The Other Side of the Coin: Sticking Out Like a Not-Sore Thumb

Eric Postal, MD

What does it take to stand out from your crowd of peers?

I’ve mentioned before how my online presence has resulted in radiologists reaching out to communicate with me. Sometimes to pick my brain, sometimes to offer their thoughts. It’s usually regarding teleradiology since that’s one of my major themes in this column.

Mostly, it’s been rads seeking work. They’ve been in conventional onsite jobs, or haven’t yet finished training, and are thinking of doing tele, but wisely want to gather intel before taking the plunge. Or they’re already in telerad, but want to know more about the virtual world before they venture out from the small corner of it with which they’re familiar.

Once in a blue moon, I hear from someone on the other side of the coin: A rad in leadership or even ownership position. Could be they are less inclined to reach out, but it’s also a simple matter of proportion that there are fewer folks at that level than the general worker-bee rads.

This past week, I was communicating with such a group leader. He offered a counterpoint to the not-uncommon complaint offered by many worker-rads, that they are stuck in the role of being mere “film readers” with no real chance of ascending to positions of greater authority. From his perspective, he’d been disappointed over the years by several rads who’d joined his group expressing such high hopes…but then proceeded to act as pure film readers, not going above and beyond in any way.

Longer-term readers of this column will recall that I’ve written more than a couple of times about the all-too-common phenomenon of rad groups which give lip-service to offering promotions to new members who prove themselves worthy…partnership, shareholding, leader positions, etc…but never actually deliver. Whether because the original promises were in bad faith, or because human nature asserts itself and they find excuses to ultimately withhold what was reasonably earned.

Maybe the leader-rad mentioned above was truly let down by his recruits, or maybe they did everything they reasonably could have, and it was just easier to dismiss their efforts than to promote them when the time came; I have no way of knowing. Just like a rad joining a group has no way of knowing how his affiliation with them will pan out; to some degree, there’s always a leap of faith.

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Regardless, if one has aspirations to receive something above and beyond the norm (higher rankings, better comp, special accommodations), one should expect to bring above-and-beyond things to the table.

I think this is where a lot of rads (and probably folks in other professions) go wrong. If your “above and beyond” boils down to performing your routine tasks better than those around you, it’s not going to stand out much. So what if you do a few percentage points better than other rads around you in terms of RVU productivity or QA accuracy? If someone is even watching your stats to appreciate it, your incremental superiority isn’t a game-changer for the group. Sure, they’ll want to keep you around…but how much extra are you really worth to them that they might substantially reward you? And what guarantee do they have that your performance won’t slip in the future?

Further, how can they even know that you’ll perform that well when interviewing in the first place? Anybody can say that they read a lot of studies and are very accurate. When I knew I was going to leave vRad for greener pastures, I took the trouble to mine my data and produce spreadsheets showcasing how many studies I read in a typical hour, day, week, etc. Bully for me; I, thus, had documentation showing that I was more productive than the average rad, but a prospective employer could easily look over those pages and assume that I’d fudged those numbers to make myself look good.

The stronger play is to bring something (or, preferably, things) to the table that most of your peers/competitors won’t have. Any rad out of training is going to generate RVUs with some measure of accuracy…but, what if you boast something the rest of the pack tends not to have? An extra credential, like an MBA. Connections with professional-society leaders, hospital or insurance-company muckety-mucks. Even politicians.

Maybe you don’t happen to be so fortunate as to have such a quasi-superpower in your back pocket? You can still develop one. Some more easily than others. Learn to read studies that other rads won’t. Be the rad who can take care of the PET on the list that nobody else knows how to read. Virtual colonoscopies, prostate MR, etc.

Even some basic patterns of behavior can make you stand out from the crowd. The leader-rad mentioned above, for instance, lamented that the recruits hoping to be more than film-readers wouldn’t even do things like staying later to clean up the worklists when busy days struck.

So, imagine if you were in that practice, a call for such help went out, and you made a point of sticking around while everyone else went home because they “can’t do it today.” Forget about standing a few percentiles taller, RVU production-wise, and hoping someone will notice the tiny difference—if everyone else goes home and you stay to save the day, you’re not a slightly-taller tree in the forest, you’re the only one left standing.

That cuts the other way too, of course: It doesn’t take much bad behavior to stick out like a sore thumb, in a way you don’t want to. Showing up late, leaving early, failing to return calls/messages, acting disagreeable…making yourself memorable in a bad way can rapidly deplete whatever good political capital you’ve amassed.

Follow Editorial Board member Eric Postal, M.D., on Twitter, @EricPostal_MD.