Tag: RVU

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What Is Your Work Limit? Find It Before You Get Your Next Job!

work limit

I’ve written before about RVUs and how much work is too much for a radiologist. But, let’s talk about how to figure your work limit before getting into RVU numbers. And that begins right where many of you are now, in radiology residency. Don’t just assume that you will start your first radiology job and you will comfortably work your tail off to make a gazillion dollars per year for the rest of your life. It’s not sustainable. Trust me. You will never be more miserable in your life.

So, how much can you do without going batty? Well, I am going to be a little bit formulaic and give you some ideas on how to figure that out now. Don’t make the wrong decision and work for that next burnout factory!

Do Some Thought Experiments To Determine Your Work Limit

Let’s Say You Could Do Your Favorite Specialty All The Time

Let’s begin by creating an ideal job for yourself where you could do just the right amount of work. For those of you who only want to practice within a specific subspecialty like mammography, this answer should be simple. How many of these studies can you realistically read in any given day without tiring yourself out? Is it twenty, forty, a hundred, or more? The number may not be entirely exact. But, it’s an excellent starting point when you begin to look.

Start thinking in this way because, for some lucky individuals, you can pick the number of studies you want to read in your desired subspecialty. Especially in this market, you can find many lifestyle jobs in the market. Who knows, maybe you can find one of them?

Let’s Say You Could Do Some of Your Favorite Specialty Some Of The Time

For many of you out there, you want to do some work within your area of expertise. But, you would also like to practice in other subspecialties as well. So, say you opt for 25% of the work in your area of fellowship training. And, maybe, the other 75 percent you will dedicate to outside your primary discipline. In this situation, think about which areas within radiology you would like to practice outside your subspecialty. And then, come up with a particular quantity of studies that you can comfortably read in a day.

Why is it more critical to figure out the number of studies you can read outside your primary area of expertise? Well, you want to figure out the most you can bear to do in specialties that you are the slowest. And, for most, that number relies on work they are willing to perform outside of their fellowship training.

In this thought experiment, I would recommend to base this number on your experience on call at nighttime or moonlighting. And then, take that number and apply it to your next job.

Imagine What It Would Be Like On A Day Of Your Worst Nightmares

And then finally, imagine what it would be like to have to practice on a day where your worst nightmares come true. Maybe, you hate reading triple-phase CT scans for pancreatic masses (probably one of my least favorite!) Well, pick a day where you have a ton of them. How much would it take to make you want to abandon ship? Well, you need to figure that number out. Why? Because Murphy’s Law says it will happen and likely more than once. Unless you make sure that you find a practice that will guarantee that you will not get a day like that, you will experience it.  So, figure out what this number would be.

Take A Test Drive Right Now- Apply The Ideal To Reality!

Now that you have some ideas about the numbers of studies that you would like to complete, you are now ready to confirm it all with real-world experience. How can you do that as a resident or fellow? Well, pick a day at your site. And then, go through the number of cases in your specialties of choice that you decided you can complete in any given day. Try it several times to confirm that this is a number that you can handle.

Of course, later on in your career, you will pick up speed and read more studies quicker. But, at least by giving it a trial run right now, it will provide you with a general idea of what your work limit might be. Well, how did it feel? Did it match with your thought experiments? If it doesn’t, and you feel like you should be reading more or less, rinse, wash, and repeat. Readjust the number depending on your experiences. There is no better time than the present to figure it all out!

Finding Your Work Limit The Right Way!

At this point, you have a realistic idea of the number of studies that you can handle. And you can apply it to your next job search. So, when you interview, ask questions about the numbers of cases that you are expected to read.  Does it match up with what you have calculated would work for you?  If it does, keep it in mind as a potential candidate for your next job.

Burnout is a hot topic these days with many job prospects expecting way too much from their applicants. If you want to prevent it from happening to you, be deliberate when you look for your next job. And, utilize these recommendations for helping you to vet the practices you seek. Being methodical and intentional about figuring how many cases you can comfortably and safely read now can be critical to your future career happiness and success!

 

 

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How Much Work Is Too Much For A Radiologist? (Think RVUs!)

RVUs

You are excited to start your career as a radiologist. And, you are interviewing, hoping to find a job where you can make the most money and pay off your student debt. There is much more to find the correct position than just assessing the income. Of course, you should consider the location and job profile. Just as importantly, however, you also need to figure into your calculations the workload and relative value units (RVUs) you need to complete to reach that income.

Avoid the following situation: an insurmountable daily imaging workload with a queue of patient studies that never ends. A job like this is bound to end badly. But, what is an unsafe workload for you, the radiologist? Or, more accurately, when looking for a job, how many studies are too much to read daily? Let’s investigate these issues together by examining some of the markers of workload and then get to some more specifics about the appropriate RVUs for an individual radiologist.

The Lowly RVU

Before we conclude how much work is too much, we first have to define a unit of work. The essential measurement of work is the RVU or relative value unit. According to an excellent presentation on the history of insurance, the first “RVU” came out in 1992 (1). It defined a relative value unit as three different components- physician work, practice expense, and malpractice. Most of the cost/workload of the RVU relates to physician work and practice expenses.

So, who decides the cost of an RVU? The American Medical Association defined a committee called the AMA Specialty Society Relative Value Update Committee (the RUC). It consists of an expert panel of an individual from the 21 major national specialty societies, two IM specialists, one primary care practitioner, one specialist, and six additional committee members. They assign explicitly what the Medicare costs are for each procedure. (1)

Why Is The Average RVUs Per Radiologist Is Important? (And Why It’s Not!)

OK. So, we have defined what makes an RVU and who creates an RVU for any given procedure. The following important question: What is the median number of RVUs per radiologist throughout the country. Well, I found a relatively recent article in The Reading Room that reports just that. (2) To summarize, it says that the average radiologist performed 10,020 RVUs in a 2020 survey. Now that we know the average RVUs per radiologist, it’s a relatively simple step to ask the average number of RVUs per radiologist per year in any given practice. Usually, the business or practice manager can obtain the number if you ask. If you find that the number deviates significantly from the mean, perhaps, you are looking at too few or too many studies.

But wait… There’s more to the equation! Let’s say you are a neuroradiologist that reads almost exclusively high-value RVU MRIs. Perhaps, you may read them significantly quicker than a general radiologist. Then, you can probably handle more RVUs than the average radiologist. Or, let’s say you just started and have not yet picked up speed with dictating. In that case, you will likely read lower amounts of RVUs. Therefore, you have to put in your weighted factor to determine how much work is reasonable.

Why Are Daily RVUs Even More Important?

Finally, we have developed your individual optimal yearly RVU number where you should lie within a reasonable spectrum. But, it is impossible to conform to that number precisely every day in any given practice. Some days you will have more studies and others less.

To add even more variation, in some practices, the radiologists may take 16 weeks of vacation, leaving only 36 weeks to complete all the work. To make the appropriate calculation of RVUs in this sort of practice, you would need to take the individual practice’s annual RVU number and divide it by the number of days per year worked. In actuality, that yearly average total RVU number does not measure the amount of daily work. A more appropriate calculation would be the daily RVU number. Therefore, a practice with a seemingly ordinary yearly RVU number can have an exceedingly high daily RVU number.

The RVU Tipping Point

What happens when a radiologist reaches the daily RVU tipping point beyond which they are comfortable? Well, most practicing radiologists have had bad days like this at some point. (Hopefully not every day!) You cut corners; your mind drifts elsewhere; burnout ensues; eye strain develops. Not only is it a wrong place for you, but it is also terrible for patient care. Let’s try to avoid that situation as much as possible.

How Much Is Too Much?

Back to the original question again. Too much work can vary widely for any individual. But at least, you now have a feel for calculating how much is too much. So, go forth and ask about the RVU number when you interview for a job, calculate the daily RVU value and compare it with your comfortable RVU numbers. That way, you are much more likely to find appropriate work for you!

(1) http://www.rsna.org

(2) https://thereadingroom.mrionline.com/2020/11/radiologist-alary-update-2020-show-me-the-money/