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That Was Then (Or Never), This Is Now


What people don’t understand about radiologists’ compensation.

A couple of columns ago, I addressed the oft-contentious issue of radiologists’ compensation for doing what they do. Some heated opinions followed, as intended (cue James Bond villain’s my-master-plan-is-revealed chuckle).

“Radiologists have it too good” attitudes, I’ve found, can generally be divided into a few major categories:

1. Envy from less-compensated physicians, or indeed non-doctors. Often fueled by a lack of comprehension of some of the factors going into what a rad earns, as mentioned in the prior column.

2. A more generalized sense of outrage that some people seem to have it better than others, whether or not by dint of their own talents, efforts, or sacrifices.

3. An erroneous perception of just how good rads have it, typically based on outdated information.

It is #3 that motivates today’s column, and indeed was exemplified in one of the more strongly-presented comments to the previous entry (although the comment did have elements of #1 and 2).

“The enormous benefits [of a rad career]…huge sign-on bonuses, paid moving expenses, receiving the maximum contribution in retirement plans, and tremendous amounts of vacation…15-16 weeks, not to mention random days off…tax free trips for CME [with implication that family comes along for a free ride]

Maybe some of this used to be the case; I can’t say for sure it never happened, or indeed isn’t happening in some corners of the globe.

What I can say is that it’s a far cry from anything I have seen or heard in the 18+ years I’ve been in the radiology field…and that doesn’t just mean my direct experience, but also what I’ve heard from friends, colleagues, the general rad grapevine, and indeed the online world of rad recruiters, who are far from bashful about hyping the benefits of the jobs they are peddling.

Sign-on bonuses and paid moving expenses? Nope, unless maybe the new job is in the middle of nowhere and they’re desperate to lure rads to their neck of the woods. Maxed matching contributions for retirement plans? Ha…the one employer I had who did match a pittance somehow managed to claw it back after he and I parted ways after I’d given over 5 years of service. Fifteen to 16 weeks vacay? The most I’ve ever gotten was 6, with one of those required to be used for CME.

And being able to deduct expenses for job-related training like CME is not at all exclusive to rads, or indeed physicians…although I hope most people aren’t deducting the cost of bringing family along on such trips. That wouldn’t hold up too well in case of an audit.

“…radiologists making over $300 an hour…most of their support staff makes around $15”

Again, maybe rads were raking in that much a couple of decades ago, but I haven’t heard of a single one doing anywhere near that well during my time in the field…unless they are at Partner level, and have a bunch of much more modestly paid rads working under them. I suspect that this appraisal of what “radiologists” receive is based on limited experience of a couple of top-dogs in a small corner of the field.

Even if more of we rads were enjoying such lofty numbers-would that be a bad thing? This gets back to a point from my previous column: When folks get around to sizing up and judging the fairness of others’ holdings and earnings, they tend not to do it in much detail, or based on a foundation of hard numbers. Instead, the response to, “Okay, how much should rads be making?” is often, simply, “Less.”

And on the subject of support staff making $15 an hour: I’m not going to go and dig up statistics for this silly little blog, but I’m pretty sure that the rad techs and anybody else with degrees, certifications, and/or significant work experience is doing better than that. Maybe not a first-job desk-clerk with a GED.

But suppose there is a legion of staff getting underpaid: Is that the fault of the radiologists cranking out cases which generate the revenue that keeps the place solvent? Or is it the managing partner of the group, who actually decides what he’s willing to pay people? Maybe even the staff themselves: If you’re getting paid less than you’re worth, maybe it’s time to find another job where you’re appreciated better.

“…others [are] working just as hard or harder than you. Many times…a radiologist [leaves] for the day [at] 4:00. Our [office staff] regularly stayed until 6 or 7 and their work was never done. The radiologist starts fresh every day with no back log.”

Once again, maybe rads used to leave early and arrive late. There are probably still part-timers who do exactly that, and get less comp as a result. Of course, Partner-level folks might take such liberties while paying themselves as if they didn’t. For the rest of us, a 9-to-5 day in a 5-day workweek would be a dream come true…as compared with our reality of 9, 10, even more hours at a clip, not to mention night, weekend, and holiday coverage.

And I’m sorry, but the claim that we rads start fresh every day without a backlog is akin to fiction writing (I won’t call it an outright lie).

I have yet to see a workplace where rads show up to begin the day without a stack of stuff waiting for them: Cases left over by the rads from the previous day, done overnight or super early in the morning. Or tasks that don’t generate “productivity” stats (ergo, not an additional penny for the rad): Requests for addenda to previously read cases, or calls to referring clinicians for discussion. Cases to be reviewed for QA. L&C paperwork. Other administrative stuff.

“Radiologists…never seemed to appreciate the support staff…the times are changing…computer[s] will probably take over the radiologists’ jobs…I wouldn’t be too cocky about how much you’re worth. You’d probably be wise to learn some other skills.”

Pot, meet kettle. Support staff make their living off of revenue generated by the radiologists who are able to employ them. This seems to wish for the hand that fed them to get bitten, hard. Maybe they feel underappreciated, but they certainly don’t sound appreciative of the rads.

Oh, and don’t worry about us one-trick-pony ol’ rads. Judging from CAD (computer-aided detection) in mammo and chest X-ray, we’ve got a loooooong way to go before we’re being replaced, en masse, by automation. I think we’ll continue to do just fine.

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