The Teleradiology Information Exchange

March 1, 2021
Eric Postal, MD

Sharing the details of teleradiology companies can level the playing field for all.

I’ve previously mentioned how this column prompts people to seek my thoughts on matters teleradiological. Go figure: Write a few hundred pages on a subject, and you’ll at least appear to know something about it.

As stated in the past, I find it gratifying and flattering when I get these inquiries. They also have an interesting side-effect, a la “you cannot touch without being touched.” When someone reaches out to me like this, they invariably bring me info I didn’t have. Even if all they have to offer is their personal experience, the sharing of wisdom is a two-way street. I gain a greater understanding of what’s doing out there in the radiology world with each of these interactions.

Most frequently, these folks are trying to learn the lay of the telerad-land: How do the various players differ? Compensation is, of course, a major interest, but not the only one. Other variables include hours needing coverage, available work volume, and less readily quantified things like the infrastructure or “personality” of a given telerad entity.

It might be interesting to puzzle at how/why such an information void exists, but most people contemplating a new gig in telerad—whether changing from a previous one or leaving a more conventional brick-n-mortar job—really just want answers to their questions. And, there isn’t any one place they can go to find it all.

Regularly perusing job listings, online forums, and social media turns up details here or there. Perhaps you’re lucky and know a savvy colleague who has good nuggets of info to share. You can try contacting each of the telerad entities – or recruiters – directly, but that can be a lot of legwork, and you wind up on a bunch of mailing-lists. You also only find out about the ones who made themselves visible in the places you thought to look.

So, it occurred to me that an awful lot of rads are going it alone—fumbling around in the dark with barely a candle’s worth of light to show them the way—when a shared approach could be far more effective for everyone involved. Multiple candles = greater illumination.

Some might not need this. Their Google-fu is strong, and/or they have the time and temperament to leave no stone unturned as they gather all of the details they could want. They might prefer to hoard their information; they found it all, why let someone else benefit? (Although I suggest that, once you’ve landed the best gig you could find, you have nothing to lose by sharing its details with others.)

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For everyone else, I propose the Teleradiology Information Exchange (TIE, if you like). A central clearinghouse where rads can go to share their intel. A capable programmer or someone with money to throw at the situation might create an actual webpage for the purpose; for the time being, I simply offer my Twitter. There’s pretty much no traffic there other than what I post myself. If that ever changed, I could always make a new page exclusively for the TIE…but let’s not prematurely create a second page for me to monitor, shall we?

A simple format lends itself most easily to browsing and comparison, so I’d suggest a brief snapshot for any given telerad entity, easily fitting in a Tweet. Something like:

XYZ TeleradABC Telerad123 Telerad
1099 only1099 or W2W2 only, with benefits
Pay-per RVU ($20)Per-RVU ($26) or hourly Salaried, partnership track
Nights/weekends/holidaysAll hours needing coverageM-F daytime hours, shared call
Contracts all over USA Single state (for now) 2 states, adding more
Large corporation-ownedRad-owned groupMulti-specialty group

Obviously, real life isn’t so cut-and-dried. Tidy little templates like these leave out plenty of details in which devils may dwell. Fortunately, Twitter allows for those to be filled in via comments: A given rad would post his XYZ Telerad snapshot, for instance, and might make the first comment in the ensuing thread: “I work in XYZ right now, and here’s what I think of it…” or “I’m thinking of applying to ABC, and this is what they’re telling me.”

Others could, then, chime in with suggested corrections, additional salient details they happen to know about the telerad entity in question, or questions if they want to know more about it. The thread for a given entity could get as lengthy/detailed as participants made it…but, the tidy snapshot would never get “buried” by the chatter.

However, times do change, and next year XYZ might not match its current snapshot. It cuts the per-RVU rate to $19, for instance, or it now offers a W2-with-benefits option. Such changes would warrant someone making a new posting for it. Rather than deleting the previous one, I’d be inclined to leave it, maybe with the first comment in the new posting advising readers that this is an update, so they could see what had been said before and keep tabs on how XYZ is changing over time.

Twitter allows a page-owner to remove comments and even block visitors, so I’d definitely take action against folks displaying sufficiently trollish behavior (including repeated posting of disinformation to wrongly smear or hype telerad entities). However, the main idea is to share information, and people do develop justified strong opinions for or against rad groups. I would, thus, try to keep my moderation to minimal intrusiveness.

A benefit to all of this, beyond simply sharing information with colleagues: As things stand, with rads largely acting in an information vacuum, telerad companies have a huge advantage when it comes to setting terms. The companies know what’s doing in the field, with employees or consultants to advise them on the matter. A lone rad does not.

Thus, an outfit like XYZ Telerad can offer per-RVU rates below what the rest of the industry is paying: They have a strong recruitment machine to make more noise than the competitors, and they know that there are enough telerads out there who won’t know that there are better deals to be had. This goes away in a hurry if the vast majority of telerads have somewhere to go and see that XYZ has a bunch of competitors who are hiring with better terms.

Net result: A lot of rads wind up with better gigs, and outfits like XYZ are forced to improve their offerings if they still want to fill their virtual seats. The balance of power shifts in favor of working rads.

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