The CMS Data - Should I Laugh or Cry?

April 14, 2014

Radiology might not be the best way to make a buck, but its rewards come in all shapes and sizes.

Two financial news items grabbed the attention of many of us recently. First, an annual salary survey showed that radiologist salaries are declining. The reasons for that are myriad and we’ll talk about them another time. Second, CMS released physician payment data. Of course, at these times I reflect on why I chose medicine and radiology. I chose medicine because I honestly think my role is to make the lives of others better and easier. I probably chose radiology for several reasons: intellectual stimulation, interest in technology and its increased use in healthcare and a little hesitancy about how I’d handle close personal relationships with patients. We’ll leave the last one for a blog on psychology.

Right now I keep refocusing myself on the other reasons I chose medicine and radiology; that is, non-monetary rewards. It definitely frustrates me at times to see that there are industries where it is apparently fine with society to suck the financial life from the rest of us. But when it comes to medicine, that is frowned upon. I stared at my Medicare average pay per patient the other day (yes, if you haven’t done it, it is super easy to see your CMS data) and didn’t know if I should laugh or cry. It was $50–$60 per patient. I had just had a repair guy come to fix my garage door. He “required” $75 just to look at the door - you know, a diagnostic evaluation. Seriously, the system allows him to charge more than I do?

After paying back $120K in debt, and giving up 20 percent of my adult earning years to training, I’m pretty confident that this is not financially right. So what does that mean? Why am I doing this? The answer is back in why I started doing this. I’m not going to pretend I didn’t expect (and get) a good salary. But I knew when I started this, it wasn’t the easiest or best way to make a buck. Rewards come in all sizes and shapes. I get them from professional respect from patients, peers, friends and co-workers. I get them from job and intellectual satisfaction. I get them from knowing I tried to help someone every day, really and tangibly. I get them from integrity - staying true to myself.

I’m not suffering financially... and I’m not soaking every penny I can from society either. That doesn't mean I won’t try to get paid every dollar I’m worth in society’s eyes, using the current system. But it does mean the yardstick I compare myself to isn’t the electrician, the investment banker or anyone else.