Why would you ever go into Radiology?

[colbgw02]

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Common in the Southeast?

Not really. There are a handful of groups in NC and Kentucky that have. That's about it as far as I know.

There's a bunch that have sold in Florida, albeit mainly in central and south Florida. Not sure if you would count that as the southeast (I wouldn't).

 

[Radology]

It’s common everywhere.

Florida is basically a wasteland of corporate jobs at this point

Major groups have sold in Austin, Ohio Connecticut, Phoenix, and Vegas to name a few others.

That’s pretty much a footprint in every region

 

[deleted674723]

It’s common everywhere.

Florida is basically a wasteland of corporate jobs at this point

Major groups have sold in Austin, Ohio Connecticut, Phoenix, and Vegas to name a few others.

That’s pretty much a footprint in every region

Do you think it is still more likely than not that a graduate in the mid 2020s would be able to get in with a private practice and avoid these corporate jobs in their career or will they keep growing? From the previous posts it seems like you all believe the business model is flawed and they won't find success... but if that is the case, why are they common everywhere now? I know you don't have a crystal ball, just interested in your musings.

 

[Radology]

I can’t predict. There are two drivers for this

1) radiologist side. There is a lot of FOMO right now, and I think a lot of practices are working themselves into a frenzy worried that they’ll get bought by the hospital system they work for with a “take it or leave it” offer and get nothing.

Selling out used to be just a thing that small groups with old partners close to retirement did. Now mega groups with complete monopolies on the local market and tons of young partners (like Austin radiology) are selling out too.

2) private equity side. Interest rates have been historically low since 2008. So private equity groups can borrow literally billions low interest loans and over-leverage themselves to buy these practices. If interest rates continued to rise, they wouldn’t have enough capital to keep the pace going. Unfortunately for us, the fed looks to be pausing rate hikes this year.

 

[TCOM12]

The southeast has avoided some of the corporate buyout situation with the large exception of Florida. But the VCs have made some large acquisitions in Austin, Houston, Phoenix, Vegas. As more and more people are aware of these models, the less attractive they become. But if you must live in an area, then you will take the lower paying job. I also feel like (just an observation, no real data) that the pay hit someone is willing to take is based on their current income situation. If you're lucky enough to have little to no debt coming out of residency, then taking the pay hit will matter less. If you have substantial student debt and no ties to an area (like yours truly) then you're willing to go to the highest bidder. Additionally, if you're a 2 physician household, your spouse can make up the difference.

FYI to any med students reading this. The locums phenomenon is not isolated to radiology. There are physicians (even surgeons) who will do a week in middle America and return to their coastal home. I prefer the other situation. Live in a 250K city in middle America and use one my many vacation days to go to the coast or elsewhere. But to each their own.

Another option that's not listed that is a lifestyle but lower pay option is the VA. 8-5, low volume, low stress. They make up for the pay in benefits.

For anyone entertaining military as an option, I'm told it's frustrating because the volume is mostly plain films and low complexity. Spend a lot of time going to meetings and less time as a radiologist.

 

[Gurby]

FYI to any med students reading this.

 

[Cognovi]

So far at my institution, I’ve seen a surgeon look at a radiology report one time and the medicine team a handful more. I’ve heard people refer to radiologists as simply liability coverage for the hospital. Their only job is to document incidental findings because the rest of the hospital takes action long before reports even come out more than half the time. Plus 75-80% of the reads are stone cold normal.

This is an amazingly inaccurate perspective and I wonder how widespread it is among medical students who do not rotate through radiology as clerkship students.

 

[Womb Raider]

Really appreciate the older guys giving insight into the VC buyout phenomenon. Does anyone know where else I can read more about this and other relevant info about the business side of radiology?

 

[guytakingboards]

Really appreciate the older guys giving insight into the VC buyout phenomenon. Does anyone know where else I can read more about this and other relevant info about the business side of radiology?

There was a great 2-part podcast on the increasing corporatization in Radiology recently.

Ep 41. Kurt Schoppe, MD — Private equity buying medical groups. What’s the deal? (Part 1)

https://www.doctormoneymatters.com/episode42/

 

[jazzman84]

This is an amazingly inaccurate perspective and I wonder how widespread it is among medical students who do not rotate through radiology as clerkship students.

Recent anecdote. Was reading an MSK pelvis CT from the ER, old lady with subacute insufficiency fractures etc. Except she also had a gas filled collection in her adductors with gas tracking into bone.

Lo and behold when I call the ER, I’m told ortho sent the patient home because she had “no acute fractures” but nobody had seen this huge abscess until I read the case. She was brought back for MRI and sure enough had pyomyositis and osteomyelitis.

My point is we do more than provide liability coverage. Clinicians and surgeons can be very good at imaging in their narrow field but throw something unexpected at them and you get situations like this.

 

[Radology]

Similar case happened at my hospital a couple years back

The radiologist got sued for not communicating the finding.

The Er doc who didn’t open the report for the study he ordered got dropped from the lawsuit

 

[Cognovi]

Similar case happened at my hospital a couple years back

The radiologist got sued for not communicating the finding.

The Er doc who didn’t open the report for the study he ordered got dropped from the lawsuit

As outrageous as that sounds, though, for every lawsuit holding the radiologist liable for not putting in the effort for nonroutine communication, there is another lawsuit holding only the referring doc liable for not following up with a radiology report. The standard of care these days is that it's a two-way street when it comes to important findings. In practice, people separate out the importance into several levels, like findings you need to page and call about, email or EMR message about, or just report routinely.

 

[Morky-Mouse]

Wow this is a really great thread! I really appreciate the older guys taking their time to answer lifestyle/job market questions.

 

[DOFOSHO]

Recently someone tried convincing me not to go into DR for the following reasons:

1. Workload is exponentially increasing and reimbursement is going down
2. You'll have to do a useless (?) Intern year that won't have much of a bearing on how you practice in the future.
3. A fellowship is essentially required at this point, extending length of training to 6 years before you start making a decent salary.
4. Burnout and job dissatisfaction is near the top of the list now according to the 2018 report.


Now I'm not so sure I buy the usual doom and gloom...If you love something you just have to do that thing. What is your opinion of these arguments?

stay away from that person.

 

[Timtom98]

Absolute gold mine of a thread. All makes sense. M4 here going into rads if all goes well match day

Hopefully the job market is still good in 6 years, probably will depend on economy like 2008.

And hopefully we get less VC and more small local groups.

Would appreciate any additional insight!

 

[thatsrad]

Recently someone tried convincing me not to go into DR for the following reasons:

1. Workload is exponentially increasing and reimbursement is going down
2. You'll have to do a useless (?) Intern year that won't have much of a bearing on how you practice in the future.
3. A fellowship is essentially required at this point, extending length of training to 6 years before you start making a decent salary.
4. Burnout and job dissatisfaction is near the top of the list now according to the 2018 report.


Now I'm not so sure I buy the usual doom and gloom...If you love something you just have to do that thing. What is your opinion of these arguments?

1. Workload increases are very small and incremental, year over year, no more than other areas of medicine. Pay remains constant or even increasing.

2. One useless intern year is infinitely better than a lifetime of pain. That’s like saying “medicine/surgery sucks so bad I can’t imagine a year of it, so instead I'll spend my whole life doing it.”

3. Fellowship is only ”required” in the neurotic minds of some radiologists. General Radiologists (which includes doing basic procedures) are some of the most in demand and highest paid , because they tend to be part of smaller PP groups. A good Generalist will always be in top demand. In my experience, most residents who go without fellowship are ballers and they end up with great positions making bank. The worst residents imaginable can still get great fellowships, it’s a total buyers market.

4. Fake news. Burnout is manageable in radiology, more so than other specialties.

 

[deleted573262]

1. Workload increases are very small and incremental, year over year, no more than other areas of medicine. Pay remains constant or even increasing.

2. One useless intern year is infinitely better than a lifetime of pain. That’s like saying “medicine/surgery sucks so bad I can’t imagine a year of it, so instead I'll spend my whole life doing it.”

3. Fellowship is only ”required” in the neurotic minds of some radiologists. General Radiologists (which includes doing basic procedures) are some of the most in demand and highest paid , because they tend to be part of smaller PP groups. A good Generalist will always be in top demand. In my experience, most residents who go without fellowship are ballers and they end up with great positions making bank. The worst residents imaginable can still get great fellowships, it’s a total buyers market.

4. Fake news. Burnout is manageable in radiology, more so than other specialties.

good points all around. this is your career: many people do a one year fellowship. lots of people have to do an internship. and oh, you have to do work while at work? get a grip.

tl;dr: rads is the best deal in medicine.

 

[odyssey2]

good points all around. this is your career: many people do a one year fellowship. lots of people have to do an internship. and oh, you have to do work while at work? get a grip.

tl;dr: rads is the best deal in medicine.

Your posts are very positive about radiology. Are you a resident or attending?

 

[plasmodium]

Recently someone tried convincing me not to go into DR for the following reasons:

1. Workload is exponentially increasing and reimbursement is going down
2. You'll have to do a useless (?) Intern year that won't have much of a bearing on how you practice in the future.
3. A fellowship is essentially required at this point, extending length of training to 6 years before you start making a decent salary.
4. Burnout and job dissatisfaction is near the top of the list now according to the 2018 report.


Now I'm not so sure I buy the usual doom and gloom...If you love something you just have to do that thing. What is your opinion of these arguments?

1. True
2. Useless? As a radiologist, you are just as much a consultant, if not moreso, as any other specialist. Intern year shapes who you become as a doctor. Intern year was an invaluable and extremely fun experience, and I did mine in surgery.
3. True
4. Radiologists are far and away the happiest physicians I've worked with across specialties, at least in academia.