the private groups contract with the hospitals?

Also, if one of the perks of rads is the fact that you can expect partner pay/benefits in one year, what does that involve? And, as posted above the ave rads guys makes 350K after 3 years. Then what is with the 900K that is on that website if these offers dont exist?

 

[f_w]

So I guess what I am asking is, do the private groups contract with the hospitals?

Radiology groups typically have a contract with a hospital which obliges them to read all (or most) imaging studies done at that hospital. The hospital bills a 'technical fee' for the performance of the study (to pay for the machine, the salary for the tech, the guy that cleans the floors), the radiologist bills a 'professional fee' for the interpretation of the study. About 80% of the total fee is typically technical, the rest professional.
This is why the radiology department (the technical end of it) is a gigantic moneymaker. In many community hospitals, the technical side of the radiology department contributes 50% of the hospitals revenue. On the professional end, hospital work is lucrative, but not overwhelming.
The downside of hospital work for the radiology group is the fact that (at least in cities) most of the work done on ER patients is not getting paid for. In the mix, the group will make enough of the paying patients to subsidize money pits like the ED.

The real money is outpatient imaging on the 'worried well insured well'. The 5th knee MRI on some middle aged tennis player with full health insurance is what pays the bills. Also, if a group owns equipment in an outpatient/office facility, they will collect a 'global' fee which consists of the technical AND professional components. And as the bulk of the money (and profit) is in the technical fee, running an outpatient imaging center is where the money is.

 

[fedor]

Also, if one of the perks of rads is the fact that you can expect partner pay/benefits in one year, what does that involve? And, as posted above the ave rads guys makes 350K after 3 years. Then what is with the 900K that is on that website if these offers dont exist?

About the 900k: That website had a salary survey and that was the maximum reported compensation per speciality. I am not sure how powerful their survey was (number of responses), but the maximums for all specialties are much higher than what is reported on that site.

In the UC system, there is a pathologist making over $1.5 million and I know a few nephrologists who make similar figures (they own the dialysis equipment).

Those average figures are decent, but disregard the maximums. They shouldn't even include them. What they should have done is posted 25th, 50th, and 75th percentiles.

If you want to see the non-radiologic equivalents of outpatient imaging centers, take a look at outpatient surgical centers. They're located primarily in states where hospitals can be built or expanded without government approval. That's where some of the outliers are.

 

[fedor]

The big money is often earned by people who, like f_w said, own the equipment. But keep in mind, you're not just a physician then, you're also a businessman and all the risks that entails.

If you're in a midsized city, making large money with a few imaging centers, and a few radiology groups decide to open up imaging centers in your town, you could be in for it...

 

[GMO2003]

The real money is outpatient imaging on the 'worried well insured well'. The 5th knee MRI on some middle aged tennis player with full health insurance is what pays the bills. Also, if a group owns equipment in an outpatient/office facility, they will collect a 'global' fee which consists of the technical AND professional components. And as the bulk of the money (and profit) is in the technical fee, running an outpatient imaging center is where the money is.

you're probably right...I've seen commercials on tv for the fully body scan centers that utilize EBT (electron beam tomography)...those rads are probably preying on the rich hypochondriacs with money to burn...it sounds a bit shady but to each his own I guess

 

[Whisker Barrel Cortex]

you're probably right...I've seen commercials on tv for the fully body scan centers that utilize EBT (electron beam tomography)...those rads are probably preying on the rich hypochondriacs with money to burn...it sounds a bit shady but to each his own I guess

Oddly enough many of those are owned by cardiologists, who have rads read the CT/

 

[f_w]

.I've seen commercials on tv for the fully body scan centers that utilize EBT (electron beam tomography)...

There was a whole flurry of activity surrounding EBT a couple of years ago. It was touted as the 'fifth generation' of CT scanners and so on. In the meantime, the regular scanners have overtaken EBT in quality and it is a technology on the way out. If someone uses EBT to take conventional images, he just admits that his scanner is not busy enough doing cardiac work.
The true 'boutique medicine' is too small of a market for many people to live on. The regular insured outpatient who isn't really sick is where the money is (patients with runny noses who get the 3r 'sinus scan', spine MRIs for back pain and so on)

As my residency director (a former private practice rad) put it: 'Overutilization has paid for the college education of 3 of my children.'

 

[rahulazcom]

I'm a lowly medical student now but I used to be a recruiter and I can substantiate many of f_w's claims. The 900k is a common recruiter trick. When a recruiter sits down and discusses salary with a group, the group usually provides a salary range. The scale will be from 300-900k. As a recruiter, you discover pretty fast that the employer has no real intention of hiring someone for 900K unless you are recruiting a senior partner in an already well established radiology firm who is earning close to that amount. So yeah, we know there is no chance in heLL that the firm will pay 900K. It's just a lure to attract fresh radiology grads to apply. It sounds better to advertise "Pays up to 900K" than state "300-900K" salary range.

If a recruiter advertises a certain salary then he is likely a shady recruiter. Most reputable firms don't discuss salary openly in their flyer or advertisement. Those are details that will be explained later to serious candidates.

And recruiting firms do provide some form of a refund if the candidate leaves within 3 months but it's usually not a 100% refund. At our company, we used to offer a 100% refund if the candidate left in 30 days and after that, we would prorate the refund per day until 90 days. We were never worried because we knew a candidate was unlikely to quit after only 30 days even if the job was a total bad job.

There are reputable recruiters. These recruiters act more like professional businessmen and thus will not advertise outlandish salaries on some anonymous website for 900K.

 

[rahulazcom]

I can't believe this would really happen, I mean, don't you sign a contract at the beginning? If they fire you, can't you sue them back? I just wonder if this kind of things really happen or is it just more of an urban legend? I mean it sounds like used car sales or something. Any examples of such outlandish offers?

No, they are not obligated to offer you a partnership. You can "qualify" for partner after working a given number of years but the firm is not required to make you a partner. The only way that you can protect yourself agaist this is to see how many of the current partners were recent associates and note how long the associateship is before being hired to partner. Shady firms will make you work a long time before they offer you the chance to become partner. It shouldn't be more than 3 years in general and these days it's not uncommon for firms to offer partnership after only a 1-2 years.

 

[blaze1306]

Would you consider a site like this one shady? They seem to offer the world I wonder if they deliver?


http://www.radworking.com/jobs/radiology-jobs.html



When is the sign on bonus Paid? Christmas or a year after emplyment? Or right up front?

 

[f_w]

And recruiting firms do provide some form of a refund if the candidate leaves within 3 months but it's usually not a 100% refund. At our company, we used to offer a 100% refund if the candidate left in 30 days and after that, we would prorate the refund per day until 90 days. We were never worried because we knew a candidate was unlikely to quit after only 30 days even if the job was a total bad job.

In medicine, you typically need a couple of months of lead time before you can really leave a job. There is a considerable amount of paperwork (credentialing, insurance#s, licensing) which has to be taken care of. Unless the group really p###$ off the new hire on day 1, people are unlikely to leave in the first 3 months. It is more common for people to leave after a year or so, once they find out that a lot of the things they where promised don't actually exist or once they notice that the 900k are for one of the senior partners who has a different partnership contract from anyone else.

radworking.com is a site mainly used by recruiters it seems. Now, there are ethical recruiters who are genuinely interested to find the right candidate for the right job. But as the insider has pointed out, their ads won't give you numbers but rather emphasize the factors making it a truly good job (years in business, democratic group, identical partnership contracts, owns outpatient centers, location...)

Many of the jobs making 'sick money' will be in scenic locations only described as:
- By plane, its only 3 hours to St Louis, 4 hours to Minneapolis and 4.5 hours to the metropolis of Omaha (= in the middle of nowhere).
- The location is an 'all america town' (= won't find too many people looking different from you)
- a 'great place to raise a family' (= small agricultural hicktown)
- for a friends of the outdoors (= because there is nothing else to do)

On further inquiry, you will find out that it is a small place where someone tried to take over the radiology of a community hospital by promising the moon to the administrators and is now paying through the nose for locums as he can't find the 4 rads he will eventually need to run the place......

Yes, there are good jobs out there, but they don't get advertised in this manner.

 

[jmou123]

In medicine, you typically need a couple of months of lead time before you can really leave a job. There is a considerable amount of paperwork (credentialing, insurance#s, licensing) which has to be taken care of. Unless the group really p###$ off the new hire on day 1, people are unlikely to leave in the first 3 months. It is more common for people to leave after a year or so, once they find out that a lot of the things they where promised don't actually exist or once they notice that the 900k are for one of the senior partners who has a different partnership contract from anyone else.

radworking.com is a site mainly used by recruiters it seems. Now, there are ethical recruiters who are genuinely interested to find the right candidate for the right job. But as the insider has pointed out, their ads won't give you numbers but rather emphasize the factors making it a truly good job (years in business, democratic group, identical partnership contracts, owns outpatient centers, location...)

Many of the jobs making 'sick money' will be in scenic locations only described as:
- By plane, its only 3 hours to St Louis, 4 hours to Minneapolis and 4.5 hours to the metropolis of Omaha (= in the middle of nowhere).
- The location is an 'all america town' (= won't find too many people looking different from you)
- a 'great place to raise a family' (= small agricultural hicktown)
- for a friends of the outdoors (= because there is nothing else to do)

On further inquiry, you will find out that it is a small place where someone tried to take over the radiology of a community hospital by promising the moon to the administrators and is now paying through the nose for locums as he can't find the 4 rads he will eventually need to run the place......

Yes, there are good jobs out there, but they don't get advertised in this manner.

So you are telling me that most radiologists out there support blatant lying about the jobs that they are offering to applicants? I am assuming that these recruiters are hired by the radiologists/groups themselves.

If you look at that website, most offers say 'x amount for x time, then you become partner and have x amount with x vacation' Both trending up. So in a previous post, the short partnership track was considered a bonus in the field of rads. Are you now saying that none of this is true? If all of these offers are fake, how do they ever hire someone? Also what are the real offers like?

 

[f_w]

So you are telling me that most radiologists out there support blatant lying

Some groups will lie when advertising a position (Or did you ever wonder why your laundry didn't get more 'colour fresh' with every cycle in the washer ?)

the short partnership track was considered a bonus in the field of rads.

A short partnership track is a bonus, but if 'partnership' is given away like candy, you have to wonder how valuable it really is ('partnership' can mean a lot of things, some groups have tiered partnership systems where the junior people have no say in the management of the group and the financial conditions are actually worse than in a comparable employee position)

Also what are the real offers like?

They are very variable.
In a urban location in an attractive city, you might make somewhere on the 'lowest' range of the table quoted above (+3 years to partnership, a 'goodwill' buy-in, short vacations).

In a b#)(_+k hicktown in the malaria infested swamps of the gulf-coast, you might be somewhere in the 'highest' range (1 year partnership, no buy-in, months of vacation).

Most jobs are somewhere in between, and there are so many factors that make a 'good job', it is difficult to sum it up.

It all depends on what you are looking for.

 

[zzz1]

They are very variable.
In a urban location in an attractive city, you might make somewhere on the 'lowest' range of the table quoted above (+3 years to partnership, a 'goodwill' buy-in, short vacations).





What's a goodwill buy-in?

 

[f_w]

What's a goodwill buy-in?

When you become partner in a group, you typically make an investment in the corporation. The price for this share calculates as:

#1 assets of the corporation (the chairs people sit on, buildings)
#2 a share of 'accounts receivable' (money patients/insurers still owe to the group)
#3 'goodwill' the monetary equivalent of the 'value of having this group already in existence'. The 'good name', the 'existing referral pattern' etc.

Depending on the structure of the group (equipment owning or purely hospital based), #1 can be very small or very large. #2 also represents real value to the corporation (you could sell the AR to a collection agency for example). #3 on the other hand is just a premium the existing partner charge you for becoming one of them. Your bribe to get into the circle of people who can participate in the profits of the group. In a less desireable location, the group will have to offer a 'straight' no-goodwill buy-in (one where your accountant comes up with the same value as the group). In a more desireable location, the group might still be able to charge a new member for being able to work in this location.

 

[zzz1]

Many of the jobs making 'sick money' will be in scenic locations only described as:
- By plane, its only 3 hours to St Louis, 4 hours to Minneapolis and 4.5 hours to the metropolis of Omaha (= in the middle of nowhere).
- The location is an 'all america town' (= won't find too many people looking different from you)
- a 'great place to raise a family' (= small agricultural hicktown)
- for a friends of the outdoors (= because there is nothing else to do)

On further inquiry, you will find out that it is a small place where someone tried to take over the radiology of a community hospital by promising the moon to the administrators and is now paying through the nose for locums as he can't find the 4 rads he will eventually need to run the place......

Yes, there are good jobs out there, but they don't get advertised in this manner.[/QUOTE]



Alright, humor aside, how does radiology practice work in rural america? If they only have a couple of general rad's or maybe even a solo practice:

How do they handle 24/7 ER radiology coverage in a small town hospital with 1, 2 or 3 people? In the city rad group covering my hospital, they have dozens of rads.

Would they have high turnover rate due to fatigue from being on call 1 out of every 2 or 3 nights if the group only have 1-3 people?

How do they handle difficult cases outside of their general expertise like mammo, IR, and neuro cases in rural hospitals?

 

[f_w]

How do they handle 24/7 ER radiology coverage in a small town hospital with 1, 2 or 3 people?

In the olden days, the rads would only come in for things like a CT scan. The plain film work was read by the doc covering the ER. The radiologist just over-reads everything in the morning.

Nowadays, many smaller groups outsource the overnight CT reads to radiology groups (companies) specializing in overnight teleradiology coverage. Some of these companies have US trained radiologists in other timezones (Hawaii, Israel, Switzerland, Australia) who only do this kind of ED business. It has made rural single or small group practice a much more viable option than it used to be.

Would they have high turnover rate due to fatigue from being on call 1 out of every 2 or 3 nights if the group only have 1-3 people?

Well, you are on call a lot, but they tend to be a lot quieter than your teaching hospital urban trauma center calls.
I have met folks during this type of rural practice, some of them for decades (you actually have a lot more control over your professional life in some respects. If you say 'no, can't be done', then it just can't be done. Who else would be there to do it.

How do they handle difficult cases outside of their general expertise like
mammo, IR, and neuro cases in rural hospitals?

Ship them to a group who has the expertise. (even for that you will find telerad providers these days.)