Recognizing the Impact of Demand in Finding the Optimal Radiology Gig
While there is a variety of factors that may factor into one’s ideal radiology job, demand is often a key consideration.
In one of the radiology social media groups I follow, someone recently asked about the current job market: Are there jobs paying $X or above? (X was high enough above average that it was a legitimate question but not so high as to be silly.)
I can’t find the thread at the moment so the only comment I recall is my own. I quickly crunched some numbers for my per-click situation and came up with a scenario that reliably achieved X. It depended on a willingness to work exclusively deep nights at a productive rate. Just how productive would determine the number of hours needed, but for anybody but a speed demon, it would have been more than one “full-time equivalent.”
No responses came my way, but I could imagine a lot of folks answering to the effect of “I won’t do deep nights full-time,” or “I’m not that fast a reader.” There is a reason higher financial rewards are attached to such things. They are in greater demand, and bigger numbers attract people who can fulfill them.
Around the same time, for some reason I had gotten into a mini habit of listening to stand-up comedians from years past. There might be great ones out there now, but I haven’t noticed any. It seems like all the folks I found entertaining have either died, retired, or been destroyed by political correctness.
Back when it was possible to tell jokes that wouldn’t get you targeted by the cancel culture faction, one of my faves was a fellow by the name of Sam Kinison. If you were around in the 80s or early 90s, you might remember him as the guy who yelled/screamed a lot. He certainly had the lungs for it, having previously been a preacher.
One of his bits took aim at the world hunger industry. TV ads would depict malnourished folks and beg viewers for donations. Of course, a lot of those donations never quite made it to feeding folks, instead lining corporate pockets. Sam would, for instance, point out that the cameramen filming the poor kids might do better to put down their gear and hand out some sandwiches, or help the hungry folks “go live where the food is.”
“Going where the food is” could also describe a general approach to professional success and echoes the advice I gave in the social media thread. If you want to be fed/paid more than you currently are, adjust your circumstances so you will have access to more sustenance/money. That can mean working in hours or locations that others find less desirable. Heck, you might find them undesirable but the rewards of putting up with them might be worth it to you.
I recall, while I was still in radiology residency, my budding awareness of the job market, which was on a downswing but far from terrible. From my house staff perspective (salary in the low 30k range), everything I heard sounded mighty fine to me. Still, one compares prospects, and we noted a job opening somewhere in North Dakota that was offering two to three times what was advertised elsewhere.
Such high numbers put stars (or dollar signs) in our eyes, but none of us seriously considered going for them. All of the residents in my program were more interested in living elsewhere or attending fellowship than “going where the food is” for that particular payday.
Just a few years before that, while still in med school and considering which specialty I might pursue, “going where the food is” was on my mind albeit indirectly. I stretched the metaphor another step, contemplating bringing the food (AKA demand) to me. At that point, the Internet was still new to most folks and far from robust enough to support the teleradiology industry that would boom later.
Still, it seemed to me that this technology would get bigger and better, and it might not be all that long that there would be an industry in radiology that no longer required you to “go where the food is” to benefit from local wrinkles in the job market. It was one of the reasons I chose the specialty, something not lost on me when I left my last on-site job a bit over a decade later. Telerad did indeed proceed to let the food/demand come to me from all over the country.
As I mentioned earlier, this philosophy isn’t just about location. It’s not even limited to things like what days/hours one is willing to work or how productive one can be. You can broaden the scope of what you are bringing to the table in other ways. For instance, it may involve the type of work you are willing/able to do.
If you happen to be a neuro rad, maybe recently out of an academic position where you could be 100 percent in your subspecialty, clinging to that might be to your detriment. In that environment, you had enough neuro food to keep yourself sated, and maybe even now you can find jobs you like that will do the same for you.
On the other hand, if you show some flexibility and redevelop your ability/willingness to read MSK, body, etc., you can tap into a lot more of the demand that is out there. Even if you don’t need to do it right now, it can be a proactive measure, so you have more options down the line. If you enable yourself to “eat” from those other subspecialties, you won’t face hunger when a neuro famine develops, perhaps on account of too many other neuro hungry rads competing with you.
Circling back to the social media post which kicked this off, the food/demand balance you seek to fulfill doesn’t have to revolve around dollars. You can just as easily substitute in whatever else motivates you (sometimes more than one thing). The hypothetical neuro only rad might really want to continue just reading neuro. He or she might find a job that is willing to provide such a situation in exchange for less than competitive pay, or a heavier share of weekends.
Similarly, a rising number of rads are seeking “ultra flexible” telerad gigs in which they can literally jump online whenever they want to read as many cases as they like. Some jobs out there can satisfy this demand for them, but the counterbalance is that they might get a lower rate per case, or less of a guaranteed case volume. Alternatively, they might be asked to commit to reading a certain overall volume: Log in whichever hours/days you want but get at least 100 RVU per week.
Newsletter
Stay at the forefront of radiology with the Diagnostic Imaging newsletter, delivering the latest news, clinical insights, and imaging advancements for today’s radiologists.
The Reading Room Podcast: Emerging Trends in the Radiology Workforce
February 11th 2022Richard Duszak, MD, and Mina Makary, MD, discuss a number of issues, ranging from demographic trends and NPRPs to physician burnout and medical student recruitment, that figure to impact the radiology workforce now and in the near future.
Where Things Stand with the Radiologist Shortage
June 18th 2025A new report conveys the cumulative impact of ongoing challenges with radiologist residency positions, reimbursement, post-COVID-19 attrition rates and the aging of the population upon the persistent shortage of radiologists in the United States.
Burnout in Radiology: Key Risk Factors and Promising Solutions
June 9th 2025Recognizing the daunting combination of increasing imaging volume and workforce shortages, these authors discuss key risk factors contributing to burnout and moral injury in radiology, and potential solutions to help preserve well-being among radiologists.
