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  • PE salary question

    Posted by hmurphy10 on August 19, 2023 at 1:53 pm

    I’m a new fellow looking for jobs and have talked to a few PE practices in different areas of the country. I haven’t done any formal interviews yet but from preliminary phone calls I’m getting quotes of mid 500s starting, 1-2 years to partner, and mid 600s as a partner with 8-12 weeks of vacation. To me these numbers sound really good.
     
    However from browsing this forum and talking with attendings and colleagues it sounds like these numbers are not realistic. So my question is how are these practices offering these numbers? Would these numbers change significantly when I sign the actual contract? Say that I sign a contract with these numbers, would there any way for them to change my compensation or vacation after I join the group? 

    buckeyeguy replied 11 months ago 17 Members · 58 Replies
  • 58 Replies
  • g.giancaspro_108

    Member
    August 19, 2023 at 2:11 pm

    Congratulations on finishing your residency and your upcoming entry into the attending world.
     
    I think you know the answers to your questions already, but just as a reminder to anyone else, there are many excellent discussions of this topic in this forum where you’ll get many good answers, and some not good ones.
     
    First, I guess I should say that there are many different PE groups and even within specific PE groups (like RP for example) there are many different practices with different types of positions, demands, compensation, etc.  So YMMV.
     
    To answer your question, yes the numbers could change significantly after you sign your contract.  Unfortunately we have seen many instances of radiologists that have a contract with a PE group and the terms are changed unilaterally.  Of course it may be a violation of your contract, but how many lawyers do they have and how many can you afford, and to what end?  They know the contracts are nearly meaningless against them and only truly useful against you.
     
    Where does the money come from? (you)  Who pays the PE group? (you) How is the money generated? (you) 
     
    You can find some positions, onsite at a difficult to fill rural hospital, where you the radiologist can get a decent position making good $/RVU because your PE owners want boots on the ground there.  You may be a loss-leader for them in that position, but it is ok because they make it up on the many other positions where they are taking 30-40% of the radiologists’ earnings.
     
    Sure you can make 650 as a “partner” in a PE group, but for the volume you’re typically reading to generate that you could be earning 1M in a private group. 
     
    There is no free lunch.  Do your research, which it sounds like you are doing, and vet any potential jobs seriously.  IMHO there is no reason for a well qualified radiologist just finishing training to take a PE position.   
     
     

    • reza800p_368

      Member
      August 19, 2023 at 2:50 pm

      Those numbers are high for PE unless you kill yourself. 

      Many jobs advertise that way. But later they claim that you have not read enough to quality for bonus or they deduct many expenses from those numbers.

      Just to give you an idea. In desirable locations the teaching hospitals pay better than PEs for a typical work schedule. You can see how much your attendings make to have a reference point. Now if you work 80 hours a week, that’s a different story.  

       

      • reza800p_368

        Member
        August 19, 2023 at 2:53 pm

        PE is the button of radiology jobs. Most of them pay the least per RVU. 

        Being an employee of a hospital system is not great but still is better than PE. At least you have a future.

        The main problem with PE Jobs is its future. For example, if next year the market becomes tight again, they can reduce your pay/study by 20% over night and you don’t won’t any power to confront it. 

        • lisa.kipp_631

          Member
          August 19, 2023 at 6:23 pm

          I signed with a PE group prior to graduating. I had to hear from the grapevine that the PE group added on a bunch of contracts and what would have been a normal volume job was now brutal. I bailed and the group is floundering. I have never regretted that decision. YMMV.

          • Unknown Member

            Deleted User
            August 19, 2023 at 7:50 pm

            Also, once you get suckered, your subspecialty specific, daytime role at the main hospital in the city you were expecting has a good chance of morphing into 60% fluoro at some site 70 miles away. They may reimburse for gas if you meet their criteria. You could be the medical director there! Tack on 1 week per month of onsite late evenings, regular forced overtime. Subtract 2 weeks promised vacation, but they will take away the burden of choosing your vacation weeks and just do it for you. Add a noncompete and exit terms that cripple your opportunities to find work elsewhere. How does this sound?

            • consuldreugenio

              Member
              August 20, 2023 at 7:38 am

              You first have to confirm first whether those salary numbers are “compensation” (which includes 401k match, insurance and whatever else they want to throw in there) or W2 salary.
               
              Ask about average and expected wrvu per day and per year. Ask if procedures or fluoro are required. Find out what their current rads are producing wrvu wise and what the salary is per wrvu. How is bonus calculated? 
               
              If you are required to be onsite doing procedures and fluoro with expectation of >70+ wrvus a day, it will be a miserable day.
               
              The only exception is if you do mammo. Getting your wrvu target will be quite easy in any setting if you have any capability of becoming an efficient productive radiologist. 

    • tdetlie_105

      Member
      August 20, 2023 at 7:39 am

      Quote from sandeep panga

      Congratulations on finishing your residency and your upcoming entry into the attending world.

      I think you know the answers to your questions already, but just as a reminder to anyone else, there are many excellent discussions of this topic in this forum where you’ll get many good answers, and some not good ones.

      First, I guess I should say that there are many different PE groups and even within specific PE groups (like RP for example) there are many different practices with different types of positions, demands, compensation, etc.  So YMMV.

      To answer your question, yes the numbers could change significantly after you sign your contract.  Unfortunately we have seen many instances of radiologists that have a contract with a PE group and the terms are changed unilaterally.  Of course it may be a violation of your contract, but how many lawyers do they have and how many can you afford, and to what end?  They know the contracts are nearly meaningless against them and only truly useful against you.

      Where does the money come from? (you)  Who pays the PE group? (you) How is the money generated? (you) 

      You can find some positions, onsite at a difficult to fill rural hospital, where you the radiologist can get a decent position making good $/RVU because your PE owners want boots on the ground there.  You may be a loss-leader for them in that position, but it is ok because they make it up on the many other positions where they are taking 30-40% of the radiologists’ earnings.

      Sure you can make 650 as a “partner” in a PE group, but for the volume you’re typically reading to generate that you could be earning 1M in a private group. 

      There is no free lunch.  Do your research, which it sounds like you are doing, and vet any potential jobs seriously.  IMHO there is no reason for a well qualified radiologist just finishing training to take a PE position.   

       
      Well said…650K in a PE group is likely >20K wWVU/year. 

      • raashid

        Member
        August 20, 2023 at 8:21 am

        old adage. if it sounds too good to be true, it probably is. it’s all talk right now. devil is always in the details. if these are in locales appealing to you, you should absolutely interview, then get actual contracts to scrutinize.
         
        as others have mentioned, things can change especially financially with the environment that PE is operating in currently. but things can also change with seemingly “stable” private groups. nothing is guaranteed. good luck. 

        • smfst7_929

          Member
          August 20, 2023 at 9:00 am

          No doubt they are probably saying 500s as total comp. That includes your health insurance, disability insurance and malpractice insurance. And on top of that, you probably have draconian metrics to hit. So sure if you want to be a hamster on a wheel and work with a bunch of clockpunchers who are only looking out for themselves, be my guest. Compensation aside, there is a lot to be said about a cohesive group willing to help each other out in a pinch etc. Clockpuncher PE types are undoubtedly less likely to cover you if your kid gets sick etc. Also if market winds shift, they will 100% cut your comp and if that happens in a bad market, you wont be able to easily go elsewhere.

          Bottom line is that PE should be a last resort. Looking at PE groups all over the country is just bizarre tbh. Dont be lazy and stop just waiting for a PE headhunter to present you with some amazing to good to be true job. Find a few locations youre ok with and find the best non PE option in the location you choose. Avoid PE at all costs.

          • smfst7_929

            Member
            August 20, 2023 at 9:04 am

            Youll have to fight human psychological frailty to make the best longterm decision. It is human nature to search for instant gratification. Nothing is more compelling after years of training than an instant payday. Sure you could probably find some desperate PE site willing to pay you serious cash but that wont last. You wont be happy in a PE site longterm. If you choose to ignore this advice, you will only have yourself to blame later.

            • reza800p_368

              Member
              August 20, 2023 at 9:26 am

              If I were a fellow now, I would work per diem for 6-12 months with ZERO commitment and no non-compete clause before settling for a permanent job. 
              You don’t know yourself well and you don’t know the private practice environment.  

              • buckeyeguy

                Member
                August 20, 2023 at 9:28 am

                Quote from OnsiteRad

                If I were a fellow now, I would work per diem for 6-12 months with ZERO commitment and no non-compete clause before settling for a permanent job. 
                You don’t know yourself well and you don’t know the private practice environment.  

                 
                This is great advice if you don’t know the people or yourself, indeed.

                • consuldreugenio

                  Member
                  August 20, 2023 at 11:26 am

                  I believe the insane non-complete clauses with PE jobs are a given. A no non-compete clause would eliminate basically all PE jobs.

                  • y.rajshekar

                    Member
                    August 20, 2023 at 12:43 pm

                    Also, if a PE job will credential you at multiple hospitals, it will be a major pain to credential somewhere else even if noncompete does not cover your new place. And you may still will be on the hook to pay credentialing costs when you decide you had enough.

                    • farzadahmadimedrn710_43

                      Member
                      August 20, 2023 at 1:35 pm

                      Where is PE starting at 550k? Must be the boonies or a group that’s undergoing nuclear meltdown. The economics of a place that pays you 550k and is PE owned means you’re doing work equivalent to a private practice income of 850k and you’re losing $300k of that to the PE middle man. 
                       
                      Once PE drops down to a 1 year partner track (or immediate parity) you know that group is circling the drain. Wouldn’t be surprised if RP Vegas, Phoenix, or Austin end up doing this in desperation
                       
                      RP is starting around 350-450k in most places where partners make 550-650kish. These same groups have fake vacation where you’re “given” 12 weeks of vacation but can only use 9-10 weeks due to short staffing because of a toxic work atmosphere and low pay. And yes they can take away vacation after you’ve signed your contract.
                       
                      Pay attention to the debt cycles of these PE firms if you’re going to join one. For example RP has massive bonds due in 2025 and 2028 in the billions. And they absolutely can’t pay them back, so they’ll have to dilute equity of buyout partners (thus causing a greater staffing exodus), cut physician salaries, and sell off valuable assets for the benefit of bond holders.

                    • tdetlie_105

                      Member
                      August 20, 2023 at 3:44 pm

                      Quote from bluedeep

                      Where is PE starting at 550k? Must be the boonies or a group that’s undergoing nuclear meltdown. The economics of a place that pays you 550k and is PE owned means you’re doing work equivalent to a private practice income of 850k and you’re losing $300k of that to the PE middle man. 

                      Once PE drops down to a 1 year partner track (or immediate parity) you know that group is circling the drain. Wouldn’t be surprised if RP Vegas, Phoenix, or Austin end up doing this in desperation

                      RP is starting around 350-450k in most places where partners make 550-650kish. These same groups have fake vacation where you’re “given” 12 weeks of vacation but can only use 9-10 weeks due to short staffing because of a toxic work atmosphere and low pay. And yes they can take away vacation after you’ve signed your contract.

                      [b]Pay attention to the debt cycles of these PE firms if you’re going to join one. For example RP has massive bonds due in 2025 and 2028 in the billions[/b]. And they absolutely can’t pay them back, so they’ll have to dilute equity of buyout partners (thus causing a greater staffing exodus), cut physician salaries, and sell off valuable assets for the benefit of bond holders.

                       
                      Should be interesting to see how this plays out
                       
                       

                    • raashid

                      Member
                      August 20, 2023 at 3:53 pm

                      [b]Pay attention to the debt cycles of these PE firms if you’re going to join one. For example RP has massive bonds due in 2025 and 2028 in the billions[/b].
                       
                      coinkidink RP’s CFO bailed not too long ago? me suspects not

                    • ChristianPlathow

                      Member
                      August 20, 2023 at 4:19 pm

                      Do you guys think that working for PE perhaps is not as bad if you are in IR or mammo?

                    • g.giancaspro_108

                      Member
                      August 20, 2023 at 5:01 pm

                      I cannot tell is this is facetious or you haven’t read anything about PE ever.
                       

                      Quote from m3db01

                      Do you guys think that working for PE perhaps is not as bad if you are in IR or mammo?

                    • ChristianPlathow

                      Member
                      August 20, 2023 at 5:44 pm

                      Quote from sandeep panga

                      I cannot tell is this is facetious or you haven’t read anything about PE ever.

                      Quote from m3db01

                      Do you guys think that working for PE perhaps is not as bad if you are in IR or mammo?

                      I’m not being facetious. It seems that IRs are held to lower wRVU thresholds at some PE owned groups given that they are involved in clinical encounters that are hard to quantify from an wRVU perspective. IRs may also hold some leverage in this regard as many of the PE owned groups are very dependent on maintaining their contracts with hospitals, of which IR coverage plays a big role. 
                       
                      Meanwhile, as a diagnostic reader, your time can be milked so that every second is spent generating wRVUs for the group. 

                    • g.giancaspro_108

                      Member
                      August 20, 2023 at 5:55 pm

                      Got it, thank you for the clarification.
                       
                      IMHO, based on past experience, if a specific individual such as an IR or mammographer is in high demand especially at a difficult to staff spot, they may be able to command a high $/RVU and possibly even something commensurate with PP income.  Until they can’t.  Since PE has shown they are going to change the deal at will, we know that the IR/mammo person can move to X location, buy a house, put kids in school, the spouse invests in the community, and then suddenly their position no longer exists, the compensation model has changed, their duties are now split between three hospitals and involves hours of driving a day, or some other misery.  Yes, PP or academic or hospital employment models could have the same dreadful situation but based on historical performance, it is much more likely to occur to a PE rad.  
                      This is to say nothing of the fact that those IR/mammo [i]have chosen to support the PE model [/i]knowing the destruction it is causing to those who practice medicine and those that need medical care.
                       

                      Quote from m3db01

                      Quote from sandeep panga

                      I cannot tell is this is facetious or you haven’t read anything about PE ever.

                      Quote from m3db01

                      Do you guys think that working for PE perhaps is not as bad if you are in IR or mammo?

                      I’m not being facetious. It seems that IRs are held to lower wRVU thresholds at some PE owned groups given that they are involved in clinical encounters that are hard to quantify from an wRVU perspective. IRs may also hold some leverage in this regard as many of the PE owned groups are very dependent on maintaining their contracts with hospitals, of which IR coverage plays a big role. 

                      Meanwhile, as a diagnostic reader, your time can be milked so that every second is spent generating wRVUs for the group. 

                    • reza800p_368

                      Member
                      August 20, 2023 at 8:47 pm

                      Quote from sandeep panga

                      Got it, thank you for the clarification.

                      IMHO, based on past experience, if a specific individual such as an IR or mammographer is in high demand especially at a difficult to staff spot, they may be able to command a high $/RVU and possibly even something commensurate with PP income.  Until they can’t.  Since PE has shown they are going to change the deal at will, we know that the IR/mammo person can move to X location, buy a house, put kids in school, the spouse invests in the community, and then suddenly their position no longer exists, the compensation model has changed, their duties are now split between three hospitals and involves hours of driving a day, or some other misery.  Yes, PP or academic or hospital employment models could have the same dreadful situation but based on historical performance, it is much more likely to occur to a PE rad.  
                      This is to say nothing of the fact that those IR/mammo [i]have chosen to support the PE model [/i]knowing the destruction it is causing to those who practice medicine and those that need medical care.

                      The moral of story: 
                      If you get a PE job, don’t get too attached to the location. Things can change very fast. 

                    • smfst7_929

                      Member
                      August 20, 2023 at 9:26 pm

                      Quote from m3db01

                      Do you guys think that working for PE perhaps is not as bad if you are in IR or mammo?

                      The answer is yes. They love boots on the ground and will slobber all over you to sign you. For IR its a great deal because IR never earns their keep. For mammo not as much of a boon

                    • smfst7_929

                      Member
                      August 20, 2023 at 9:28 pm

                      Regardless PE will eventually bend you over and diddle you. They are literally biding their time. If they ever have leverage, they will cut salaries 40% overnight

                    • farzadahmadimedrn710_43

                      Member
                      August 20, 2023 at 11:14 pm

                      IR and mammo are paying the same private equity tax as anyone else in the group. Theyre taking 30-40% of your labor too. Its not like PE IR is allowed to get away with more fuckery than someone in a private practice.

                    • smfst7_929

                      Member
                      August 21, 2023 at 3:41 am

                      Quote from bluedeep

                      IR and mammo are paying the same private equity tax as anyone else in the group. Theyre taking 30-40% of your labor too. Its not like PE IR is allowed to get away with more fuckery than someone in a private practice.

                      Hmm yeah but youre looking at it wrong.

                      But my comment was in regards to IR and Mams being offered more money than other diag people which is true. For example if they are desperate they may offer 600k to IR or mams despite the fact they pay other diag people 500.

                      IR in PE often only do procedures with very little diagnostic work. If they are only doing procedures they might generate 300k in productivity if they are lucky. So basically PE subsidized them. Meanwhile mams might genérate exactly 600k or perhaps more. So not much of a subsidy there. IRs are always subsidized whether is PP, hospital employed or PE. They just dont earn their keep, ever. You can make an argument that the reimbursement isnt fair and I would agree wity you but thats life and the reimbursement is what it is..

                    • farzadahmadimedrn710_43

                      Member
                      August 21, 2023 at 11:03 am

                      Im coming from a large RP group. The IR rads got paid the same salary as diag. Mammo also got paid the same. IR made slightly more due to their call. And they were expected to produce RVUs too, albeit not at the same level as a gen diag slot. When an IR was in a gen diag slot they had to produce identical to any full diag person. And they had at least 1 full day of gen per week so they were producing. Maybe in the boonies RP gigs you can get away with it but not these mega groups that RP bought in major metro areas where things are more horizontal income wise.

                      Diag is more short staffed than IR at many of these places. Was definitely true at my gig. If IR had a higher salary and dicked around all day theyd get murdered by their colleagues who are staying until 6 pm reading diag studies. Im now at a private practice and the IR doesnt seem to be working any harder than the ones I know from my time at RP.

                    • smfst7_929

                      Member
                      August 21, 2023 at 12:07 pm

                      Depends on the group. An IR at a medium sized hospital should be able to knock down minimum of 50 diagnostic cases between procedures in a 9 hour day. At my group they do a little more maybe 60 cases, mostly plain films but also approximately 10 cross sectional, 10 ultrasound in that number. If you do less than that, you are not anywhere close to earning your salary

                    • Zuleyka

                      Member
                      August 21, 2023 at 2:06 pm

                      The way I look at it: IR keeps the contract. DR generates the cash.
                      No contract = no money

                    • reza800p_368

                      Member
                      August 21, 2023 at 2:28 pm

                      IR helps to keep the contract but its role is exaggerated

                    • Zuleyka

                      Member
                      August 21, 2023 at 2:32 pm

                      Maybe. 
                      Seems binary to me – either they do or they do not, meaning exageration would not be possible. What do you mean?

                    • reza800p_368

                      Member
                      August 21, 2023 at 2:57 pm

                      It means you need to have some boots on the ground to do fluoro work, basic procedures and some angio. But you don’t need to offer a full gamet of vascular procedures to keep the contract. It is not like that the hospitals give you contract because you are going to do PAD.

                      In some practices like my prior one, IR does 4 paras, 2 thoras, 2 FNAs and one drain a day and 2 vascular procedures a week and doesn’t touch any diagnosis studies. If you question them, they claim that they are the ones who anchor the contract.

                    • Zuleyka

                      Member
                      August 21, 2023 at 3:13 pm

                      I see. Makes sense.

                    • farzadahmadimedrn710_43

                      Member
                      August 21, 2023 at 3:38 pm

                      Maybe that truism worked in prior job markets but today diagnostic radiologists are harder to find than IR radiologists. There is a shortage of people to read studies. You can get a PA to do the 4 paras, 2 thoras, 2 FNAs for much less than you’d pay an IR rad.

                    • Zuleyka

                      Member
                      August 21, 2023 at 3:39 pm

                      Right. But if you are working at a hospital other than some half-hospital – a hospital with complicated patients in it – the noctors cannot do the cases.
                       
                      If it is paras, thoras, and FNAs, thats not really IR

                    • DanielQuilli

                      Member
                      August 21, 2023 at 4:21 pm

                      Ive heard that at some PE places mammo is getting paid straight by RVU. If you are a highly productive breast imager this would be a huge boon. If I could be paid just what I produce in wRVUs I could retire after a few years, would never expect a private group to be able to pay me that way, but apparently some PE places are.

                    • Unknown Member

                      Deleted User
                      August 21, 2023 at 4:42 pm

                      No way they are paying mammos straight without a skim. No chance.

                    • DanielQuilli

                      Member
                      August 21, 2023 at 5:12 pm

                      Quote from 271819

                      No way they are paying mammos straight without a skim. No chance.

                       
                      There could be a substantial skim and a mammo rad could still make way more than typical PP draws if getting paid per RVU.

                    • smfst7_929

                      Member
                      August 23, 2023 at 7:57 am

                      If I had a nickel for every time I heard IR keeps the contract I would probably be retired. Overblown and a knee jerk comment you always get from IR when you explain that they dont earn their keep. I will say I dont think it is fair that their reimbursements are so low for the time required to do their work. That is not their fault and it is not fair in my opinion. Life isnt fair of course. But I do think they should be separated from diagnostic rads and subsidized by the hospital as needed.

                      It is the future and you know that if you have your ear the ground. . Even IR wants that and now increasingly so with the integrated pathway which sees them do less diagnostic work during training.

                    • Unknown Member

                      Deleted User
                      August 23, 2023 at 9:48 am

                      Over the next 5-10 years I think there will be a massive push by both DR and IR to separate and IR will be hospital employed the majority of the time.

                      I know in our group, our IRs are the source of innumerable cultural battles (about half of them are problem children – constantly want more money, show up late and leave early, avoid taking on work at all costs).

                      In times when radiologists are hard to come by, the IR burdens look more and more attractive to offload to the hospital

                    • reza800p_368

                      Member
                      August 23, 2023 at 11:15 am

                      Quote from Labslave

                      Over the next 5-10 years I think there will be a massive push by both DR and IR to separate and IR will be hospital employed the majority of the time.

                      I know in our group, our IRs are the source of innumerable cultural battles (about half of them are problem children – constantly want more money, show up late and leave early, avoid taking on work at all costs).

                      In times when radiologists are hard to come by, the IR burdens look more and more attractive to offload to the hospital

                      The sense of entitlement of new IR graduates is unbelievable. 

                    • Zuleyka

                      Member
                      August 23, 2023 at 11:20 am

                      Not a good look.
                       
                      What have you seen, specifically?
                       
                      I never understood why the academics would push for a separate IR residency. Makes no sense in the majority of private practices,  as far as I see things.

                    • reza800p_368

                      Member
                      August 23, 2023 at 12:47 pm

                      Quote from TripleJumper

                      Not a good look.

                      What have you seen, specifically?

                      I never understood why the academics would push for a separate IR residency. Makes no sense in the majority of private practices,  as far as I see things.

                       
                      I have always been fine to see than IR does not make that much RVU. It should be a mutual understanding. Can not be one sided.
                      The problem is that most new IRs don’t have a clue that what they do does not generate that much. They keep nagging that they are making a lot of money for the group so why they have to do DR. Eventually when you show them numbers, they put all the blame on DR and start to say that if the group provides them with office space and IR clinic, then they will be able to generate huge amount of money. Always they know a guy who knows another IR guy who has started his OBL clinic and is rolling in dough.  
                      I feel many of them have a very inflated ego, want to work DR hours and make more than neurosurgeons.  
                       

                    • Unknown Member

                      Deleted User
                      August 23, 2023 at 3:50 pm

                      My sense is that IR guys feel that because they work harder and longer hours – and I will grant them that, they work hard and deal with a lot of people and stress I’d rather not deal with –  they think they should be making more. But wishing it so doesn’t make it so. It’s like when breast imagers in my group complain that they have to drive in to work more frequently than the body imagers but take equal call, and the body imagers who mostly work from home. Our leadership says to them, “tough. you picked breast, now you get to live the dream.”

                    • reza800p_368

                      Member
                      August 23, 2023 at 4:16 pm

                      Quote from Flounce

                      My sense is that IR guys feel that because they work harder and longer hours – and I will grant them that, they work hard and deal with a lot of people and stress I’d rather not deal with –  they think they should be making more. But wishing it so doesn’t make it so. It’s like when breast imagers in my group complain that they have to drive in to work more frequently than the body imagers but take equal call, and the body imagers who mostly work from home. Our leadership says to them, “tough. you picked breast, now you get to live the dream.”

                      Good point. 
                      If they feel they work harder, then they should be happy to change positions i.e. doing DR. 
                      But I also have seen when you give more DR days to IRs, they start to complain. 

                    • Zuleyka

                      Member
                      August 23, 2023 at 4:29 pm

                      To be fair, Onsite, your statement presumes that the goal of the IR radiologist is to work less hard, which likely it often is not.
                       
                      They probably often:
                      – don’t want to work less hard
                      – don’t want to do more DR
                       
                      I am not saying they should be paid more or get special treatment.

                    • reza800p_368

                      Member
                      August 23, 2023 at 4:39 pm

                      Quote from TripleJumper

                      To be fair, Onsite, your statement presumes that the goal of the IR radiologist is to work less hard, which likely it often is not.

                      They probably often:
                      – don’t want to work less hard
                      – don’t want to do more DR

                      I am not saying they should be paid more or get special treatment.

                       
                      Their goal is to get paid more or to get special treatment. 

                    • Unknown Member

                      Deleted User
                      August 23, 2023 at 5:19 pm

                      Fact is that IR and breast often do have to drive into the hospital up to four days a week when some of the body, neuro, and MSK Radiologist might come in once a week or less. Depending on where the practice is located , not being able to work from home can be a significant burden. So we should acknowledge that. At the same time, the group decides these things, so usually there is not much or any premium for having to drive into work to do your job, you basically picked your own specialty, and the greater burden of clinical interaction is baked into that decision. I do think its helpful to pay some lip service and vocal recognition to the interventional folks, it helps them swallow the bitter medicine a little bit. I dont know about your practices, but our IR guys often finish up at 7 PM whereas our diagnostic guys finish by 5 PM unless they are on swingshift. Interventional guys in our group definitely work harder and longer hours and they are paid a little bit more, but not enough to make up for that. Oh well.

                    • farzadahmadimedrn710_43

                      Member
                      August 23, 2023 at 5:58 pm

                      Lol I know IRs who go to the gym 1-2 hours a day and get to go home at 4:30. Every group is different. Sounds like yours are letting themselves get taken advantage of by your group.

                    • reza800p_368

                      Member
                      August 23, 2023 at 6:55 pm

                      Quote from Flounce

                      Fact is that IR and breast often do have to drive into the hospital up to four days a week when some of the body, neuro, and MSK Radiologist might come in once a week or less. Depending on where the practice is located , not being able to work from home can be a significant burden. So we should acknowledge that. At the same time, the group decides these things, so usually there is not much or any premium for having to drive into work to do your job, you basically picked your own specialty, and the greater burden of clinical interaction is baked into that decision. I do think its helpful to pay some lip service and vocal recognition to the interventional folks, it helps them swallow the bitter medicine a little bit. I dont know about your practices, but our IR guys often finish up at 7 PM whereas our diagnostic guys finish by 5 PM unless they are on swingshift. Interventional guys in our group definitely work harder and longer hours and they are paid a little bit more, but not enough to make up for that. Oh well.

                       
                      Our interventional rads finish at 5 pm similar to DRs. One of them stays on call and receives call money and that person may stay in the hospital up to 7 pm or even more because anything coming after 4 pm goes to that person. 

                      Generally speaking the pace of work of DR is more than IR. 
                      If someone works from home, their shift is one hour more. So that is calculated and people never complained why someone gets the luxury of working from home. 

                       

                    • Unknown Member

                      Deleted User
                      August 23, 2023 at 6:58 pm

                      That def sounds more fair than our setup. Our more senior IR guys are pretty burnt out and transition to DR.

                    • Unknown Member

                      Deleted User
                      August 24, 2023 at 8:06 am

                      Finishing past 5pm is common for our IR guys too. However their day is much less efficient. They are waiting for rooms to turnover and my understanding is there is down time. Apples and oranges compared to a hyperefficient 9hour DR workday from 8a-5pm. I can tell you that despite the longer day for IR, DRs are in the lunchroom less than half the time the IRs are. 
                       
                      Subspecialization is going to produce RVU-winners and RVU-losers. To some extent as long as everyone is working more or less equally hard, those arbitrary RVU disparities should not drive pay differences. Unless you want to pay your plain film readers less and watch your plain film list grow as no one will read them. You could set up a tiered model where you hire some older rads at a lower rate to just pound plain films all day, set up mammo-only and IR-only pools at different pay structure (with incentives to make more if they produce more), a neuro pool, a body pool, etc. Takes a lot of work. 
                       
                      Here are the main issues:
                      IR can titrate to some degree how much they work by taking longer on procedures, delaying or canceling procedures. 
                      IR has a built-in limit to how efficient they can get based on room turnover, transport, etc. 
                      DR has almost continually increased efficiency and is at a breaking point
                      DR covers hospitals and sites that IR doesnt
                      DR subsidizes the hospital by providing IR docs to them so the hospital can reap facility fees
                      Subspecialization usually means DR cant cover IR call and vice versa
                      The whole point of being a “group” is to have power in numbers and that means by definition some people are subsidizing others. That’s life.
                       
                      The bottom line is that modern group scheduling/dynamics are *complex* and if a LOT of time ISN’T spent on figuring out workloads and appropriate pay structures, then they WILL be unfair/resentment-generating. 
                       
                      Granted, if the majority of the group agrees to accept a lower salary, you can just hire more DRs to lower pay, reduce the workload of DRs, and thereby ower the disparity in “perceived pay” between DRs and IRs. 
                       

                    • mwakamiya

                      Member
                      August 25, 2023 at 2:39 am

                      Take at look at CMS proposed cuts for Medicare in 2024.  Once again they disproportionately negatively impact IR related CPT codes. If you thought hospital based IR was a serious headwind for the meager remaining radiology groups’ profits, 2024 will be much worse. 

                    • buckeyeguy

                      Member
                      August 25, 2023 at 7:49 am

                      It seems most things are going into the “Ok, hospital, you want the services, start sharing more of the pie, or else you’ll get just a couple guys to show up here and there – if you’re lucky.”

                    • reza800p_368

                      Member
                      August 23, 2023 at 11:13 am

                      Quote from sartoriusBIG

                      If I had a nickel for every time I heard IR keeps the contract I would probably be retired. Overblown and a knee jerk comment you always get from IR when you explain that they dont earn their keep. I will say I dont think it is fair that their reimbursements are so low for the time required to do their work. That is not their fault and it is not fair in my opinion. Life isnt fair of course. But I do think they should be separated from diagnostic rads and subsidized by the hospital as needed.

                      It is the future and you know that if you have your ear the ground. . Even IR wants that and now increasingly so with the integrated pathway which sees them do less diagnostic work during training.

                       
                      Agree. 

                      IR reimbursement is not something that happened randomly. It happened similar to what happened with general surgery.  Other surgeons took over lucrative procedures and general surgeons ended up with low paying procedures. 

                      It is interesting that IR itself wants to separate. They have zero clue about what they are doing to their specialty.  

  • 22002469

    Member
    August 19, 2023 at 5:40 pm

    Pay attention to the volume expectations for that salary.
     
    Yes, the contract be changed as market conditions change.
     
    If the “partnership average is 600k+” beware there may be a few outliers making 7 figures that read 30k+ wRVU/year and don’t care at all their reports miss half the important findings. 
     
     

  • mwakamiya

    Member
    August 22, 2023 at 11:09 pm

    WHATSTHECATCH:
     
    “”I’m getting quotes of mid 500s starting, 1-2 years to partner”
     
    The first and most glaring rookie mistake you are making is the the false “partner” assumption after XYZ years of work.  Let it be clear to ALL — there is NO partnership in PE groups.  None. Period end.  So do not fall for that — please see multiple forum topics that discuss and actually prove (some have gone as far as putting the actual clauses of their contracts online) this very important point. 
     
    Once you get past that fantasy, then you can BARELY begin to start doing some legit comparison and pros/cons on PE jobs versus more traditional PP, etc. One of the most important factors that young pups do not consider or analyze very well are the onerous non-competes and time frames needed for termination without cause (some are 12 months independent of what party terminates). 

    • Zuleyka

      Member
      August 23, 2023 at 7:40 am

      I know this is me on my high horse and not being realistic about people’s lives, but if possible I urge radiologists not to take jobs with PE groups. They are ruining our profession and one way we have of shutting them down is not working for them. 
       
      I understand there are many other considerations apart from who owns the practice people consider when finding a job.