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Give Yourself a Raise: Goals and Systems in Your Radiology Career, Part 3


A four-phase approach to moving onward and upward in your career.

A relatively recent comic-strip from Scott Adams, whose work I’ve referenced in the past couple of columns: An office-cubicle dweller complains that his company won’t pay current employees competitively, but hires newbies with better salaries. He’s answered that the company’s budget for recruitment is bigger than the one for retention.

One might divide the professional world (radiological and otherwise) into upper and lower tiers. Upper folks have a seat at the table where the budgets are set and adjusted, and can do so in their own favor. Lower folks abide by the retention-budget where they work…or leverage recruitment-budgets by switching jobs.

My hope has always been to land a good gig. Wow them, earn partnership or its compensation-equivalent, and stay put for the rest of my career. That hasn’t happened. Rather than wring my hands and endure the status quo, I’ve developed a cyclical system of moving onward/upward from dead-end jobs, giving myself a raise each time:

Phase 1: Early in a Job

Maybe it’s your very first gig after training, maybe not (remember the system is a cycle, so this might follow phase 4). As a newcomer, you’re watched carefully. So make a great first impression, and give them every reason to believe they made the right decision in hiring you! Turn out better than they could have hoped, such that you prove yourself to be a “sweet deal.”

Make yourself indispensable. Go above and beyond in every way you can—which might be jarring if you’d been relaxing a bit in waning days at your previous job. Be your most professional and collegial self. Constantly be on the lookout for ways you can fulfill as many of your new group’s needs as possible. As with all good systems, this has more than one benefit: In addition to impressing your new team, some of these good habits might just “stick.” You become a better radiologist, and if this group doesn’t ultimately keep you, you’ll bring more to the table when you’re seeking a new gig in phase 4.

Meanwhile, don’t let the post-hiring scrutiny be a one-way street. Keep eyes and ears open for anything not living up to expectation. Of course that includes contractual stuff, but there were surely things said and implied during recruitment/negotiation that didn’t find their way into print. This honeymoon-period might be your best chance to get the group to honor such verbal commitments…if you let stuff slide now, it’ll be much harder to correct later.

Phase 2: Job Maturity

Things have settled down. You’ve been accepted as sufficient for your position, and are now just another member of the group. The scrutiny-spotlight has moved on from you, and is now focused on newer members of the team or other things requiring attention. You reach the compensation-ceiling I referenced in last week’s column, or soon will; there’s nothing else coming down the pike to regard with eager anticipation.

There’s also less outreach in your direction: Partners or other senior folks might no longer ask how things are going, your thoughts on the practice, etc. Whether or not such inquiries were ever genuine (as opposed to lip service). Things might still change regarding your role here, but probably not in big ways.

Don’t take this as excuse to halve your efforts. You might not be able to maintain the “look what a great new member of the team I am” pace you did in phase 1…but the more you relax it, the less reason you’re giving the group to let you above your ceiling.

In this phase I constantly reevaluate my situation. I have a mental satisfaction-thermostat. Upper extreme is “This job is a dream come true,” and bottom is “This is a nightmare, I’ve gotta get out.” Everything factors into it: Daily nuisances like software or workflow issues that never seem to get fixed, festering disappointments like “They promised X and it doesn’t look like that’s ever going to happen,” or pleasant surprises like “Wow, these folks didn’t tell me they were going to be so generous with their bonuses.”

Not everything impacting the thermostat is external. In 2011 I was fine with working 7-on, 7-off nightshifts. Enthused, even. A few years later I was glad to get back on days. A couple years after that I was pretty darned sick of having to work every other weekend. It’s not necessarily your job’s fault if you grow dissatisfied with it…be sure you give them a reasonable chance to accommodate your evolving needs.

If my thermostat remains fairly high, this might be the end of my cycle. I might stay in phase 2 forever, effectively having found an exit-ramp for my find-the-best-job system. Almost certainly if the radgroup does something like make me a partner or other equity-shareholder type. But if my thermostat drops sufficiently, it might move me into phase 3.

Phase 3: Late-Stage Job; Eyeballing the Exits

Things haven’t gone so well. Maybe the radgroup hasn’t delivered on its promises. Maybe they turn up their demands and/or cut back rewards. Maybe they develop bad attitudes towards non-partners like me. Or maybe I just happen to hear about other jobs that are offering things mine is not.

Careful with that last bit: Do not go prowling job-listings until you’re pretty sure this is a dead-end for your career and you need to move on. If there’s even a chance that your dissatisfaction is transient, refrain. Getting that job-hunting ball rolling creates an emotional momentum that can be hard to stop. Once one mentally has a foot out the door, it can become easier to leave than stay…even if that entails trading down.

The opposite is also the case: Don’t wait until you’re perfectly miserable or otherwise in a super-hurry to quit. The search for your next job will be most fruitful if you can do it under your terms, meaning that you don’t have to lunge for the first halfway-decent thing that comes along.

Let your current gig be a comfortable armchair from which you assess your other options; not an ejection-seat from a tailspinning airplane. If you know you can stay put and work more or less comfortably until just the right opportunity comes along, your chances of trading up are far greater than if you’re desperate to move on. In the armchair, you remain open to the possibility that your current gig is still better than anything you can find out there, and thus stay put until/unless that changes.

Soul-search and think about what you really want: Work-schedule, comp based on productivity versus time, onsite vs. remote, subspecialty vs. a more generalized case-mix, etc. Some of your preferences may have changed since you started your current job; take special note of them. Get a feel for which facets trump others, because it’s unlikely you’ll find a “dream job” that has it all. And be sure to include pertinent negatives: Things you’ve encountered in your current gig or priors that you don’t want to see again.

You might be tempted to let the leadership of your current group know that you’re considering moving on, giving them a last chance to fix what’s broken and retain you. I tend not to: At this point, it’s unlikely that they’ll do anything substantially favorable in response to a threat from me. Plus, as long as they don’t know I’m thinking of leaving, I can remain comfortable in my metaphorical armchair for as long as my search takes. Once they do know, they might figure they’ve got no reason to be particularly nice to me anymore, and my current job might get increasingly unpleasant.

Phase 4: The Hunt

Time to trade up! You know what you’ve got, and how it’s fallen short. You know the things you want, and how you’ve prioritized them. You’ve probably glanced at job-listings, even inquired of other rads on social media.

Now it’s time to pull out all the stops and routinely check in with every source you can think of. Cast a wide net so you don’t miss anything. I use half a dozen websites for my “rounds,” and check them every single day when I’m on the hunt. Twice, actually, since I noticed that there seem to be certain hours when a lot of recruiters post their wares. Some sites’ filters and sorting-tools are less-than, so I regularly do a general search and then a second for my interests (teleradiology for instance). I sort by recency.

With this system of daily or twice-daily checking, I immediately see what’s new since I last looked. I come to know the verbiage associated with certain jobs, even if they update their listings now and them. And I get familiar with the import of things not said.

Another important feature of looking frequently: If a particularly good opportunity turns up, you want to respond to it ASAP...because a bunch of other people will, too. Try to be one of the first rads they consider, since they might get overwhelmed and less “hungry” for later applications. Or stop responding to job-seekers entirely.

As your search goes on, take note of what’s being offered out there—even by jobs that you’ve ruled out for one reason or another. Develop a sense of the marketplace, and adjust your expectations. You might find you were expecting too much (or too little). You might yet discover that your current gig is pretty darned good by comparison—enough to push you back into phase 3 for awhile.

If you’re still in your comfortable armchair at this point, hunt as long as you can. Don’t let amazing opportunities go by, but also don’t prematurely apply and interview for gigs failing to stand out from the rest in terms of how they match your wants/needs. Take a long time aiming at prospective targets before you pull any triggers.

When you do, if at all possible aim for 2 or 3 at once; I found it surprisingly frequent that when I got one “hit,” others surfaced in my daily searches along with it. Even if one stands out above all others, it can be worthwhile to go for the second- and maybe even third-best options you’ve found recently. You can thus change the power-dynamic in your mind: It’s no longer you competing with an unknown number of other applicants for a single job, now it can be the jobs competing for you against one another.

You can even leverage one against the others when it comes to negotiating deals: “Gosh, I really like the opportunity you’re offering, but this other job I’m considering is offering similar comp with fewer nights/weekends—do you think you’d be able to reduce those?” “They’re willing to let me work from home 2 days per week; would you really need me onsite every day?” “They’re can have me 1099 or W-2; do you offer that flexibility?”

A proficient liar might be able to say exactly the same sorts of thing without having an alternative job lined up—but I suggest sticking with the truth. It’s simpler, no risk of contradicting your own story later on, some folks might detect it if you BS them…and really, do you want to chase away the best job you’ve actually found in favor of one you just made up? Remember, this is a chance for you to find a “rest of my career” job that will be your exit-ramp from this cycle.

One last word, speaking of cycles: No good system exists in a vacuum. The job-market has its own cyclical motion, and you should adjust your approach to it. Trading up is going to be a lot easier if groups are hungry for rads—especially if you got your current gig when the market was grim and they didn’t have to give you very much. If the market gets tighter, try to prolong your stay in phases 2 and 3.

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