Radiology Salaries are Down, Now What?

April 4, 2014

Survey says radiology compensation is down from last year. Maybe we should keep that our little secret.

Surveys are an interesting interface between the objective and subjective. On the one hand, you have the often-illogical, fickle (when not downright random) attitudes and behaviors of humans being surveyed, and on the other, there is the reliable, number-crunchability of data obtained in the process. Even if one cannot fathom why the surveyed population answered as they did (I refer you to the “Family Feud” TV game-show), one can generate all sorts of science-y statistics and pictorial renditions of their responses.

People generally seem to like surveys, both for perusal of their results and for the notion that they might, by participating, have their opinions “count.” One might think that a physician, having been force-fed enough academia about the nuts and bolts of research and statistical analysis, would be less susceptible to the allure…but it seems that, given subject-matter near and dear enough, we’re not entirely jaded. (I confess to clicking more than a few times on “Game of Thrones” Facebook quizzes lately.)

So, when a survey of radiologist compensation turns up, it’s really no surprise that we’re going to pay attention. What sort of attention, and how the survey (or its results) are received, however, is a rather heterogeneous affair.

For instance, suppose I send a SurveyMonkey invite to a bunch of radiologists, asking what their salaries are. Right off the bat, I’m betting that a decent number of them aren’t even going to see the thing…my message won’t get past their spam-filters. Another substantial fraction will see the message, but is either uninterested or too busy to play with surveys, and into the virtual trash-heap it will go.

Let’s say half of the rads actually get the invite and consider participating. Some still won’t-any time there is talk online of compensation (whether annual or per case), there’s an understandable chorus of respondents who advise, ask or demand that such numbers not be discussed in a public forum. I imagine that a number of them wouldn’t be participating in my survey, on principle.

As the pool of actual respondents diminishes, it becomes more and more a case of surveying not only apples and oranges, but a veritable fruit salad. Some are reporting their salaries, while others are reporting independent-contractor earnings. Some are partners, some employees, and some locums: rads in job-markets ranging from the saturated Northeast to middle-of-nowhere towns which are desperately trying to attract talent. Neurointerventional rads covering Q2 call lumped in with general rads from outpatient imaging-centers. And I won’t even get into the phenomenon of respondents exaggerating or understating their compensation for the purpose of the survey.

So, eventually I arrive at a number, and call it the “median salary.” Perhaps I get a little fancier and break down the results by region, etc. When I present my results, what does the public do with them?

An individual radiologist might compare his own annual income with the average, and feel better or worse about himself. But what action is he otherwise going to take? If he’s below the median, is he going to be able to take the survey to his employer (or other payors) and argue that they need to give him more money? I suspect they’d laugh him out of the room.

The survey could show radiologists, as has happened this year, that their average income is dropping. This comes as no surprise, as most of them have been experiencing it firsthand. Misery loves company, so perhaps the news offers some solace, but chances are if there was anything the rads could do to prevent or reverse the trend, they would already be doing it before the survey came along and reminded them.

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There are, however, some folks out there who could take very real action based on numbers like these: the policy-makers who are ultimately behind the dropping radiology reimbursements, hospital and insurance-company executives, for instance, or governmental types. They’re looking to cut costs, maximize profits, or divvy up dollars within the healthcare system, and they’re already swamped with complex input from countless sources. Lo and behold, a tidy little survey makes headlines and offers them a quick (if overly simplified) answer: Survey says those bellyaching radiologists are still doing pretty well for themselves as compared with, say, pediatricians, a handy enough excuse to cut imaging reimbursements some more.