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$1mil jobs
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What Waduh has done is actually pretty easy. All it takes is hard work, the will to succeed, and a $49M trust fund.
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wadung buffet over here
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I’m self-made, no daddys money.-
What investments made you that fortune? Im genuinely curious in this stuff.
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hes just assuming his portfolio will double every __ years. which will then result in 50 mil in a few decades
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Waduh – I think from previous posts you are a mid career rad. While I agree that it would be very difficult to replicate what the SNACman has done, its not impossible to read that kind of volume for a day, particularly if it is all prelims. I couldnt do it for 26 days/month, but there may be rads out there that have the attention span for it. Also keep in mind that there are lots of younger rads that are looking at a pile of student debt with some uncertainty about the long term outlook for the field and they decide they are going to work really hard for 5 years and then see where they are at. I dont think there is anything wrong with that approach if that is how they want to live their life.
I think a more important take home message for young rads is that you have options now. You can do remote tele pay per click and make more than the private practice partners in town. You can work from 9-3 and drop off and pick up your kids so your spouse can work. If your job sucks, you dont have to make your family move in hopes that the next one will be better, but you are living across the country from your family. You have the ability to create the job you desire.
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I was just trolling him. We have a history, we troll each other often. I think I got him good this time.
I don’t care what he does. I also don’t pass any judgement on his character. I am also a hardcore capitalist.
Why would I care?
I made my nut early and invested early and often and it made me pretty well off. I still don’t feel “wealthy” but net worth $8M plus. Obviously Rad income is good also coming in and in my setup I have a LOT of time off.
I could see myself transition to Full tele from home gig at some point but I wouldn’t push as hard as SLACman since I am more about lifestyle now.
Just dividends reinvested automatically plus 401k and spouse Roth IRA I’m putting $200-250k automatically into the market every year plus any portfolio growth make it silly work very hard at this stage.
I have other issues in my life that take a lot of my attention also, my life has issues no doubt, but Rads has been good to me.
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im glad i made you nut
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wait nvm i read that wrong 😐
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Look, I come on AM.com for entertainment.
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Otherwise this website is terrible. Looks like it was from AOL days.
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dong you’re kind of mean though
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LOL
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Are there jobs that you can work after regular 8-5 job that supplement income without too much strain?
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i thought the point of becoming a radiologist was so that we wouldn’t have to work after our regular 8-5
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Flounce makes a good point as usual. I am seeing a lot of younger Rads these days who are looking to work like animals, read insane volume and make as much as possible right now. This, of course, is a challenging way to work and can lead to burn out. Perhaps it is because younger Rads feel uneasy about the future of Radiology / medicine in general.
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I feel like my experience is the opposite.
For the places I work, no one wants to work. Its impossible to staff weekends.
From my perspective, no one seems to care about making money and everyone is focused on lifestyle.-
Uncertainty about the future making one of grasp for money in the present is as old as Time and as common as dust.
I say, if a radiologist who earns in the top 1% of the wealthiest country in the world cannot unclench his heart to smell the flowers and say, “I have enough and am happy with what I have and need no more” then who ?
I think it’s a good thing that our generation as whole is more focused on lifestyle than past generations, which is not to say we should be lazy or weak or shirk our duty to God, family, and country. There’s a lot going wrong in recent times and no one would mistake us for the generation that fought and won World War II, but a focus on lifestyle and working to live rather than living to work is one trend that I think is healthy.-
yeah but then what happens to all those studies piling up in the ER.
After taking some time off and not having to work weekends or holidays, it really changed my perspective. Working weekends and holidays at this pace is awful but then again, slower pace, but adding more weekend and holidays by adding extra staff stinks also.Quote from Flounce
Uncertainty about the future making one of grasp for money in the present is as old as Time and as common as dust.
I say, if a radiologist who earns in the top 1% of the wealthiest country in the world cannot unclench his heart to smell the flowers and say, “I have enough and am happy with what I have and need no more” then who ?
I think it’s a good thing that our generation as whole is more focused on lifestyle than past generations, which is not to say we should be lazy or weak or shirk our duty to God, family, and country. There’s a lot going wrong in recent times and no one would mistake us for the generation that fought and won World War II, but a focus on lifestyle and working to live rather than living to work is one trend that I think is healthy.
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That’s just cause they don’t want to pay up.
Everyone does the $/RVU vs time off calculation in their head.
When corps and other want to low-ball, time off is worth more.
I bet if they 1.5x or 2x payment/RVU they would have no issue getting the work done.
Even a guy like me would be tempted to pick up the dictaphone more often for the right price…..
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When we increased the amount we pay for evening shift, then we were able to cover the evening shift. n=1
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there is a good chance that what will happen is that someone will do the calculation in their head that if they work those premium shifts, they can cut back on some other shifts thus overall capturing more time and also making a little tidy extra sum as well. Yes others may work more but time is a scarce commodity and many rads want to enjoy the fruits of their hard work by vacationing more, just taking it easy or doing other more interesting stuff.
Quote from Waduh Dong
That’s just cause they don’t want to pay up.Everyone does the $/RVU vs time off calculation in their head.
When corps and other want to low-ball, time off is worth more.
I bet if they 1.5x or 2x payment/RVU they would have no issue getting the work done.
Even a guy like me would be tempted to pick up the dictaphone more often for the right price…..
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The younger generation is very lifestyle focused. While there are some outliers on AM, if you talk to most younger rads they dont want to work any evenings, weekends or holidays.
However in the end a certain number of STAT studies are performed during those times. Someone has to read them, hopefully for an appropriate premium, and willingly.
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Agree.
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SNACman, if I remember correctly you used to work your tele shifts in the mornings. What prompted the shift? They paying that much of a premium for evening work?
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I have trouble falling asleep here n there so it was hard to consistently wake up on time. 8-1am fit better with my lifestyle.
also when i was working mornings, the work ended at 11am. now, if i want to stay a little longer after my shift, i can -
SNACman, have you tried Whoop? Even putting the heart rate variability science aside, just simply having an app that tracks your sleep hours and seeing those metrics about sleep quality and quantity has an effect of making you want to go to bed earlier. I just got Whoop after decades of not giving myself good sleep and ‘getting by’ , and it has helped motivate me to sleep more. It’s most useful for those who are training hard every day – e.g. multisport, running, lifting, jiu jitsu – to let you know your degree of recovery, but as radiologists, I think we can afford it for the sleep feature alone.
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Quote from golden gate
The younger generation is very lifestyle focused. While there are some outliers on AM, if you talk to most younger rads they dont want to work any evenings, weekends or holidays.
However in the end a certain number of STAT studies are performed during those times. Someone has to read them, hopefully for an appropriate premium, and willingly.
I don’t think it’s that extreme. I’m in my 30’s and every single one of my colleagues works weekends and holidays….I did change gigs to one with no evenings – but that’s just a part of the job, not something I sought out. I think there are a fair share of young rads out there who want to make good money and are willing to work hard for it. Just not q3 weekends and working midnight shifts
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Boomers and Gen X ruined the ability of millennials to earn high salaries in major metro areas because they all sold out the future of our field to private equity for a quick buck. Of course we don’t want to work for 40% less income than you did for the same amount of work and less vacation.
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yeah but no one explained that if you join a private practice group and work hard that some rads that are not working as hard benefit financially from your efforts.
Quote from Flounce
i thought the point of becoming a radiologist was so that we wouldn’t have to work after our regular 8-5
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There is something to say about taking your time with cases.
Radiology is much more enjoyable and intellectually satisfying when you are not rushing through cases.
Part-time (0.5-0.8 FTE imo) Radiology may be one of the best jobs on Earth currently.-
Quote from Waduh Dong
Part-time (0.5-0.8 FTE imo) Radiology may be one of the best jobs on Earth currently.
+1
Part time, day time radiology, where you have most all evenings, nights, and weekends off, where you are working at a reasonable pace, is a pretty sweet gig and the kind of stuff that makes med students want to become a radiologist.
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In fairness, the ones that did sell, did not sell out then next generation: they sold what they owned at a price they accepted. Yes it was detrimental to physician-owned private practice. But to see it as a sort of inheritance the next generation of radiologists are entitled, that they were robbed of, is factually incorrect and melodramatic.
If you were in their shoes and offered a 7 figure check for what is yours, youd be in your rights to sell and might well do so if it served your interests.
This pitting of different generations of radiologists against each other is unnecessary.
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Quote from Flounce
In fairness, the ones that did sell, did not sell out then next generation: they sold what they owned at a price they accepted. Yes it was detrimental to physician-owned private practice. But to see it as a sort of inheritance the next generation of radiologists are entitled, that they were robbed of, is factually incorrect and melodramatic.
If you were in their shoes and offered a 7 figure check for what is yours, youd be in your rights to sell and might well do so if it served your interests.
This pitting of different generations of radiologists against each other is unnecessary.
The Gen X/Boomer buyout is partially funded by non-buyout and new hire millennials working for 40% less income for the 5 years of their buyout vesting. That’s how this private equity model works. If no millennials joined these groups during the buyout vesting period then the group would implode before 5 years is up. That is an incontrovertible fact.
You’re also wrong on the other front. Gen’Xers who had a 7 figure check in front of them were financially foolish to accept it. Most of them are working 10-20 more years so the permanent 40% reduction income is more than the buyout (this is why the PE firms will give you that money upfront! They make a profit off you). In addition there are secondary effects of the buyout that ruin their quality of life and job satisfaction for the remainder of their careers. You can’t recruit new millennials so vacation becomes extremely tight and is reduced. The morale of these groups also goes into the basement so you dread showing up to work every day. The group also loses the incentive to work hard when every hour of work pays 40% less than it used to. Your lists grow longer and the days grow longer. You now hate your work and are headed to a divorce, subsequently losing half your 7 figure buyout to your ex-wife. Post tax and post divorce it’s probably six figures.
Was it worth it? At least now you get to come to AuntMinnie.com and complain that millennials don’t want your job or to work as hard as you. Take a look in the mirror sellouts, there’s good reason we millennials don’t want to be your slaves to fund your PE buyout retirements.
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Bluedeep, I don’t doubt you that it was a bad decision for many, but it was their bad decision to make. As for those who were within 6 months of partnership and missed out on a payout, that sucks but at the end of the day they were W2 employees and not partners. There’s no obligation for business owners to share proceeds from that sale even if those employees were doing the bulk of the work of the practice, it sucks but it’s just capitalism.
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Quote from Flounce
Bluedeep, I don’t doubt you that it was a bad decision for many, but it was their bad decision to make. As for those who were within 6 months of partnership and missed out on a payout, that sucks but at the end of the day they were W2 employees and not partners. There’s no obligation for business owners to share proceeds from that sale even if those employees were doing the bulk of the work of the practice, it sucks but it’s just capitalism.
Yes, Gen X and Boomers have the legal right to destroy the radiology job market in most major metro areas because they wanted a big check. They’re still awful people and deserve the divorces and ****ty post-buyout work environments that they created. Millennials have no obligation to work for these parasitic groups that are funding their buyouts with non-buyout labor. And if a millennial joins such a group they have no obligation to work any more than the bare minimum and they should leave work early. The buyout Gen X’ers and Boomers can stay late reading their infinitely building list due to being unable to hire.
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one thing i have definitly noticed, there are A LOT of divorced rads.
I honestly feel liek more than half of all rads i meet are divorced.-
Yeah, what’s the point of that buyout when you lose half of it to your ex? And then you’re stuck at the job you got the buyout at (with a lower salary) because if you move to a new job with higher pay your ex will come after you for an even higher alimony/child support payment.
I know many divorces that were strategically timed after the private equity sales. The schadenfreude is delightful. 🙂
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Quote from Flounce
Bluedeep, I don’t doubt you that it was a bad decision for many, but it was their bad decision to make. As for those who were within 6 months of partnership and missed out on a payout, that sucks but at the end of the day they were W2 employees and not partners. There’s no obligation for business owners to share proceeds from that sale even if those employees were doing the bulk of the work of the practice, it sucks but it’s just capitalism.
Complex situation, particularly given we live in a society where materialism/money is King. I can see how a rad that has put 25 plus years into a practice and is comfortable receiving a sweet buy-out on their way out. Biggest problem I have with this would be that they are knowingly scr*wing current associates/colleagues (and likely know PE sale was in the works when hiring these new guys)…Overwhelming sentiment in my current group is that if we are so desperate and have to hire any former legacy partners that voted to sell out to PE, they will never have voting rights. Many in my group think very lowly of these rads.
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Quote from bluedeep
Quote from Flounce
In fairness, the ones that did sell, did not sell out then next generation: they sold what they owned at a price they accepted. Yes it was detrimental to physician-owned private practice. But to see it as a sort of inheritance the next generation of radiologists are entitled, that they were robbed of, is factually incorrect and melodramatic.
If you were in their shoes and offered a 7 figure check for what is yours, youd be in your rights to sell and might well do so if it served your interests.
This pitting of different generations of radiologists against each other is unnecessary.
The Gen X/Boomer buyout is partially funded by non-buyout and new hire millennials working for 40% less income for the 5 years of their buyout vesting. That’s how this private equity model works. If no millennials joined these groups during the buyout vesting period then the group would implode before 5 years is up. That is an incontrovertible fact.
You’re also wrong on the other front. Gen’Xers who had a 7 figure check in front of them were financially foolish to accept it. Most of them are working 10-20 more years so the permanent 40% reduction income is more than the buyout (this is why the PE firms will give you that money upfront! They make a profit off you). In addition there are secondary effects of the buyout that ruin their quality of life and job satisfaction for the remainder of their careers. You can’t recruit new millennials so vacation becomes extremely tight and is reduced. The morale of these groups also goes into the basement so you dread showing up to work every day. The group also loses the incentive to work hard when every hour of work pays 40% less than it used to. Your lists grow longer and the days grow longer. You now hate your work and are headed to a divorce, subsequently losing half your 7 figure buyout to your ex-wife. Post tax and post divorce it’s probably six figures.
Was it worth it? At least now you get to come to AuntMinnie.com and complain that millennials don’t want your job or to work as hard as you. Take a look in the mirror sellouts, there’s good reason we millennials don’t want to be your slaves to fund your PE buyout retirements.
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Spot on-
Yeah its been said ad nauseum but private equity promoted s clock puncher everyone for themselves mentality. Same for employed gigs to a lesser degree. If you are getting paid the same regardless of productivity and you have zero incentive to maintain a cohesive group with camaraderie, you basically just look out for yourself. Even if RVUs bonuses are in play, you just see people cherry pick the easy high rvu studies, throw back the complex ones and avoid time consuming low rvu stufies like bilateral arthritis hand xrays. It creates a terrible work environment not to mention you arent even getting paid what you deserve not matter what you do. Throw on top of that- these PE groups typically pay IR to just do procedures and dont care if they read studies. We all know IR never earns their keep in terms of revenue for procedures , so guess who picks up the slack?
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Quote from Flounce
In fairness, the ones that did sell, did not sell out then next generation: they sold what they owned at a price they accepted. Yes it was detrimental to physician-owned private practice. But to see it as a sort of inheritance the next generation of radiologists are entitled, that they were robbed of, is factually incorrect and melodramatic.
If you were in their shoes and offered a 7 figure check for what is yours, youd be in your rights to sell and might well do so if it served your interests.
This pitting of different generations of radiologists against each other is unnecessary.
The problem I see with comments like these is that it’s not really based in reality. First off, do you really own it? If you really own it, why are you required to stay on for 5 years if you sold something you own? What about those retiring upon RP acquisition or in 1-2 years? They technically “own it” yet they receive nothing or next to nothing.
Secondly, the math is almost always break even for these deals. After your five year stint in private equity prison, best case scenario you’ve perhaps made 100-200k, not millions like some might suggest. Often times it’s breakeven or even worse if RP funny money shares are a big part of it. Those that made made more than above break even, it’s probably because the group was so understaffed that they had to work extra hours than stipulated in the original contract and made some sort of internal moonlighting money, of course at an extra time expense to the radiologist. No free lunch type of thing there.
And Dong I believe said this somehow saves a group close to implosion? Laughable. At best what it did in these groups is put a bandaid on a bullet hole. These small rural practices are not super high volume yet still need people on site. Staffing it predominantly remotely and with one onsite mammographer and onsite IR capable person really isn’t giving them the same service they had before. And this doesn’t even take into account the fact that RP can’t even given proper TAT in these situations anyway, so that point is moot. Lose that onsite mammographer or IR capable person and then what? What about vacations? Oh you’re gonna use locums? Seal Team 6 from RP? Or the ones paid market rate locums? Yeah that sounds sustainable in the revolving door that is fresh RP recruits. Hospital admin loves to see rapid turnover in their radiologists. Clinicians love it too.
A lot of superficial thoughts on these topics that sound good at first glance, but really lack any sort of deeper analysis or any longterm thinking.
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This was our experience also. We examined possibilities to sell and the accountants agreed that we would just be taking an advance on our future income in exchange for giving away our company. Yes, you get a big check up front, but then you are obligated to work at a significant discount and in the end it was in no way a big windfall, it was break even or a pittance for something that took so long to build. The only ones in favor of it were the newest rads that had only been with the group a short time. Selling made no sense. Perhaps the situations were different for others and it was much more compelling, but certainly not the deals we were seeing.
Quote from sartoriusBIG
Secondly, the math is almost always break even for these deals.
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32% yield on those RP bonds!
If it doesnt go bankrupt that would turn out to be a great investment.
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Distressed debt can be a huge money maker in the right circumstance. Look at what Howard Marks does at Oaktree. However, the companies he invests in have inherent value.
However, RP will never be the “right circumstance” because they have nothing now that the radiologist time costs more than they can charge for it.
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Quote from sandeep panga
This was our experience also. We examined possibilities to sell and the accountants agreed that we would just be taking an advance on our future income in exchange for giving away our company. Yes, you get a big check up front, but then you are obligated to work at a significant discount and in the end it was in no way a big windfall, it was break even or a pittance for something that took so long to build. The only ones in favor of it were the newest rads that had only been with the group a short time. Selling made no sense. Perhaps the situations were different for others and it was much more compelling, but certainly not the deals we were seeing.
Quote from sartoriusBIG
Secondly, the math is almost always break even for these deals.
Of course, the larger issue is that people who are closer to the money printer are able to do this because of the corrupt setup in the US. In the past, not only would this not be possible, they wouldn’t do it because of a better (moral uprightness) culture and shame about the usurious nature of it.-
I dont think the younger generation of radiologists felt like they were owed anything by partners that sold out their practices. Many of us would gladly buy into a well run private practice and pay our share of the fair market value to do so. The retiring partners could have sailed peacefully into the sunset, many of them getting to enjoy at least a piece of the golden age of radiology where they were making twice as much as they do now in dollars that were worth twice as much, and working far, far less.
Partners that sold out their practices did so purely out of greed. They all come up with justifications for doing so (coming up with money to expand, better management, better negotiating with insurance companies, etc.). And if you talk to practices that sold to RP, Envision, Lucid, and US Radiology, they all come up with shockingly similar answers, like they are being fed them by their new overlords. But, its all BS. It was done out of greed. The situation is clearly worse for the radiologists, staff, and their patients after the sale as we have seen time and time again with all of these PE backed groups.
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Quote from Alpha Angle
[b]Partners that sold out their practices did so purely out of greed. [/b]
Acting out of greed/self-interest is modus operandi in our society. I don’t think you will find any legacy partners stating they sold bc they believed it was going to be beneficial for the practice/future radiologists/field long-term-
Quote from jd4540
Quote from Alpha Angle
[b]Partners that sold out their practices did so purely out of greed. [/b]
Acting out of greed/self-interest is modus operandi in our society. I don’t think you will find any legacy partners stating they sold bc they believed it was going to be beneficial for the practice/future radiologists/field long-term
As someone in a RP group buyout partners have literally told me such things. Theyve drank the Koolaid. They thought incomes would stay the same (see the United lawsuit and Singleton Associates contract w/ higher billing rates) and being part of RP would protect them from bigger hospital chains and insurers.
Of course reality hits eventually and now they concede incomes will near go back to what they were and it is what it is. And our vacation will never go back to the amount it was presale. And we wont ever be able to recruit good radiologists again because of the RP stigma.
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I bet the RP groups in desirable markets, like Austin, can recruit fine. The rural contracts highly unlikely so RP may lose those but they may not care as long as they can staff their big purchases.
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Quote from Waduh Dong
I bet the RP groups in desirable markets, like Austin, can recruit fine. The rural contracts highly unlikely so RP may lose those but they may not care as long as they can staff their big purchases.
RP is having recruitment issues in desirable cities too. Look at how many open positions they have in ACR for Nashville, Houston, and Phoenix. That Austin group is literally recruiting for everything – 11 listings!
[link=https://jobs.acr.org/jobs/?keywords=Austin&pos_flt=1&location=&location_completion=&location_type=&location_text=&location_autocomplete=true&radius=320&kfields=pos&without_salary=1]https://jobs.acr.org/jobs…s=pos&without_salary=1[/link]
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WD has strange delusions.
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Why would you even live in a Republican state. For the women who are as educated as becoming a radiologist, they refuse to be controlled by the state and refuse to be state property.
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I remember before the RP days ARA inaustin never had to put up a single add despite suboptimal partnership track and the only way to get in was if you knew someone in the group.
Oh how times have changed. There is now even a remote job posting for work in Austin lol. -
Long thread, short attention spanI only read ER studies.
So, rp is now offering $1M?
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Quote from xraygiggles
Long thread, short attention spanI only read ER studies.
So, rp is now offering $1M?
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No….just that 1 m is actually doable if you’re willing to work your tail off. RP still not an ideal place to work. -
In PP, it would be unusual for one partner to make 1 mil while the other partners make 600-700k. That partner would have to work significantly more shifts and weekends. Not sure if there are many groups where everyone is uniformly down to crank to the point everyone is making 1 mil. Another possibility is the group could have a bunch of starting partner track rads reading >15k wrvus and making 300k.
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Quote from Umichfan
Another possibility is the group could have a bunch of starting partner track rads reading >15k wrvus and making 300k.
That doesn't exist anymore.
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Quote from Flounce
In fairness, the ones that did sell, did not sell out then next generation: they sold what they owned at a price they accepted. Yes it was detrimental to physician-owned private practice. But to see it as a sort of inheritance the next generation of radiologists are entitled, that they were robbed of, is factually incorrect and melodramatic.
If you were in their shoes and offered a 7 figure check for what is yours, youd be in your rights to sell and might well do so if it served your interests.
This pitting of different generations of radiologists against each other is unnecessary.
I think youre uninformed about how these deals worked. I agree that there is no “inheritance right” of the next generation of radiologists. However, the rads that actually made good deals did sell out the future work of the employed/non-partner rads and other employees of their groups.
Imagine a practice with 5 partners and 5 employed/partner track rads. The five partners sell the future work of 10 rads, imagine that on a much larger scale in these bigger groups, thats how you end up with deals that are indeed very lucrative for a select few. So what if a few leave, youve still transfered a portion of someone elses future income to yourself. Indeed greed and indeed selling out.
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Actually, RP was a positive for many at-risk groups. If you feel your contract is at risk, RP buyout is a good hedge. Keep in mind, many small hospitals are being bought out by large health systems, so a small group can be at risk. Small groups in small towns are where there is very high income, so even with RP cut you can still make good money plus you got lump sum upfront you can invest and shares in RP, the value of which who knows.-
But also I don’t believe it is worth working hard in Radiology once you have a sizable investment portfolio.
Prioritize time off and exercise so you can achieve some longevity. Continue to work reduced shifts and let investments grow on their own.
Ex-wife situation can mess this up for sure, as your assets will be cut in half and you will have to pay for the ex-wife and kids.
Very important to stay married if you want to benefit from compound investment growth. -
Quote from Waduh Dong
[b]Actually, RP was a positive for many at-risk groups. [/b] If you feel your contract is at risk,[b] RP buyout is a good hedge.[/b] Keep in mind, many small hospitals are being bought out by large health systems, so a small group can be at risk. Small groups in small towns are where there is very high income, so even with RP cut you can still make good money plus you got lump sum upfront you can invest and shares in RP, the value of which who knows.
Until you need to hire a new millennial partner and you have the scarlet letter of RP on your job posting – which to us means a 40% paycut from pre-buyout salaries, decreasing vacation due to chronic understaffing, and poor work culture/bad morale. There are a lot of jobs out there today. If you have RP in your job posting it’s a huge red flag and many new graduates and early career radiologists move on to the next one immediately. Combine that with being in an undesirable/rural location? LOL. Good luck.-
RP staffs the most difficult to staff locations with internal locums and tele radiology.
I’m just saying if RP want to be successful, the best way is to leverage teleradiology. In fact, the best strategy is to make teleradiology and extremely easy / desirable career choice. Most Rads would love that, most don’t want to touch a needle and would rather read in comfort with a coffee. That will cause many Rads to leave groups, the groups will collapse, and RP can get the contract staff with internal locums – telerad hybrid model.-
There are 29,250 radiologists in the US. RP employs 3,300 radiologists (none are partners in RP, they are employed as per their contract).
1762 job postings on ACR. 455 of them are RP.
So RP has 26% of all job postings on ACR and are 11.3% of the radiology workforce. This is a massive red flag. They have massive turnover and can’t fill most positions because of low pay, little to no vacation due to staffing shortages, and bad work culture.
Teleradiology doesn’t work for rural locations where you need someone to do light IR and mammo. RP positions go unfilled. Then the guys who get the buyout decide to leave. Then the group implodes and RP loses the contract to young hungry millennials who form their own private practice and start making good money again.-
Are such groups being formed? I haven’ heard any in my relatively heavy RP involved area…. perhaps Millennials aren’t into starting / running a business? I think it would be an interesting power shift if it happened, but so far I see zero evidence.-
RP will follow the path of Envision. No way RP can pay back their 2028 debt. Bond markets show RP debt trading at 45 cents on the dollar. And it keeps going down.
[link=https://finra-markets.morningstar.com/BondCenter/BondDetail.jsp?ticker=C876699&symbol=MDAS4940586]https://finra-markets.mor…amp;symbol=MDAS4940586[/link]
Yuma AZ was covered by Envision but it recently was taken over by a private practice with a large cohort of young radiologists on site. Unhappy hospitals will be eager to jump on the opportunity to no longer have to deal with RP’s chronic staffing shortages, long turn around times, and bad radiologist attitudes due to poor work culture.-
Wait, they have more money than us. That’s what one of the suits told me.
Correction, they can BORROW more money than we can.-
Quote from drad123
Wait, they have more money than us. That’s what one of the suits told me.
Correction, they can BORROW more money than we can.
Not anymore-
Look, RP has basically stopped growing and has small share of the Rad market. They are never going to take over Rads. Personally, I think we can co-exist.
RP could do some positive things in the Tele-radiology space imo.
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Hopefully the US will follow the Australian model, after a very worrying time of radiology being controlled by a couple large corporates they are significantly more private practice.
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Quote from Waduh Dong
Are such groups being formed? I haven’ heard any in my relatively heavy RP involved area…. perhaps Millennials aren’t into starting / running a business? I think it would be an interesting power shift if it happened, but so far I see zero evidence.Someone brought this up and it was discussed ad nauseum. Surprised you didn’t see it, but RP lost 5 chicagoland contracts which are soon to be in private hands if not already. Wonder if they have a multistate ambition? Look out waduh dong, they may just swipe up your contract before you have a chance to sell to RP if you haven’t already. Although, I’d prefer you to sell to RP to be honest. That way you’ll truly understand what they’ve done to radiology. The look on your face when you go to cash in your worthless RP shares would be priceless. Send us a photo when that happens.
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Quote from bluedeep
Quote from Waduh Dong
[b]Actually, RP was a positive for many at-risk groups. [/b] If you feel your contract is at risk,[b] RP buyout is a good hedge.[/b] Keep in mind, many small hospitals are being bought out by large health systems, so a small group can be at risk. Small groups in small towns are where there is very high income, so even with RP cut you can still make good money plus you got lump sum upfront you can invest and shares in RP, the value of which who knows.
Until you need to hire a new millennial partner and you have the scarlet letter of RP on your job posting – which to us means a 40% paycut from pre-buyout salaries, decreasing vacation due to chronic understaffing, and poor work culture/bad morale. There are a lot of jobs out there today. If you have RP in your job posting it’s a huge red flag and many new graduates and early career radiologists move on to the next one immediately. Combine that with being in an undesirable/rural location? LOL. Good luck.
THIS.
Anybody with half a functioning brain would not sign on with RP. Maybe in some of their less desirable localities if youre an IR, who are treated a bit better at some RP groups. Still – Scarlet letter comment is spot on.
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This was one of the rare examples where Flounce got pwned.
Flounce, the USA we currently live in is a generational war CREATED by the very people who had the great run and now are worried about no one to fund the back end of the ponzi. Someone brings that up and you label him a gen warfare guy.
This is where you lack wisdom at times, trying to be a “moderate” (when the overton window changed decades and years ago). I know you have the ability for discernment, so I expect more from you.-
Maybe. It may well be that you are wise and I am a simpleton.
It sounds to me like a bunch of wealthy physicians grousing about why they arent wealthier because other people owe them things that were never theirs.
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Quote from Flounce
Maybe. It may well be that you are wise and I am a simpleton.
It sounds to me like a bunch of wealthy physicians grousing about why they arent wealthier because other people owe them things that were never theirs.
No, and don’t fall into that type of thinking either – you have plenty of great takes, and I’m not suggesting that you don’t. But on this take, you were off, that’s all. You are missing the point of the conversation or more generally, OUR FIELD. And that is, no, people don’t “owe us” anything. Of course they don’t. But we shouldn’t talk about anything that happens in medicine if this is the case, because how dare we criticize a group of people, the business nature of it … they don’t OWE us anything, right? -
Quote from RADD2010
Why would you even live in a Republican state. For the women who are as educated as becoming a radiologist, they refuse to be controlled by the state and refuse to be state property.
What sort of gibberish is this? Do you have some point you are trying to make?
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Quote from Thread Enhancer
Quote from RADD2010
Why would you even live in a Republican state. For the women who are as educated as becoming a radiologist, they refuse to be controlled by the state and refuse to be state property.
What sort of gibberish is this? Do you have some point you are trying to make?
Distraction
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It definitely still exists. A group I recently talked to had a very similar initial offer. Not surprising they’re having a very hard time convincing anyone to take the job.
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Just read this thread and watching the banter between SNAC Man and Dong play out. I have seen a radiologist or two who hit those numbers (20 MRI/ 2 hours) without any QA issues, so I believe it is possible. My question for SNAC man (or anyone else) is how it is done. Do you have an eye where you can simply take 1 scroll and see everything? Do you have any tips or shortcuts? Do you use a head set instead of a dictaphone? How is your mouse set up and how have you arranged your keyboard shortcuts? Do you free dictate everything? Do you use a bunch of powerscribe shortcuts (e.g. “powerscribe white” for small vessel ischemic disease? ) . How (in)frequently do you take your eyes off the screen?
Any tips would be appreciated.-
Do you have an eye where you can simply take 1 scroll and see everything? [b]For the past 3 years i have been reading ER cases just about every day (20-26 days a month). Needless to say, i have become very efficient at it. I can usualy scroll once and pick up everything on a CT AP, CT head, CT C spine, or CTA chest within a few seconds. Then a few more scrolls up and down to dictate it all out. [/b]
[b]To be clear we are talking about very routine ER cases: Appys, stone studies, head CTs, C spine CTs, Wrist XRs, etc. Anything that requires more than r2 level complexity (post op cases for example) does take more time and i do not go through those quickly. [/b]
[b]IMO atleast half of ER work is negative or r1 level.
[/b]
Do you have any tips or shortcuts? [b]Read a lot. See below. [/b]
Do you use a head set instead of a dictaphone? [b]I use a podcast mic which hangs above my monitor. The mic-on/mic-off function is a side button on my mouse. [/b]
How is your mouse set up and how have you arranged your keyboard shortcuts? [b]Logitech G600. Everything is programed to it. window/level presets (lung, bone, soft tissue, and brain), measure tool, pan tool, roi tool, copy, paste, and enter (3rd mouse button). Copy/paste and Enter as side buttons is a secret hack that makes the report stuff much quicker. [/b]
[b]i play this thing like a piano when im working. I dont even know which button does what, but when im reading, my finger just knows which button to click. This is def one of the biggest secrets to reading efficiently. [/b]
[b]Also, we use rScriptor. This means we never have to make an impression. For example if i say “positive for appendicitis. Impression.” and then hit F10 (also a side button). Itll form a report that says:[/b]
[b]IMPRESSION:[/b]
[b]1. Positive for appendicitis. [/b]
Do you free dictate everything? [b]Negative reports get a negative template. Positive reports are free dictated. I usualy free dictate full reports but if im preliming a stone study and there is only 1 finding, my report may be 1 sentence. [/b]
[b]negative XR prelims for the ER may only say “no fracture” and thats it. [/b]
Do you use a bunch of powerscribe shortcuts (e.g. “powerscribe white” for small vessel ischemic disease? ) [b]No[/b]
[b] [/b]How (in)frequently do you take your eyes off the screen? [b]Almost never. I work 5 hour shifts. When im working, im pedal to the metal, full focus. No meds/Adderall/caffeine/etc (i dont drink coffee or take caffeine). [/b]
[b]I usualy nap 1 to 1.5 hours within a few hours prior to my shift so im ready when my shift starts. No eating, drinking, etc. I try not to use the bathroom (ill usualy just go before my 5 hours starts)[/b]
[b] [/b]
Any tips would be appreciated. [b]The more you power read, the easier it gets. The volume I put down now would have been impossible for me even 6-8 months ago. I think the naps pre-shift are a big help. [/b]
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Quote from theSNACman
Do you have an eye where you can simply take 1 scroll and see everything? [b]For the past 3 years i have been reading ER cases just about every day (20-26 days a month). Needless to say, i have become very efficient at it. I can usualy scroll once and pick up everything on a CT AP, CT head, CT C spine, or CTA chest within a few seconds. Then a few more scrolls up and down to dictate it all out. [/b]
[b]To be clear we are talking about very routine ER cases: Appys, stone studies, head CTs, C spine CTs, Wrist XRs, etc. Anything that requires more than r2 level complexity (post op cases for example) does take more time and i do not go through those quickly. [/b]
[b]IMO atleast half of ER work is negative or r1 level.
[/b]Do you have any tips or shortcuts? [b]Read a lot. See below. [/b]
Do you use a head set instead of a dictaphone? [b]I use a podcast mic which hangs above my monitor. The mic-on/mic-off function is a side button on my mouse. [/b]
How is your mouse set up and how have you arranged your keyboard shortcuts? [b]Logitech G600. Everything is programed to it. window/level presets (lung, bone, soft tissue, and brain), measure tool, pan tool, roi tool, copy, paste, and enter (3rd mouse button). Copy/paste and Enter as side buttons is a secret hack that makes the report stuff much quicker. [/b]
[b]i play this thing like a piano when im working. I dont even know which button does what, but when im reading, my finger just knows which button to click. This is def one of the biggest secrets to reading efficiently. [/b]
[b]Also, we use rScriptor. This means we never have to make an impression. For example if i say “positive for appendicitis. Impression.” and then hit F10 (also a side button). Itll form a report that says:[/b]
[b]IMPRESSION:[/b]
[b]1. Positive for appendicitis. [/b]Do you free dictate everything? [b]Negative reports get a negative template. Positive reports are free dictated. I usualy free dictate full reports but if im preliming a stone study and there is only 1 finding, my report may be 1 sentence. [/b]
[b]negative XR prelims for the ER may only say “no fracture” and thats it. [/b]
Do you use a bunch of powerscribe shortcuts (e.g. “powerscribe white” for small vessel ischemic disease? ) [b]No[/b]
[b] [/b]How (in)frequently do you take your eyes off the screen? [b]Almost never. I work 5 hour shifts. When im working, im pedal to the metal, full focus. No meds/Adderall/caffeine/etc (i dont drink coffee or take caffeine). [/b]
[b]I usualy nap 1 to 1.5 hours within a few hours prior to my shift so im ready when my shift starts. No eating, drinking, etc. I try not to use the bathroom (ill usualy just go before my 5 hours starts)[/b]
[b] [/b]
Any tips would be appreciated. [b]The more you power read, the easier it gets. The volume I put down now would have been impossible for me even 6-8 months ago. I think the naps pre-shift are a big help. [/b]
Good info! thx.-
That sounds awful.
Maybe a Foley just in case you may have to urinate?
What are we becoming?-
My bathroom is 5 feet from my workstation. If I have to go I go, but I just go before I start my shift.
I only work 5 hours a day so I like those hours to be as productive as possible.
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To be clear Joeblow, I dont think anyone is too skeptical of 20 MRI in 2 hours. For an experienced subspecialty reader in a short burst thats certainly conceivable.
The (potential) issue is with making 1-1.2k per hour at corp tele rates. Thats looking like 30ish CTs an hour. Even if mostly prelims thats much harder to do.
There are ways to be efficient and fast, but theres only so many standard deviations away from average speed that the vast majority of rads can do safely. As I said before, Im still open to the possibility SNAC is The Chosen One.
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Case complexity is a big component. 90% of the cases I read are r1-r2 level
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Hes young however. When I was younger I could read for more hours straight nonstop without much issue. I was hungrier back then and obviously thought I was the shiznit.
Now I am older (and richer) and if Im grinding through a very busy shift getting crushed about halfway through the shift I start thinking Why the F am I doing this to myself?
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I dont doubt the complexity issue.
I guess the next obvious question is, whats wrong with the rads reading only 12 CTs an hour for $300-400/hour at these corp rates? I suppose they unfortunately are just not the Chosen Ones.
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It takes a lot of brain work to read liek I do. I was exhausted beyond capacity for months of doing it before I adapted and can do it normally. Not many rads are really willing to go pedal to the metal if they dont have to. Its exhausting till its not
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LOL.
I suppose my last piece of entirely unsolicited advice is if there are tips you would never share to have things make sense, it might be worth considering those tips may not be a great idea.
But regardless, congrats on the efficiency and making a lot of money :). Plenty of feedback here is at least in part jeolousy Im sure!
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Why not share? If it is not unethical there is no reason not to share and help out other Rads
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Less than 3 years into an attending eh? Hope the lawsuits dont start rolling in year 3. Lawsuits dont happen instantly. Usually about a 2-3 year lag. If youre as accurate as you say at that speed, nothing to worry about. If youre average to below average accuracy at those case volumes may want to hire a legal secretary.
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No idea if they are unethical.
I just know reading 10 MRI/hour in your subspecialty sounds much more plausible to me than 30-40 CTs/hour for 5 hours in a row.
One is fast but Ive seen it done well. The other is an entirely different level of efficiency, congrats on getting to that point.
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I think 20 Neuro MR’s in 2 hours is plausible (6 min/ MR).
I have seen a few ppl do 1 MSK in 10 min (on average), but usually there are more positive findings and there is more to say.
I believe SNAC man mostly reads MSK.
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Quote from joeblow54321
I think 20 Neuro MR’s in 2 hours is plausible (6 min/ MR).
I have seen a few ppl do 1 MSK in 10 min (on average), but usually there are more positive findings and there is more to say.
I believe SNAC man mostly reads MSK.
His primary corp tele 1k+/hour job is not MSK.
The one you are referring to is his side gig.
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radsoxfan – if you REALLY want to know. DM me your name, where you work, and your number. ill tell you over the phone the secrets.
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Quote from theSNACman
radsoxfan – if you REALLY want to know. DM me your name, where you work, and your number. ill tell you over the phone the secrets.
Haha all good man, appreciate the offer though. I’m OK with keeping it a mystery.
Not interested in Corp or Tele so even if they’re genius they wouldn’t do me any good.
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no worries. most people would hate my job. i keep trying to recruit my friends, theyre not interested. for me its perfect.
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Not surprised.
I know one of the secrets is definitely legit…. working 26 shifts a month. Props there and that’s a hard pass for me.-
that is by far the biggest secret.
This month, i read every day (some were only the side gig).
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I was thinking 20 MR (10/hour) at $50-60/ RVU is $500- 600 / hour.
Not $1000/hr, but not bad.
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Something about doing it from home and by choice makes it easier for me.
I woke up today, did some errands, sushi with the fam for lunch. Bout to watch the warriors game with my daughter.
Will prob go out for dinner later, take a nap.
And when the fam goes to sleep ill bust out my 5 hours.
I feel like i had the weekend off but im really working a “full day”
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Curious what company lets you work 5 hr shifts? What are the hours and how many days a week is the minimum they let you work? Looking ahead to cutting back soon.
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i do 5 hours because i work more of them (no matter what, atleast 20 per month)
Most commonly its 7 on 7 off – 9 hour shifts
Usualy they want around 100-130 hours a month, with same shift. Cant jump around shifts.-
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So you work more than 7 on 7 off and fulfill their hourly requirements?
One of the things I want to do is shorten my shifts because I think reading for 9 hrs straight is too much and exhausting.
I also think working 7 days straight and giving up every other weekend is too much.
I would like to work 3 5-6 hr shifts a week but I have never seen something like this offered. Just trying to keep my medical license active at this point.
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you can work 3 shifts per week for us, at 5-6 hours each.
But i think we only hire for that little amount if they are going to be more weekend heavy.
No option with us for that to only be weekdays.-
^^working weekends may be the compromise I make to work that little.
Does your company have work list and productivity pressures? Is it mostly prelims?
How many licenses and hospitals does your company typically credential you at?
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no work lists. we have an auto-assinger software which gives you 3 cases at a time. When you read 1, another fills its spot. So your list always stays at 3.
There are no productivity pressures. You just need to be able to justify the cost of credentialing you, which is extremely low.
No idea, its different for everyone. Someone liek me, they credential everywhere. someone liek you, will be much less.-
Can you avoid deep nights at your practice and work say evenings, or very early mornings, weekend early mornings?
Is the pay in line with other telerad?
How did you find the company you work for? Did someone you know recommend it? Also, is it one of those big telerad companies we all know?
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the work is all set at PST time zone. We need most help around 5am-6am start time EST.
I think the pay is the best but i dont really know.
Its a big company you all know about (not vrad)-
So basically the secret is there is no secret? Just work more shifts and read more volume to make more $.
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Quote from Waduh Dong
So basically the secret is there is no secret? Just work more shifts and read more volume to make more $.
Working a lot of very high volume shifts at $500/hr would be one “secret” to a very good tele salary.
There may be an extra “secret sauce” to double that hourly rate.-
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I agree.
But feel free to compare to others reading the same prelim pan scans.
Anyone materially affecting patient care thats going faster than 99% of his or her peers should be highly scrutinized. I dont think this is particularly controversial.
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