Those Numbers You Were Going to Crunch Might Be a Little Soggy

May 30, 2018
Eric Postal, MD

Even the best calculator struggles with the reality of a radiology career.

A guy back in my residency department was of an entrepreneurial and generally financial frame of mind. He not uncommonly could be seen fiddling with a calculator, figuring ventures he’d probably love to talk about, should anyone wish to ask him. (Being house staff with more than enough to do and oft-insufficient sleep, none of us did.)

His behavior has come to mind more than a few times in subsequent years, as I’ve gone through various turns of career and personal life. Especially when contemplating some of the bigger decisions I’ve had to make-the sort that, once made, can’t easily be undone. I’ve been known to go over and over whatever data I’ve had to work with, trying to make absolutely sure that I’m making the best moves on an objective rather than subjective basis.

For instance, when I was thinking about leaving my last brick-and-mortar job in an imaging center for the world of teleradiology, I was able to break down my soon-to-be-former gig in terms of hours (per day, week, or year). I could divide my salary and other meager benefits by those hours to know what that gig was getting me. And I could kinda-sorta do the same for the telerad companies I was considering, to see how they stacked up.

The former job, I might reason, had an average workday of 9 hours, and 6 weeks of vacation. So they had me for 46 weeks x 45 hours per week = 2,070 hours per year.

The typical telerad schedule at the time was alternating 7-day workweeks, 10 hours per day. (Things have gotten more flexible in subsequent years.) So it was to be 70 hours x 26 weeks = 1,820 hours per year.

Well, hey, that was pretty cut and dried, wasn’t it? By switching to telerad, I stood to reclaim 250 hours of my life each year!
Except…not quite. The telerad deal turned out to require a certain number of extra holiday-coverage shifts each year, plus “backup” shifts during which one might or might not be required to work. Which essentially placed the rad under house-arrest. It was a little harder to specifically track those numbers.

Similarly, the brick-n-mortar job entailed a certain number of weekend hours…sometimes q5, sometimes q6. It was supposed to be half a day, but that had a way of expanding without warning. Again, the numbers were getting a little less crunchable…more like soggy, like breakfast cereal that had been allowed to sit in its milk a bit too long.

Some folks, upon reaching such moments of realization, might just shrug and give up trying to calculate everything in favor of going with their gut. Others might pursue things further. We rads do tend to be more analytical, what with our education based in the sciences. If there is a correct answer, darn it, we’re going to find whatever evidence points to it.

So we press on, at least some of us. Confronted with numbers that are more soggy than crunchable, we make estimations. Or we tell ourselves that one indefinite factor cancels out another (for instance, the weekend hours in the brick/mortar job counterbalancing the holiday and backup shifts).

The further down the number-crunching rabbit hole we go, the more soggy things seem to get. There’s data you just don’t have-for instance, heading into telerad, I had no idea how many cases I’d be able to read in a typical hour, or indeed what case mix would turn up on my worklist. While I was able to figure out my hourly income at my previous job (Salary X ÷ number of hours worked in a year), I really wouldn’t know my hourly telerad worth until I was actually doing it.

The numbers get even soggier. For my brick-n-mortar job, I was commuting. On a given day, I might spend anywhere from 30-60 minutes in my car. I also had to take a bit of time to make myself presentable in the morning before going in. With telerad, I could look as hideous as I liked-zero primping time-and my commute was a few paces to my computer. Except for when my internet might be out, and I could earn nothing until it was restored (versus an outage in the brick/mortar job, during which I could spin in circles on my office-chair and still draw a salary).

And then there are things that don’t translate into numbers at all. Like being nocturnal as a telerad, so that, yes, you have a week off at a time…but slices of that week get devoted to changing your internal clock if you want to be up and about during the day like everyone else. Or the fact that, as you’re working 26 weeks of 7 days each, half of your weekends-the days when most of your friends and family are liable to be free from their jobs-will be spent at your workstation.

Of course, few if any of such details will be a surprise to one who thoroughly evaluates a situation rather than jumping into it without a second thought. They just can’t all be punched into a calculator to arrive at a tidy sum.