If last year’s job market looked good for radiologists, this year is even better. That’s great news for radiologists looking for work, but not so much for those who need to hire. It will cost more to bring on new radiologists and those on the hiring end may need to rethink their traditional business model.
One statistic that best shows this trend is that radiology is now the 10th most recruited specialty for physician search firm Merritt Hawkins. The company, which has been tracking permanent physician placements for 24 years, saw radiology jump from number 19 last year to the number 10 position this year, in its Merritt Hawkins’ 24th annual Review of Physician and Advanced Practitioner Recruiting Incentives. It’s the first time radiology has been in the top 10 in a decade. In the last year, Merritt Hawkins conducted 80 retained searches for radiologists, double the number from the previous year, and up from 22–24 searches during the two prior years.
“We’re a direct indication of the market difficulty,” said Travis Singleton, a senior vice president at Merritt Hawkins. “No one will pay me for something they can do for free. We’re the best barometer out there.”
The ACR also shows a hiring increase. It’s been releasing its annual ACR Commission on Human Resources Workforce Survey since 2012. The current survey estimates that 1,569-2,037 radiologists were hired in 2016, and they’re predicting increased hiring in 2017. They estimate 1,826 to 2,370 radiologists will be hired, a 14% increase over last year’s numbers.
This year’s radiologist job trends also include an increased demand for urban hiring and higher salaries.
Follow the Money
According to the Merritt Hawkins survey, the average salary for a radiologist hired in 2016-2017 is $436,000. There tends to be a magic number for hiring, even if the funds are allocated in different ways, said Lauren DeJesus, principal at the Medicus Firm, another physician search company. “The buzzword for radiology as a whole is $400,000–$450,000 across the board,” she said. “All in, if we don’t have a “4” in front of the number, we’re not doing anyone any favors. We won’t attract the right candidates and the health system is not playing ball,” she said. That all-in figure may include a sign-on bonus and incentives. A base salary of $350,000–$375,000 will lead to that target pay.
There used to be “new grad” pay and “experienced” pay. The current difference for that pay is $20,000. The time difference between calling someone a new grad versus an experienced radiologist can be as little as one year. In the past, the sign-on bonus was based on location and need. Now, $20,000 is the going rate for urban sign-on bonuses. DeJesus knows one candidate who completed a rural residency program and was offered a $50,000 bonus to stay on.
How Much and What Experience is Needed?
Practices aren’t recruiting for specific amounts of experience, said Singleton. It’s across the board. Practices are looking for succession planning, plus the number of films a physician can read, and the types of films. The more appropriate conversation is about quality and technology and whether the radiologist can adapt to and use the technology.
DeJesus agrees that the hiring is across the board, based on experience, training, and subspecialty. During one recent week, she placed a 32-year-old and a 62-year-old radiologist. “They just want the right candidate,” she said.
The ACR survey showed that in 2017, the most recruited subspecialists would be neuroradiologists, general interventionists, after-hours radiologists, and body imagers.
The need for after-hours radiologists is due to increased demand for general and subspecialty radiologists, as well as demands for higher pay and better quality of life. Hospitals and radiology groups increased the number of nighthawk radiology opportunities in the last five years so general radiology candidates won’t have to work nights and weekends. Nighthawk has become another radiology subspecialty. DeJesus has been placing radiologists to work in this role at full-time salaries. The hours are 7 p.m. to 7 a.m. one week on and two weeks off. That’s working 17 weeks a year. Or radiologists will split the night shift, working 4 p.m. to 12 a.m. or 12 a.m. to 8 a.m., one week on, one week off.
She likened this position to the creation of the hospitalist position, as some doctors only wanted to do outpatient work. “We have to have nighthawk to make general radiology attractive again,” she said. “They want money or they want quality of life, the same as any other specialty.”
These nighthawk radiologists might be stationed at one hospital, but provide night and weekend reads for other hospitals in the system. The physicians average 120-150 reads during their 12 hour shift. There’s a high rate of burnout, and it’s hard to make it through the three-year contract. “They’re young, right out of fellowship,” she said. “Once they do this role, they often move within the system into their specialty.”
The subspecialization of the radiology service line has made the general radiologist position higher on the desired list. “No one is wanting to do all bread and butter radiology,” she said. To meet radiologists’ demands, a lot of hospitals are adding subspecialty practices. While building it up, they’ll guarantee that radiologist 40% of their reads in their subspecialty and they’ll share the general call pool. They promise to transition them to 80%–90% of their specialty reads later on. That way they can build up their program while still serving their general reading needs.
Teleradiology continues to hire in spades. “Really over the last 15 months, the teleradiology business has gone bonkers,” Singleton said. The groups can’t keep up with the volume and are growing too fast. These groups can find radiologists, but not enough who can meet the quality standards and are licensed to read in states within their time zones. Also, it’s tougher to find radiologists at the price that teleradiology companies want to pay. Singleton said recruiting for teleradiology is twice as hard as it was two years ago.
“People still talk about it as if it’s a new phenomenon,” Singleton said. It’s been around for a decade plus.” Teleradiology is now better accepted, with higher quality, affordable technology, and better communication. Radiologists now see this as a viable career path. It’s reached critical mass.
Singleton says his firm is staffing for almost every large and small teleradiology company out there. Radiologists no longer only use teleradiology as a source for additional income, some are making it their career.
And teleradiologists on average are out-earning traditional radiologists. “For the first time ever, teleradiologists averaged more compensation than boots-on-the-ground radiologists,” Singleton said. While the average radiology salary was $436,000 (strictly salary from their traditional job), the average teleradiology salary was $494,000, for those doing 100% teleradiology.
Employment arrangements have changed for teleradiology. Four to five years ago, teleradiologists offered contract labor arrangements, not a salary. There were limited, if any, benefits. Their perk was quality of life. Now, that’s not enough. To fill their contractual agreements with health systems and to attract radiologists, they’re now offering competitive salaries and guarantees, along with signing bonuses. In return, the radiologists must guarantee a certain case load. “That’s a pretty new and changing dynamic for teleradiology companies,” Singleton said.
While DeJesus doesn’t recruit much for teleradiology positions, when she gets inbound physician calls about job opportunities, 60% of the time they ask her about available teleradiology positions.
Location, Location, Location
One of the biggest changes in this year’s job market is the increased hiring in urban settings. The Merritt Hawkins survey showed that 55% of their searches were for cities with 100,000 people or more, which was the highest percentage in the company’s 24-year survey history.
One reason that urban settings are having a harder time is that residents aren’t staying at their health system when they finish their training, as they might have done before. Programs used to replenish their outward migration of radiologists with inbound residents. “They’re not afraid to go outside of their training program because they’re offered a lot of money to do it,” said DeJesus. These urban health systems now need additional financial resources to recruit.
DeJesus said she’s gotten increased interest from cities and regions that typically don’t need recruiting help, including jobs in Orlando, Florida and Santa Fe, New Mexico. “These places are not usually hard to recruit to, or that come across our desk very often,” she said. “There’s an uptick of locations that are needing our services nationwide.”
As tides shift, radiologists are now more in the driver’s seat. “I tell hospitals and health systems, you had many years where it was in your favor, and you were getting them cheaper. Now it’s starting to catch up with you,” Singleton said.