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Ballpark Starting Salaries?
Hi, where can I find general info on starting full and part time salaries for: General Rads as well as Breast Imaging or Breast/Body (Women’s Imaging) positions for upcoming 2021 fellowship grads?
Obviously there it varies with geography, full time/part time status, and practice setting but wanted to get a ballpark idea. I’ve seen $350k and others boasting up to $700k potential for full time.
Thank you in advance! -
157 Replies
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Excuse me but how stupid is this question.
There is no national average.
It is so situation dependent and geography dependent.
What does part-time mean?
You should have a clue about what the market is like. Ask the fellows where you are about what sort of rangers they are expecting.
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Why are you such an ass?
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Maybe… and Bwahahahahaha!!!!! Starting at $700… in a solo practice 24/7 working out of an igloo an 11 hour sled dog ride from the next town.
A word to the wise, avoid any position that advertises “potential” compensation.
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I remember this match class of 2015 (current 2020-2021 fellows). It was the peak of unfilled pgy2 positions for radiology. 137 unfilled positions from 999 available. I recall the chief residents and a few of the faculty at my residency program had to lower the standards and expectations for this specific class as they had a tougher time covering call shifts, etc. Luckily the classes after were much better.
Congratulations to these graduating 2021 fellows! They have come a long way and can now reap their rewards!
[link=https://www.nrmp.org/wp-content/uploads/2015/05/Main-Match-Results-and-Data-2015_final.pdf]https://www.nrmp.org/wp-c…nd-Data-2015_final.pdf[/link]-
lol shots fired.
I will say that this past year CORE failure was at all time high tho.-
OP , what you listed is a sort of range for full time (or near full time) jobs after working a number of years. Most community rads will fall in that bracket. Academics can dip lower. Starting income can be around or lower than your lower number. Theres your answer.
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Flounce is correct. The higher the number, the rarer the practice.
Starting is usually not higher than mid 3s, unless rural location or desperate etc.
Academics routinely dip into the 200s. This is especially true ivory tower academics and some long partner track PP jobs.
Top end number is rare without rural location, moonlighting or high volume setting.
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I get recruiting letters, and see starting salaries for PP from $350 to $425k. The higher end are rural/less desirable locales. I think many would require prior experience to get that number. I know 5 years ago some starting salaries were at $305 or even high $200s for desirable metro PP. The market has improved but is still very local.
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Be careful about salary and compensation. I think many PP intentionally blur the two. What they put in the salary box is really compensation, meaning salary plus CME, malpractice, disability,…also throw in potential bonus that may never materalize. So you need to deduct 50k from it to get a salary number.
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11 bucks at the concessions. The girl who delivers the beers in the stands makes a pile of money in tips.
Oh, and you get free tickets for weekday games. Not a bad gig.-
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Anything is possible if you want to work 7 days a week. Numerous std dev from mean
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I started at 110k .. and got a 70k bonus.
Academic in 1997. -
Quote from dergon
I started at 110k .. and got a 70k bonus.
Academic in 1997.
Cumulative rate of inflation since 1997 is 61.3% according to the first website google came up with. So… that’d be equivalent to 290K in 2020… seems about right for academics/first year in PP with average volume.
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Quote from TheSLACman
fwiw i made about ~450 in my first 6 months as an attending. its possible but you gotta work a lot for it
Why just a 6 mo figure? Were you fired for misses or did the contract holder lose the contract for poor management?
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Quote from TheSLACman
iv only been an attending for 6 months.
robust QA (70% of cases reviewed) shows my miss rate is just about average for the group. far less than 1%
Are you implying that you are going to make 900k your first year out? LOL
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Quote from fw
11 bucks at the concessions. The girl who delivers the beers in the stands makes a pile of money in tips.
Oh, and you get free tickets for weekday games. Not a bad gig.
Well-played, sir
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There will be no difference in your lifestyle after taxes between 340-500. Go to a practice with sane administrators and partners and in a place that you can call home.
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Quote from icthrewu
There will be no difference in your lifestyle after taxes between 340-500. Go to a practice with sane administrators and partners and in a place that you can call home.
Amen. I shout this from the rooftops and the drones look at me like the clueless people they are. But more is MOAR, isn’t it? I might retire one day, supposedly, even though, I won’t
LOLOLOLOL-
Pay me you welcher
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I’m not familiar with these tax-brackets, obviously i’ve been in debt most my life never breaking more than $65,000 salary even as a fellow. So you’re saying that incomes of $400-$500k are gonna get taxed like crazy anyways- and it’s less of a tax hit if your income is $350k? So basically it evens out? Then why do people break their neck for that salary if it’s all going to taxes?
I feel $400k is a fair full-time subspecialist salary. $200 seems awfully low-
In my state:
65k – 23.9% Effective Tax Rate (37% Marginal) – 49k Take Home Pay
350k – 39% Effective Tax Rate (47% Marginal) – 213k Take Home Pay
500k – 42% Effective Tax Rate (47% Marginal) – 292k Take Home Pay
1MM – 45.2 Effective Tax Rate (49% Marginal) – 547k Take Home Pay
80k btw 350k and 500k… Impact on lifestyle, devil’s in the details and savings goals. The bigger difference for me is do you have a job with 60k in tax differed retirement contributions or one with 100k+? Do you have a job you don’t hate to point of fixating on retirement?
All of this will change, when income above 400k goes through a SS donut hole and gets assessed an additional 12% payroll tax (Employers on hook for half will respond accordingly). 401k will all essentially become Roth 401ks subject to upfront income tax with tax-sheltered growth and hopefully tax-free withdrawals. Your long-term capital gains rate will be safe if you are earning under 1MM… Oh, who am I kidding? This will get watered down on its way to President Biden’s desk.-
Biden tax Plan Highlights
Repeal the TCJA components for high-income filers
Impose 12.4% Social Security payroll tax for wages above $400k
Increase the corporate income tax to 28%
Establish a corporate minimum tax on book income
Double the tax rate on GILTI and impose it country-by-country
Temporarily increase the generosity of the Child Tax Credit and Dependent Credit-
Lets bring this back down to earth: despite some people with an unusual arrangement, aint no one gonna get $900K their first first year, probably not their last year, either.
Dont focus on income so much. Focus on the geography, then the working environment of the practice day-to-day, and stability. This things a marathon, and your focus will be building the best life both in and outside of work.
Time will be a more valuable commodity than money, as you can always have enough money but never enough time.
Live close to work, dont let your commute be long. Dont do Telerad right out of training – thats my advice. Learn some radiology first, I.e. get some experience running a service and learning from clinicians especially specialists so their needs will shape your reports.
The opportunity to spend your nights looking at a never ending stream of negative noncon heads, PEs, appendicitis, and diverticulitis is for radiology what hospitalist work is for internal medicine, a sort of well paid internship that will always be there and is not going to be a perishable skill if you are working somewhere. On the other hand, a body MR fellow who doesnt read much high level body MR for his first four years in practice is just a general radiologist. You gotta read everything, but still focus on some professional development in your niche. My colleague was on a lot of hospital committees and is now President of the county medical association, and really enjoys it. I wouldnt enjoy that stuff but its really neat to see him do it. Money is not an issue for any of us, we all have money. Not all of us lead an interesting life.
Just my 2 cents. I end up steering these discussions toward broader philosophical issues because I care about our young guns and dont want you wasting time chasing your own tail.
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OP likely will end up at a RadPartners job who will give him a high starting salary. Most rads right out of training are starving for dollars and in debt and they go chasing the highest starting salaries. Years later after they have experienced a miserable life earning those high salaries, they change to an easier job. At the end, they go part time or VA. Thats the usual pattern and job advice usually is not appreciated until mid career.
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OP likely will end up at a RadPartners job who will give him a high starting salary. Most rads right out of training are starving for dollars and in debt and they go chasing the highest starting salaries. Years later after they have experienced a miserable life earning those high salaries, they change to an easier job. At the end, they go part time or VA. Thats the usual pattern and job advice usually is not appreciated until mid career.
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You mean to say the life in PP cannot be miserable ? I had the worst time of my life in PP and I am a sub specialist. I work telerads now and will never ever go to PP. It brings out the most vicious of human traits out in the open. My radiology PP partners were the most vile and greedy human beings I have ever come across.
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Do you think it bugs people that they have to do admin stuff they probably don’t want to do? If you embrace that kind of thinking its a race to the bottom.
Esp neuro you can do a disproportionate amount of RVU. Obviously every group has some snails or lazy people but that is life. There’s no good system. If you go to a strict production model of compensation then you get cherry picking for easy cases and no one wants to do the post-op spine.
Part of offering a comprehensive service is being comprehensive, not just saying ” I will only do these 5 highest RVU value studies,” That would be like if the group said we are not going to offer IR because it’s not worth it from an RVU standpoint.
Do your best and don’t focus on what others are doing. If you do that you will be in pretty good shape.
With your pace 50-70 MR daily should be easy and considered very light for slightly less compensation than you are doing now. -
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Are your prelims one liners like “no acute process” or are they actually paragraphed reports? I have seen what I think are called prelim reports which are essentially just full reports, except someone else(another rad) looks at it and says if they agree or not? I don’t really understand the difference between a prelim and final telerad read. Is a final meant to be that a radiologist never has to look at the study again and thus is higher quality and more detailed?
The prelims that we review usually reference all the incidental stuff like fleischner etc. If it’s like that then I’m not sure how it’s any faster than a final read, you still have to talk about all the incidental stuff. Obviously this may vary per each company. -
Quote from TheSLACman
genuine question for any high volume PP rads out there.
When i was a resident i always noticed a few of the neuro/MSK guys who read tons of MRI per day (50-70). I would imagine they brought it way over a million/year for their group.
Yet when they split it all, they ended up with like 600k ish.
And then, there were, say, the peds rad in the group who would read like 50 xrays and 20 us per day, and walk away with the same 600k.
How does that not bug anyone? doesnt that factor into the RVU equation.
PP rads say “i make ___ per RVU” but do you really? when you split it with the lower producing rads in the group?
Sounds like a poorly organized department. In every large place with a peds department I have been through, peds was highly productive with a large cross-sectional volume fed by ped-onc and ped-neuro. Their reimbursement stunk because most kids in urban centers are on some kind of medical assistance or no-pay, but the peds-rads worked as hard as anyone in the group. If providing subspecialty coverage for a childrens hospital is part of the overall package, you just eat the poor reimbursements that come with it (’21cause if you don’t, someone else will). -
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Its a new take on Yankee Downunder…
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Everybody provides value. Just because the IR guy doesn’t generate as many RVUs as the neuro and MSK guys doesn’t mean he or she isn’t valuable. To have a successful practice, you need to provide certain services, and some pay better than others. I don’t think I deserve to make more since I’m MSK than the IR guy spending an hour declotting a fistula. Sure, I generate more RVUs, but that doesn’t mean I’m more important to the practice. The hospitals might not be as inclined to contract with us if it weren’t for those guys doing work that keeps patients in house.
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100% agree with that. Laziness is an entirely separate issue for which I have little tolerance.
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Quote from TheSLACman
agree and laziness hoesntly is fine if youre earning somewhat proportional.
reading 20 CT a day taking home partner income while your partners are slaving away at the list is entirely different.
atleast i know the sh*t rates im earning
I gotta say I agree with this beyond measure and by talking to several of my partners, I know several other rads who feel the same way, yet we sit idly by while true snails collect that partner income reading 15-20 CTs or performing 5 CT guided biopsies (yes for the whole day and reading nothing else). Truly astonishing the level of apathy in this specialty and I can see why many go solo/tele. I would gather that it is far more rewarding actually.
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In both scenarios, the Rad is not getting paid his/her worth. In the first scenario, corporate is taking half the $ but there is ability to make more by working more, and geographical flexibiility. In the second scenario, the rad is subsidizing the lazy partner(s) but taking much less of a haircut. However, this can be particularly troublesome in smaller groups where the haircut is larger and the effects of the lazy rad are greater.
I prefer the second scenario because the pay per work ratio is higher and generally guaranteed more vacay/better hours. In the first scenario, knowing that corporate is eating half your pay is hard to live with. And killing yourself to make PP #s gets old after awhile. -
Look, guys like slacman are working for the man. They are picking beans in the field for the dollar, like my grandmother did. Long run it’s a losing proposition, skin cancer and arthritis.
You need control your destiny.
Trust everyone, trust no one.
Trust, but verify.
Etc.
The middlemen will kill you.
My PP is inefficient and frustrating. But the amount that leaks to lazy partners palls compared to PE and corporate firms.
I’ll take it any day.
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Quote from boomer
Look, guys like slacman are working for the man. They are picking beans in the field for the dollar, like my grandmother did. Long run it’s a losing proposition, skin cancer and arthritis.
You need control your destiny.
Trust everyone, trust no one.
Trust, but verify.
Etc.
The middlemen will kill you.
My PP is inefficient and frustrating. But the amount that leaks to lazy partners palls compared to PE and corporate firms.
I’ll take it any day.Why not clip coupons when young and full of energy? Then go to pp after knocking it out of the park for a few years. 850k is nothing to sneeze at.
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Here is a thought, FIRE the lazy partners (you know, like in the real world). Rads have ZERO balls. Then you have the best of both worlds.
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Can’t just snap your fingers and fire partners.
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Quote from rayZor
Can’t just snap your fingers and fire partners.
It’s old school politics; you deal with it.
You can’t snap your fingers and get a perfect group.
But at least it’s your group. It’s a spectrum, a normalized curve.
But there are no suits skimming you.
Leakage is unavoidable, you minimize it, you can’t stop it.
That’s what mature adults understand.
Compromise. -
Invest the time and effort it takes to implement assigned worklists. No more lazy rads or cherry picking or anything else. It’s not like MBA corporate overseers are the only ones clever enough to keep the radiology trains running on time.
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Sure you can, vote them out or put them on shit rotations permanently
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Quote from Flounce
Lets bring this back down to earth: despite some people with an unusual arrangement, aint no one gonna get $900K their first first year, probably not their last year, either.
Dont focus on income so much. Focus on the geography, then the working environment of the practice day-to-day, and stability. This things a marathon, and your focus will be building the best life both in and outside of work.
Time will be a more valuable commodity than money, as you can always have enough money but never enough time.
Live close to work, dont let your commute be long. Dont do Telerad right out of training – thats my advice. Learn some radiology first, I.e. get some experience running a service and learning from clinicians especially specialists so their needs will shape your reports.
The opportunity to spend your nights looking at a never ending stream of negative noncon heads, PEs, appendicitis, and diverticulitis is for radiology what hospitalist work is for internal medicine, a sort of well paid internship that will always be there and is not going to be a perishable skill if you are working somewhere. On the other hand, a body MR fellow who doesnt read much high level body MR for his first four years in practice is just a general radiologist. You gotta read everything, but still focus on some professional development in your niche. My colleague was on a lot of hospital committees and is now President of the county medical association, and really enjoys it. I wouldnt enjoy that stuff but its really neat to see him do it. Money is not an issue for any of us, we all have money. Not all of us lead an interesting life.
Just my 2 cents. I end up steering these discussions toward broader philosophical issues because I care about our young guns and dont want you wasting time chasing your own tail.
I would think any job with such high income is likely to be productivity based as no salary will be anywhere near that amount. Would just take an extremely high level of productivity to achieve such an income.
I agree wholeheartedly about focusing on geography and valuing time over money as its a more precious resource. But what if after going through training I strongly dislike a lot of the issues that arise working in a hospital setting and have no interest in academia/research/etc…I would prefer a setting like telerads in the long run as it’s more of shift work and allows me to prioritize my time and purse outside interests. Then wouldn’t it be fitting to do telerads right out of training?
Income is going to be important to people coming out of training such as myself with such extremely high debt burdens. I know multiple people, myself included, with over $500k of student loans. With the tax brackets mentioned above and the fact that we have to pay these loans off with post-tax dollars it is extremely burdensome and leaves us little ability to save for a down payment on a house. We’ve put off gratification for over a decade and because of our debts we likely have to continue that delay for another decade. Add that to the fact that our workloads are ever increasing, reimbursement going down, and liability going up, it seems like my generation of incoming doctors were really screwed by the system.Do you have any advice/words of encouragement? Your posts are very insightful and appreciate any feedback you have.
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Using the most comprehensive data of household wealth to compare the net worth of young adults over time, they found that the typical Millennial today holds [b]41 percent[/b] less wealth than a similarly aged adult in 1989.
[link=https://www.stlouisfed.org/open-vault/2020/february/millennial-wealth-gap-smaller-wallets-older-generations]https://www.stlouisfed.or…lets-older-generations[/link]-
Quote from drad123
Using the most comprehensive data of household wealth to compare the net worth of young adults over time, they found that the typical Millennial today holds [b]41 percent[/b] less wealth than a similarly aged adult in 1989.
That’s because for the most part they are lazy bums who spent waay too much money and too much time on getting a worthless education.
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Quick and dirty math < $25/RVU, you’re certainly working for your money.
180 cases per day and 115 CT/MR per day isn’t easy, from home or otherwise.
If you can do that 6 days a week, 9 hours a day, without a vacation for 6 months straight without making a ton of mistakes or going crazy yourself… more power to you.
The vast majority of people have seen try that volume (in fewer days of work month), have crashed and burned. But there is a Gaussian curve and perhaps you are in the top 0.1%.
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Though to make 450k in 6 months at $2995 a shift….
You would have to do that exact shift 25 times a month 🙂 -
Quote from Radsoxfan
Total for the 8 hours and 55 minutes: 110 CT, 14 US, 5 MRI, 49 XR. – Assume 70% were prelims. All the MRI were final, MSK or brains.
Total earned: $2995.
Quick and dirty math < $25/RVU, you’re certainly working for your money.
180 cases per day and 115 CT/MR per day isn’t easy, from home or otherwise.
If you can do that 6 days a week, 9 hours a day, without a vacation for 6 months straight without making a ton of mistakes or going crazy yourself… more power to you.
The vast majority of people have seen try that volume (in fewer days of work month), have crashed and burned. But there is a Gaussian curve and perhaps you are in the top 0.1%.
My quick math puts that at 18-19 $ per wRVU.
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Everybody misses. PP, corporate, telerad. I don’t make a big stink about overnight misses. My partners miss, I miss. I would feel a bit on edge if I was telerad and some other rad was going to go over my work and inevitably find misses. I think we need to appreciate telerad workers more. Nobody ever calls and congratulates us on the awesome finds we make — only on our mistakes (and I am speaking about ALL radiologists).
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Quote from ChuckI
Everybody misses. PP, corporate, telerad. I don’t make a big stink about overnight misses. My partners miss, I miss. I would feel a bit on edge if I was telerad and some other rad was going to go over my work and inevitably find misses. I think we need to appreciate telerad workers more. Nobody ever calls and congratulates us on the awesome finds we make — only on our mistakes (and I am speaking about ALL radiologists).
Agreed. The person reading the telerad study the next morning also conveniently ignores the misses they would have made on some studies had they not checked what the prelim report caught. -
Quote from DonJohn
My quick math puts that at 18-19 $ per wRVU.
Mainly depends on the # non-con head CTs in there vs. body stuff. But yeah, high teens/low 20s sounds about right. If you can really crank and value the home gig, I get it.
40k+ RVUs per year is going to be a monumental task for any rad no matter what, but outliers do exist on both sides of the spectrum. -
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Sounds adventurous . Not for everyone. A sprint..40 K. Less shin splints with slow long distance run, but high risk of fracture.
Mistakes might be covered by morning rads, but its taking a big chance. Most doctors I have met made more money than they knew what do do with it and ultimately left the money for the family/ wife to deal with. Hope we can have a thread on how to spend it ! -
Quote from TheSLACman
Dont forget, its always not that busy. Cant take an extremely busy outlier shift and attribute that to every day. But yes, tele can be very busy as you service so many institutions
You have no control over the work. You are in a struggling business. It is in ownership interest that you read what you do. When it is not in their interest….you wont.
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lols
Also, how much do you think Adderall (amphetamine salts) aids in your work? Some have told me it helps them because it gives them motivation and makes their day more enjoyable. Others have told me they are faster without it because when on adderall, it makes them perseverate more on cases and they end up overanalyzing things and putting too much unnecessary detail in their reports.
And I am talking about the legal adderall prescribed for a legitimate psychiatric condition. You know, like when one shows up to the 70 y/o psychiatrist malingering and saying that they have ADHD symptoms. And then the psychiatrist asks how much of what medication is needed, and you tell him I want the 30mg adderall xr so that I can split them up into smaller doses to last me a few months. -
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Yes. I have heard vyvanse does not give a sense of euphoria like adderall does. Maybe one day, we all can take adderall to help us speed up our reads so that we can counteract the effects of getting paid so little per RVU by the corporate entities. That is where the synergy they are talking about is at.
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Quote from TheSLACman
damn youre right, i never thought about it that way. brb im quitting
Don’t you fear the tele business model? Half of revenue and all control going to suits? I do.
Private practice radiology with independent billing is the only thing holding up salaries. -
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Quote from TheSLACman
i already quit. if i PM you my CV will you consider letting me work for you? im an expert in head CTs and extremity radiographs from the ED
I don’t call those shots. I am a solo radiologist hospital employee. Towns above and below me have high compensation private practices. This keeps my income up.
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Quote from drad123
Quote from TheSLACman
i already quit. if i PM you my CV will you consider letting me work for you? im an expert in head CTs and extremity radiographs from the ED
I don’t call those shots. I am a solo radiologist hospital employee. Towns above and below me have high compensation private practices. This keeps my income up.
Just another salaried employee. I could tell from your prior posts, you didn’t have the acumen to become a partner in those towns close to you. You like to check in to work, read some studies and leave without worrying. What a millennial mentality. Shame!
Im messing with you. -
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Quote from TheSLACman
agree with the pigeonholing.
thats why iv maintained my relations with a reputable PP from my home town in CA (was ready to start on PP track but had to move cus wifes residency) and read MRI MSK every day for my local PP.
This is great
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Quote from TheSLACman
agree with the pigeonholing.
thats why iv maintained my relations with a reputable PP from my home town in CA (was ready to start on PP track but had to move cus wifes residency) and read MRI MSK every day for my local PP.
I read my own MSK cases. Thank you very much.
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Some rads are really thin-skinned.
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Quote from TheSLACman
Salty bunch
I don’t see how you could work so hard while being paid so little. I would be completely demoralized. You are either a god or a fool.
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Quote from DonJohn
Quote from drad123
Quote from TheSLACman
i already quit. if i PM you my CV will you consider letting me work for you? im an expert in head CTs and extremity radiographs from the ED
I don’t call those shots. I am a solo radiologist hospital employee. Towns above and below me have high compensation private practices. This keeps my income up.
Just another salaried employee. I could tell from your prior posts, you didn’t have the acumen to become a partner in those towns close to you. You like to check in to work, read some studies and leave without worrying. What a millennial mentality. Shame!
I offered to do my own billing. Hospital said no. All prior rads or rad groups had a hospital service contract. I am the first hospital employed rad. I am on RVU production. Pay is nice. 90th percentile or more. LOL
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Quote from DonJohn
Quote from drad123
Quote from TheSLACman
i already quit. if i PM you my CV will you consider letting me work for you? im an expert in head CTs and extremity radiographs from the ED
I don’t call those shots. I am a solo radiologist hospital employee. Towns above and below me have high compensation private practices. This keeps my income up.
Just another salaried employee. I could tell from your prior posts, you didn’t have the acumen to become a partner in those towns close to you. You like to check in to work, read some studies and leave without worrying. What a millennial mentality. Shame!
The sharp edge of a razor is difficult to pass over; thus the wise say the path to partnership is hard. Katha Upanishad
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Adderall is good if me if I am already very tired and it is causing me to slow down or miss things. If I and well rested and take Adderall, I think there is overall a net negative effect on my productivity. I become extremely accurate but sacrifice speed and efficiency. I also tend to read a negative study more times than necessary, almost in a compulsive way.
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Quote from api7342
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Quote from TheSLACman
Heres an update from my last post a few hours ago, for any who care. And based of the crazy amount of PMs, im sure there are a few.
Shift over (i left 5 mins early) becuase it picked up a lot and im drained.
Total for the 8 hours and 55 minutes: 110 CT, 14 US, 5 MRI, 49 XR. – Assume 70% were prelims. All the MRI were final, MSK or brains.
Total earned: $2995.
Drained, need a nap, canceling those brunch plans.
That level of earning is crap for that amount of work. But at the end of the day, its good money for reading from home and being done at 2pm.
for me pros outweigh the cons. For some its the other way around. fwiw id prob be happier reading half that volume being onsite than reading this much from home.
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and side note, i got a QA for “missing a stone in the distal ureter” on a L-spine CT. Its not a stone, its a phlebolith. the ureter is clear!!. QA is so ridiculous as a telerad. They think you miss everything……
SLAC-thanks for being genuine and showing your sense of humor about this entire topic (telerads vs PP) despite the flak you are getting. Its a bit amusing but revealing how those doing well in telerads elicit vehement angry defenses of top down private practice groups. A lot of responses you have gotten are driven as much by fear of not getting fresh marionettes getting into the bottom rungs of PP, as much as it is disdain that youre satisfied and successful.
The careers a lot of telerads have speak for themselves. Almost all the time, telerads fit into a good personal niche with their work. Often, they are professionally and financially successful. I have personally never met a telerad whos thrown up his/her hands and told everybody thats it for me.. back to East Bumf*ck WV to sling barium and do a breast loc.
My financial situation in the last decade + from doing reasonable work as a telerad, forming my own corp and legally deferring income could only be matched by a 650-700K/yr private practice offering 55-57K in retirement. And that is assuming a state with average taxes. In California, Ill, NY or NJ, it would take a 750-800K practice. Those private practices dont exist anymore except in E.Bumf*ck or equivalent. As one could already assume, it was better to put money into Facebook, Amazon, Netflix and Lululemon (and a couple of top end TRowePrice mutual funds) rather than state or federal gov. coffers. Most investments in the last 10 years grew like a weed.
The solo 200 + case work weekends(along with procedures), working 12 hr+ weekend days (over holidays, 3 days like this) should tell any young rad graduate to stay away from almost all PP. SLAC you are probably a high-end MSK guy who emergency doctors and Orthos value. A bad nightmare for you would be a pulmonologist complaining about a lung biopsy you did; and worst of all, having the rad chairperson mimic the complaints back to you (or else it goes to the hosp powers that be).
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Why is a solo 200+ case 12 hr weekend (with presumably lighter weekday load) bad, but doing 180 studies in 9 hours on a busier than usual day ok? I don’t get it. That’s like a weekend call, every single day.
I don’t think people are giving flak, they’re just saying if you work a lot and read a ton of studies you are going to make a lot. Most people aren’t going to work that much and read that much = less money. I don’t really think thats sustainable and numerous people have told him that but we will see. That is 3 minutes per study on average when 2/3 of them are cross sectional. Yikes
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Quote from TheSLACman
and side note, i got a QA for “missing a stone in the distal ureter” on a L-spine CT. Its not a stone, its a phlebolith. the ureter is clear!!. QA is so ridiculous as a telerad. They think you miss everything……
Is there a QA you can give back to the final reader? Why is it assumed the final reader is the gold standard on what the correct interpretation is? (I assume it’s because they are the ones paying to use the telerads service).
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I see. A rads that worked for vrad told me he’d get annoyed because he would dinged for not mentioning simple cysts in the kidney. I only mention them in maybe half my reports, so I understand the ridiculousness.
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If you are interviewing with PP groups, here are a few things that you may find helpful in maximizing your potential and value.
You could start off with a Excel-type spreadsheet. List the groups, along with weighted pros (+1 vs +2 or +3) and cons of each practice.
Some of the things you should be looking/ask for:-Malpractice: If Claims -made malpractice insurance (requiring an insurance tail) is offered, you have to contemplate what would happen if you are not offered/decline a partnership, or the partnership you were told about is altered. The fix here would be for the practice to cover your tail if you leave the practice before partnership for any reason. I know rads who were cut loose before partnership and had to pay enormous tail insurance policy post-tax up to 100K.
– If you are good at procedures or mammo, offer those services as you will be coveted. Its a win-win for both sides. However, Mammo and body/vasc interventional procedures are not the normal for imagers to take on nowadays and your wishes not to do them should be respected.
-An associate should not really start off with anything less than 375-400K . Youre top-notch educated talent, young and have the same responsibilities as partners. The groups growth is dependent on your value and you have significant student loans. As a reference point, new rads 20+ years ago were getting 300-350K out of residency/fellowship.
– Ask about weekend call of every partner and associate in the partnership pipeline. This is where the rubber meets the road about their practice. 1 in 4/1 in 5 on site weekend call-150-200+ cases/day ,10-12Hrs on site in the hospital is murder. And its 3 days of that crap in a row covering 2 to 3 holidays a year.
-Ask what the partners are earning and if you can see the contract the partners have with each other. Ask how long until the contract between the group and the hospital(s) needs to be renewed.
-Are you solely responsible for all minor IR procedures in the practice on day nights/weekendssuch as drainages, and lumbar punctures.– Question any and all buy-ins of accounts receivable nowadays. And, for that matter, having to overpay for a practice’s own imaging infrastructure, which is a rapidly depreciating asset in this environment.
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He should unscrew the blue state folks who didn’t get to deduct mortgage interest. Let people deduct it now if they couldn’t before.
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Quote from Nice Guy
He should unscrew the blue state folks who didn’t get to deduct mortgage interest. Let people deduct it now if they couldn’t before.
Why should someone in a low COL locale subsidize the homes of the rich in California and NY ?
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Quote from drad123
Biden tax Plan Highlights
Repeal the TCJA components for high-income filers
Impose 12.4% Social Security payroll tax for wages above $400k
Increase the corporate income tax to 28%
Establish a corporate minimum tax on book income
Double the tax rate on GILTI and impose it country-by-country
Temporarily increase the generosity of the Child Tax Credit and Dependent Credit
We need to eat the rich. What’s new ?
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Quote from TheSLACman
i avg 54hr week over the month, from home
Just to do the math, assuming a very generous $30/RVU rate for daytime telework. If you are making 450k in 6 months at 54 hours a week…
15,000 RVUs in 6 months
2,500 RVUs per month
580 RVUs per week (4.3 weeks per month)
10.7 RVUs per hour
No vacation
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Quote from TheSLACman
more like mid 800s
You must be holding up the deep nights for Radpartners. Unlimited volume now. That won’t last forever.
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Quote from TheSLACman
i dont work nights and i dont work for radpartners
No private practice is going to pay a new guy 850k first year.
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OP likely will end up at a RadPartners job who will give him a high starting salary. Most rads right out of training are starving for dollars and in debt and they go chasing the highest starting salaries. Years later after they have experienced a miserable life earning those high salaries, they change to an easier job. At the end, they go part time or VA. Thats the usual pattern and job advice usually is not appreciated until mid career.
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In response to your questions. Just my 2 cents: You mentioned academia / research, no one’s talking about that, we’re all talking about community practice. The volume you read in telerad for how much you make is not favorable compared to other options, and you’re just an expense on someone’s spreadsheet. Working nights is a young man’s game and not conducive to family life and personal development long term. Doing telerad does not have you working closely with your local orthopods as an MSK imager, or your local breast surgeons as a breast imager, or your Head &Neck / Neurosurgeons as a neurorad. You didn’t do a neuro fellowship to learn how to prelim traumatic SAHs faster, or a chest fellowship to find more PEs and call more pneumonia per hour. Once you ride the telerad gravy train for a bit and later decide to get out and look for a regular job, your experience and niche is either not as helpful or not appreciated, and may make it harder to get a good position in a desirable area. My group would not hire someone, regardless of where they trained, who has only done telerads for five years straight out of training, for anything other than per diem to cover some of our evenings and weekends, or sling barium or bang out the plain films. Granted, people have done telerads and then found great jobs, and good for them.
Our last star applicant, IIRC, was an MSK guy who one of our partners had known from working alongside at another group, guy had read lots of MSK for large local ortho group, did MSK ultrasound, held conferences with ortho, who insisted on having him read all the tough cases. He also did breast diagnostics including procedures, and nucs including therapies and PET/CT, didn’t have fellowship in either but was considered really good by his peers. Great attitude, ready to fill in for someone who called out sick, considered a team player. Did a good MSK fellowship but didn’t train at a top residency, but who cares. You can’t develop a reputation as a team player doing telerad, you’re just a guy who reads exams fast, exams that most rads can read.-
Flounce is on point.
Re slacman, the teleradiologist; seems like a bright, earnest, hardworking radiologist. But he still a newbie; not at it for long, and naively enthusiastic about teleradiology.
Some of us have been at this a long time; wisdom in experience.
There is empowerment in cohesive radiology practices. Teleradiologists are individualized replaceable widgets; working at the whim of employers.
The sum of the parts is greater than the whole; and the segmented parts are worth less.
There is no secure future as a teleradiologist; a ghost; a replaceable cog.
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BTW, my thoughts on Telerad above are in regards to someone coming out of training, looking for advice.
I dont mean to belittle or criticize the choice of TheSlacMan or anyone already in Telerad for whom it is a great fit. Power to you guys, if Telerad works for you and you are earning well, I am happy for you and hope you continue to do well.
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I also work from home, not productivity based though. Just ran the numbers out of curiosity. Gross around $60k on around 1300 wRVU a month (mostly ER with some inpatient and outpatient studies sprinkled in), work around 53 hours/week. I know it is a lot of hours and wRVUs but Im a young gun. Love my setup – tele isnt for everyone, but its been my dream since before I started residency.
Kudos to theSLACman, he either works harder or faster than I 🙂 I am also a fast reader, but since I am not productivity based I usually have some non-interpretative time around 20-40% on shifts when I can just chill. If I were pedal to the medal the whole shift long, probably couldnt work that many hours.
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Quote from TheSLACman
Currently on shift right now, started 3 hours and 15 minutes ago, earned $1146 so far. Not busy at all, list hovering around 2-3 CT for me.
Wife’s up with my daughter, theyre making pancakes in the kitchen one room over, will take a few mins to go have breakfast with them, then back to the grind.
stark difference compared to working in a hospital basement, eating a sabre hummus cup for breakfast because all the other food tastes like ass
tele has its cons, but it DEF has its pros
This sounds FAR better than any experience I’ve ever had working in a hospital setting. I think the pros outweigh the cons for me.
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Curious about the earned part. Do you get real time amount of money you make?
Quote from TheSLACman
yeah, if you went off AM for tele you’d think this is the worst job in the world.
update: 6 hours in, earned 1800$. cases have stopped coming, just spent 30 mins with my family finishing up TRON on disney +.
ill prob earn another 400$ in the next 3 hours and thats a typical weekend day. Done at 2pm, will go out for a brunch later probably. pancakes didnt come out that great
The “lot of weekends” of a tele job are not as terrible as working from the hospital.
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Quote from TheSLACman
yeah, if you went off AM for tele you’d think this is the worst job in the world.
update: 6 hours in, earned 1800$. cases have stopped coming, just spent 30 mins with my family finishing up TRON on disney +.
ill prob earn another 400$ in the next 3 hours and thats a typical weekend day. Done at 2pm, will go out for a brunch later probably. pancakes didnt come out that great
The “lot of weekends” of a tele job are not as terrible as working from the hospital.
Another non-RVU way to look at 450k in 6 months at 54 hours a week is…
Six 9 hour shifts a week for 26 weeks without vacation while making $320/hr.
If you’re making that to throw in ER prelim reports…. honestly that’s a great gig and don’t give it up for any PP set-up (eventually fold in some vaca before the burnout creeps in).
Don’t tell anyone where you found it either.
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‘Outpatientradsrules’ reborn !!
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Thats disappointing you cant tap the wife while on the job. :-p
Quote from TheSLACman
no quickies, take my time while dictating
and yes i know how much i earn in real time, updated 10 seconds after each case signed
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Slacman, every post is costing you $.
How much?
A quickie; what does that cost you?
Is it worth it?
Crazy.
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Quote from golden gate
Gross around $60k on around 1300 wRVU a month
So $46 per wRVU? The pro tele argument gets a lot stronger at that rate.
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Another pro is you can grab the wife for a quicki?
Quote from TheSLACman
agree. i work hard my first 6 hours, light my last 3 hours.
the shifts which are busy all 9 hours are miserable. would be unsustainable.
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Currently on shift right now, started 3 hours and 15 minutes ago, earned $1146 so far. Not busy at all, list hovering around 2-3 CT for me.Wife’s up with my daughter, theyre making pancakes in the kitchen one room over, will take a few mins to go have breakfast with them, then back to the grind.
stark difference compared to working in a hospital basement, eating a sabre hummus cup for breakfast because all the other food tastes like ass
tele has its cons, but it DEF has its pros
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At >40,000 RVUs per year, you are performing the job of about 3 radiologists.
Sounds stressful to me.-
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Removed due to GDPR request
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Quote from TheSLACman
Most months I do 27 shifts
You work twice the number of shifts a normal telerad puts in. Considering that, your reported income is not exceptional.
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I feel like I deserve a cut for having to add in missed skull fractures, intracranial hemorrhages, and other not so incidental findings when I get to work every morning. Not to mention calling providers who have already left from overnight.
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27 shifts a month is a lot of work, it took a while for that to sink in. Are they all 6am-2pm shifts? That would be a nice shift to have.
I am a partner in PP that has gone to part-time, 4 days a week usually Mon-Thurs, mostly 8:30-5pm, twice a month doing the 10am to 7pm swing shift. Averaging in the infrequent Saturday + Sunday in-house 10 hour shifts, I average around 17 days a month, one of those days being a weekend day in. The volume I’m reading in 8 hours is a fraction of what theSLACman posted, but these are final reads and not prelims i.e. do take longer. I won’t post how many screeners or CTs constitute a day’s work, but it’s not a lot. Many days over the noon hour I go lift, go to the gun range, or visit the wife, or grab a bite. I gross only half of what theSLACman posted above, and have been out of training for around 10 years.
I’d say for most people, you can’t look at number of hours worked per week between telerad and a typical job because the hours worked are different and include nights and weekends. For most people with kids, any work past 5pm or before 8am, or any work between Friday afternoon to Monday morning, is considered more onerous and has to be paid at a higher rate, or overall hours per week and per month would have to be decreased to be considered an apples to apples comparison.
It’s great that people have different sweet spots for work hours/time vs. money, such that different jobs are optimal for different people. “A butt for every seat” someone used to say.-
Who wants to work 27 days a month? Ya if you work a lot you can make a lot, even in adverse environments.
Grinding 27 days a month is literal hell for 99.999 % of all radiologists. You could work half as much and enjoy a 95% similar std of living and probably have 10x the life satisfaction but to each their own
The amount of people who want to work 27 days a month is microscopic-
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Quote from Flounce
27 shifts a month is a lot of work, it took a while for that to sink in. Are they all 6am-2pm shifts? That would be a nice shift to have.
Sounds something like 5 am-2 pm 6 days a week with no vacations. For a year…. ballpark #s are very roughly 130 RVUs per shift, 324 shifts per year, 42k RVUs per year. Sounds like more than half prelims at least.
For certain personality types it makes all the sense in the world, I certainly don’t begrudge anyone if they can pull that off. I personally have not seen many people be able to live that way but that doesn’t mean SLAC can’t. I do know someone who came out blazing after fellowship in a similar, though not quite as extreme way. Aided by ADHD diagnosis/medication. Didn’t end very well….
Apropos of nothing, there is a good 4 episode Netflix doc called “How to Fix a Drug Scandal” out recently. The star Massachusetts state crime lab chemist named Annie Dookhan was very ambitious, first one into work, last one to leave. Did 4x the work of the average chemist. I won’t spoil the ending for anyone who hasn’t seen it.
[link=https://en.wikipedia.org/wiki/Annie_Dookhan]https://en.wikipedia.org/wiki/Annie_Dookhan[/link]
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Touche!
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Well, that ought to narrow it down.
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The RVU discussion again.
Ultimately, it is about leadership. RVU’s are good for comparing same rotations, but not between rotations. Some rotations are RVUphillic.
And then quality is never brought into the equation, because some rads put out garbage; and it should be.
So, leadership needs to cut to chase. When there is incompetent leadership; chaos ensues, and those lazy rads take advantage of the situation.-
Quote from boomer
The RVU discussion again.
Ultimately, it is about leadership. RVU’s are good for comparing same rotations, but not between rotations. Some rotations are RVUphillic.
And then quality is never brought into the equation, because some rads put out garbage; and it should be.
So, leadership needs to cut to chase. When there is incompetent leadership; chaos ensues, and those lazy rads take advantage of the situation.
If one guy on the peds rotation brings in X RVUs while anyone else who covers the service brings in 2X, you may have to do something. But I found there are always ‘explanations’. You know that I am on the xyz committee, right ? Yeah buddy, that committee meets quarterly, for an hour.-
Quote from fw
Quote from boomer
The RVU discussion again.
Ultimately, it is about leadership. RVU’s are good for comparing same rotations, but not between rotations. Some rotations are RVUphillic.
And then quality is never brought into the equation, because some rads put out garbage; and it should be.
So, leadership needs to cut to chase. When there is incompetent leadership; chaos ensues, and those lazy rads take advantage of the situation.If one guy on the peds rotation brings in X RVUs while anyone else who covers the service brings in 2X, you may have to do something. But I found there are always ‘explanations’. You know that I am on the xyz committee, right ? Yeah buddy, that committee meets quarterly, for an hour.
You need leadership to sift through such nonsense.
In any business, management is what makes it work. In radiology, we don’t take that too seriously; thus we abdicate it to MBA’s, or sell out to PE.
A serious empowered radiologist could make a big difference; like Ped rad #2, don’t bullsheet me.
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Shared worklists are great if the radiologists are all team players and group culture is healthy. I knew such a group, the partners would regularly look at other peoples lists and if anyone was falling behind during the day, the others would jump in and clean them up a bit. No request needed, no payback needed, just happened automatically, and this was not a small group.
But if the rads are not team players or group culture is weak or worse, then shared worklists arent worth it as it hurts morale and is perceived as rewarding the lazy and devious, and penalizing the hardworking and conscientious.
Assigned workouts are not as efficient as shared worklists but when the latter is not possible for the reasons above, then assigned worklists are the way to go. Assigned work lists can be used to allow the fastest readers to make a little more money, for some rads to work more hours and others to work a bit fewer hours, setting it up just takes a little effort. Assigned worklists can be used to allow the tumor board presenters or hospital committee members to feel supported/compensated for their noninterpretive work that benefits the group.
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Agree with above.
If admin or bean counters only care about wRVUs and little else, then the honest rads may see their productivity fall behind expectations while the sloppy gamers are just fine.
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Such truth. We miss something every single day and it’s hard to get over that fact sometimes. As you mentioned too, we rarely get credit for a “good call.” That’s just the nature of the job though and as long as you feel you are trying your best and not being negligent/not looking at the whole study/etc. then I think it’s just the best a human can do.
That being said, one thing that has helped me is pairing every study with the indication and before closing it, make sure I look for the “can’t miss” things on it.
