Question About High Salary/Patient Contact
Dr. Julius, I read the article you wrote last year on how to choose a fellowship. Have you any new insights since then? Also, could you help me narrow down my specialty?
What I am looking for: a very high salary, independence, being able to work from home would be a luxury, minimal patient contact, be a specialist.
My background: I finished two years of general surgery and switched to radiology. R1.
Thanks for starting this website,
Unsure Resident
Answer:
Hi,
I’m glad you have developed specific criteria for what you require in a fellowship. Often, that can be the hardest part. Of course, I wouldn’t tell the folks interviewing you that you would want minimal patient contact unless you know the interviewers well. Radiology 3.0 has become part of the vocabulary of most academic departments. And that implies some patient care — just a word of warning. But, between you and me (and the wall), we both know that not all subspecialties carry the same amount of patient interaction! So, which specialties have less contact? Most of the pure imaging subspecialties are without procedures. MSK or Neuro would be specialties more likely to have less patient contact.
High Salary Issue
Returning to the main question, which fellowship should you choose? Let’s start with the first criterion, a very high salary. Unfortunately, compensation is more tied to the number of reads and the location where you work than the type of fellowship you do. And, every year, the benefits of any given modality can change. For example, at one point, interventional radiology was the highest-paying specialty per procedure. Now, it generally pays less than most others. Currently, MRI probably reimburses better than most other studies. However, you would be chasing a moving target if I were to tell you that it would remain the same.
Independence Issue
Regarding independence, you ultimately rely on your referrers and patients, so you are never truly independent. But, if you want to become a group of 1, something like teleradiology would enable you to get your business paid with a 1099 form instead of a W-2. Also, teleradiology would allow you to interpret films as much or as little as you want. So, theoretically, you can “create” your desired high salary if you’re going to read like crazy! Additionally, teleradiology would naturally allow you to work from home.
Summary
So, there you have it. Based on your criteria, a possibility would be a teleradiologist specializing in MRIs such as MSK, body MRI, or neuro MRI. However, the two things that you failed to tell me were whether you wanted to work late hours or what procedures you enjoyed the most. You should probably consider that in this “equation” as well. Let me know what you think!
Regards,
Barry Julius, MD
