Tag: radiologists

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Radiology Practices Feeling The National Radiologist Shortage Crunch!

shortage crunch

I can’t speak for everyone. But, nowadays, most practices throughout the country feel the pinch of an acute radiologist shortage crunch. For those on the job seeker’s side, the news right now is a mixed blessing. It is excellent for those of you searching for a job. But, once you set your career path, you may notice longer-term issues until the crisis resolves. Here are some of the problems you may encounter once you start working.

New Radiologists Making More At The Expense Of Future Earnings

Most of you probably see some of the advertisements for new radiologists on the web. Starting salaries of 400,000, 500,000, or more are not uncommon. But all this money needs to come from somewhere. Well, it is coming out of the pockets are practices, hospitals, or corporate radiology, to meet the coverage needs of the radiology work that needs completion. It just means that new radiologists are less likely to see the more significant raises they typically get when they achieve parity with the partners or own shares in the practices. Every dollar comes from somewhere!

Larger Stipends From Hospitals Means Increased Dependency

The lack of radiologists also means that hospitals are committed to ensuring that radiologists stay in the fold. Commonly, hospitals are issuing increasing stipends to practices throughout the country. Unfortunately, this process increases the dependency of radiologists on the hospital and not their work. So, when conditions change (and they certainly will at some point!), it can make it all the more painful when hospitals pull the rug out from the radiologist and stop issuing stipends upon leaner times. Eventually, hospitals are more likely to be able to take over lesser well-run practices. Too much dependency on other institutions is not ideal for the solvency of radiologists in the long run!

Unending Work And Shift Coverage

Sure, extra work is great when you are starting and are hungry for more business and money. But as you get along over time, the extra work is not so desirable. Many of you will likely have families and other obligations to which you will attend. Nevertheless, the streams of work keep on flowing to no end. And who will be covering all this work? Most likely you, whether you like it or not!

Shortage Crunch Increasing Long-Term Competition And Midlevels

I’m all for physician assistants, nurse practitioners, and other mid-levels to help the radiologist. However, suppose radiologists cannot meet the demands of the radiology world. In that case, different professionals will likely replace our roles due to a lack of ability to meet the needs of today’s imaging. These include increasing independent procedures and reads performed by these helpers. In addition, it also makes us more likely to lose work to other physicians. Cardiologists, urologists, and neurologists are just some physicians who would be happy to take over some of our business. Over the long run, this situation does not bode well for radiology practices.

More Films Going Unread And Increasing Liability

With the inability to command more staffing, more films will go unread. Patients will have more complications from a lack of appropriate imaging workups. And this can all lead to increased liability for radiology practices that are obligated to read all the films promptly. An incomplete workforce of radiologists hampers medical care and increases the potential for lawsuits!

The Shortage Crunch Continues! 

Although I do not have a crystal ball, I don’t see an abrupt end to this acute radiologist shortage crunch; The imaging loads increase every year with new technologies and the increasing age of our population. The numbers of new radiologists are not significantly increasing to meet the demands. And it takes ten years to create new radiologists starting from the beginning of medical school, so creating more radiologists is like turning a large aircraft carrier- it takes forever. Moreover, based on recent experiences with artificial intelligence, it has not replaced us or made us significantly more efficient. If these trends continue, we will continue to dive into the abyss of a shortage crunch. Good news, we’ll all be in high demand. Bad news, these pressures will probably continue for years to come!

 

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Why Do Radiologists Overall Have A High Net Worth?

high net worth

As some of you know, income is merely a snapshot of the overall financial health of the profession. On any given year, that can change on a dime. Procedure reimbursement can change. Codes can vary. And, professional or technical fees rarely stay the same.

However, most financial surveys report on physician income, ostensibly the real marker of physician economic well-being. But, what is the one long term indicator of a medical specialty’s financial health? Well, it’s going to be a long term indicator of physician savings, their net worth!

More to the point, each year, Medscape publishes the physician debt and wealth report. And, this information is more telling about the long-term state of our profession than any other survey out there. Therefore, I look at these statistics very carefully to see how we compare to everyone else out there in the medical world.

And, this year I found something interesting. On one of the last Medscape survey slides (#23 to be exact), our specialty has the highest percentage of physicians with a net worth over 2 million, tied with a few other specialties (plastic surgery and orthopedics). At the same time, we have the lowest percentage of physicians with a net worth under 500,000 dollars (slide #22). However, we are not quite at the top for the proportion of physicians over 5 million dollars (slide #4). And, on another presentation on physician income on the 2019 Medscape Physician Compensation Report, we are only tied for 5th highest mean income.

So why is it that we do not have the highest income but yet we have a higher percentage of physicians with a net worth of over 2 million dollars? Moreover, why do we have a lower portion of radiologists with a net worth of greater than 5 million dollars than many other specialties?  Let’s dig further into the weeds.

Radiologists Are Not Show-Offs

You probably know a few radiologists that drive their 100,000 dollar Tesla and live in a castle. However, overall, radiologists are not ones to take all the credit. And, from my experience, most are more humble, similar to how we need to work within our profession.  And, this personality trait more typically describes their more simple spending patterns.

What do you do if you don’t spend much on things to display to the world? You save or at least get rid of debt!

Many Years Of Good Fortune

For years, radiologists have been blessed with more and more new procedures and technology. And, each year, private insurers and the government continues to reimburse reasonably well. This pattern has become long standing for years and years. Regular salaries mean more saved wealth!

Additionally, even in the leaner times, newer radiologists could command a higher salary than most other professions out there. So, even recent grads will tend to have lower debt loads and higher net worth than other specialists.

Skewed Age Of The Measured Population

Elsewhere in the survey, you will note that the older the physician, the more net worth saved. And, the population of radiologists slightly skews to older age compared to some of the other professions. We can still work into our 70s, 8os, and even 90s (if we are lucky!) All we need is a set of glasses and some insurance credentialing, and we are good to go! Therefore, savings can take the same overall weighting as well.

We Do Not Have As Many Income Extremes

What exactly explains why radiologists less commonly have a net worth over 5,000,000 dollars compared to some of our other subspecialty brethren? At least, this is my explanation. We can’t sell eyeglasses in our offices (as some ophthalmologists do) and engage in businesses that involve patient purchases. And, we need to take all sorts of insurance to make ends meet. (Many physicians in other specialties have concierge practices that don’t!) So, as a whole, we tend not to have some of the upper extremes of income that other medical specialties can provide. Therefore, most of us do not accumulate the more substantial assets (over 5 million dollars) that other specialties more often do.

Radiologists And High Net Worth

So, these are my explanations for the overall state of financial affairs for the average radiologist in the community. Remember. Not all of us adhere to these rules. You will undoubtedly find impoverished debt-ridden radiologists as well as radiologists who live more similarly to Jeff Bezos than the typical physician. But, based on being in the trenches, these overall patterns seem to explain the survey results. Shoot me an email or message if you think differently!

 

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Do Caribbean Trained Medical Students Make Better Radiologists?

Before I begin addressing the title question of this article, I think it is essential to provide you with my background. I have gone to an American medical school (Albert Einstein College of Medicine) and have trained at all American institutions throughout my residency and fellowship.  During my time as an associate program director, I have taught mostly American and Caribbean trained medical students. Additionally, we have had a smattering of a few other scattered foreign-trained medical students in our program. Our institution has a connection to St George’s University. Also, a majority of the Caribbean medical graduates that attend our radiology residency come from this institution. So, my training and the mix of students in our program may reflect my biases. Other program directors may have different opinions based upon their own experiences and combination of residents.

In the United States, we think of Caribbean schools as a place for college graduates to go when they cannot get into an American medical school. When I first started working at Saint Barnabas Medical Center back in 2006, if you would have told me the best trainees come from Caribbean medical schools, I would have looked at you funny and said “Really?”.  However, as time went on, my biases have significantly changed. So, what are some measures of the Caribbean versus American resident quality to justify this change in opinion?

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