How Big a Target Do You Want to Be, Radiologist?

April 28, 2025

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There is something to be said for finding the sweet spot between hardwired ambition and consistent success under the radar in radiology.

When I bought my current home a little over a decade ago, it was a financial stretch. It straddled the border between “Can I do this?” and “I probably shouldn’t.” Fortunately, things worked out.

One of the aspects of the property that I could have done without was the security system. The place had multiple cameras hardwired to a nerve center to the point where nowhere outside of the house could escape monitoring/recording. I figured the seller had both wealth and paranoia that far exceeded my own, and this was the result.

Having more does make you a bigger target for thievery or other mischief. Mere appearances count in that regard. My net worth was less than 1 percent of the previous owner’s but someone looking at the house wouldn’t know that he had moved out and taken his loot with him until after they had broken in and tried ransacking the place. Thus, while I considered the system a frippery, it was a reassuring one.

Years later, I learned about another piece of his puzzle. The previous owner had made his fortune in pharmaceuticals (not “Big Pharma” but his own little operation that had created some wildly successful chemotherapy agents). He became a target on account of the animal experimentation that pretty much has to occur before you do human trials. I don’t know if PETA was specifically involved but demonstrators — some more unhinged than others — found out where he lived.

I have no reason to believe I will ever know what that is like, and I am fine with that. However, the thought did occur to me, way back when, that I was making myself a target just by pursuing a medical career.

Similar to living in a nice house, being a physician puts a target on your back. Folks believe that you have stuff to take. Not everyone understands that you might be an intern fresh out of med school who owes way more than he or she owns. Even folks savvy to that are commonly aware that you are covered by a deep-pocketed malpractice policy, and possibly other insurances (umbrella, for instance) of which they can take advantage.

Money isn’t the only thing for which we might get targeted. Before I became a rad, I remember it being a real doctorly concern that one could be eyed hungrily for meds or prescription pads that one might be carrying.

This goes beyond the tangible.; For various reasons (envy and resentment being the big two), a lot of folks are eager to go after whatever prestige we might have and take us down a few pegs. I don’t think I was even out of med school when a virtual stranger at a party decided to take me to task for all she thought was wrong with the healthcare field.

Adversity need not enter the picture. We can be targeted for “good” things as well. Folks want our time, whether it’s for our opinion on their personal medical issues or health-care-related news items of the day. Come join our website or social group, exclusively for doctors (and we will hype your participation to our sponsors)!

Some of these things were on my radar from the get-go. Others came into focus as I went on in my medical career. While I never lost sight of the “special” attention docs get in this regard, I eventually saw that nobody is really exempt from the phenomenon. The larger your profile of success or overall good living you have, the juicier a target it makes you.

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For instance, think of celebrities, high-profile politicians, and upper-rank pro athletes. They have clearly got their fans, but they also have huge numbers of detractors. They are viscerally hated by vast swaths of the population they’ve never met. That hate might only have been “earned” by being particularly good at what they do. It goes without saying that they can pour gasoline on the fire by actually doing something, like committing a fashion faux pas.

Some high-profile types do a better job of avoiding this than others. One way is to retain top-dollar publicists who know how to avoid (or squash) bad press. Michael Jordan famously refrained from offering a political statement which might have alienated half his fans: “Republicans buy sneakers too.”

Coming back down to radiological Earth, I have mentioned in previous blogs how I failed to grab some brass rings in my career this far, whether it was meaningful partnership in my first job, upper rungs of leadership ladders in subsequent gigs, and even an attempt at starting my own international telerad operation. They were, of course, disappointments at the time.

With the passage of years, however, it got more “front and center” for me that any such professional prominence would make me more of a target. Instead of just one of many thousands of rads plugging away at worklists across the country, I would become a figurehead for an entire radiological group. Now lawsuit-hungry attorneys could not only seize upon any particular case I had read, but also for any alleged misdeed in my entire organization.

Further, I would have become a potential target for other rads or non-rads in my organization. They might seek to oust me so they could try getting my position, or to influence me to make policies, decisions, etc. of interest to them. That would also go for referrers and other clients, great and small.

There is something to be said for keeping a lower profile. That even goes for comparatively mundane things like where your compensation stacks versus other rads. A bigger paycheck might be nice, but if you stand out as the best-paid rad in the group, guess who is going to be the first consideration when budget cuts are on the table.

There are shades of The Devil’s Advocate here: “No matter how good you are, don’t ever let them see you coming. Keep yourself small. Innocuous. Be the little guy.” Of course, that doesn’t feed your ego as much and there is nothing wrong with pursuing the greater rewards that come with having a bigger target painted on your back. I would just advise maintaining an awareness of that tradeoff.