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Productivity goal for a night telerad position
Recently a private practice offered me a night position asking for 145 working unit per 8 hour shift with 7 on 14 off schedule. That practice working unit each equals to about 1.3-1.8 wRVU, so it is essentially 188-261 wRVUs per 8 hour shift. I was told their average productivity is 160 work units per 8 hour shift. I understand it is more of ER and IP cases, which might make it faster, but I still feel it to be too much for a safe shift. Currently I am a Neurorad in a private practice and we have 100 RVU goal for each 8 hour ER shift. I would like to hear from you what do your practice RVU goal is? Any suggestion if I should consider this position (I personally like the 7 on 14 off schedule).
Thanks!
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39 Replies
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OMG.
RUN AWAY.-
🙂 The recruit rad said that their average rad can reach this goal easily, which to be honest made me very confused. That is why I would hope to see what a typical RVU goal is for an 8 hr ER shift.
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The offer is 400k/year. I thought there might be some misunderstanding for their working unit conversion but I talked with a second rad from their group and got the same answer.
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That is about $16/wRVU (again, using 200 wRVU/shift, the low-end of their range).
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Yeah that does seem to be quite low based on $/RVU.
Both of the two recruitment rads told me it is easy to reach the goal. I am confused and thought am I missing something?
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If those numbers are true, then this is the worst job in the country! I’d just LOL at them and cut off all contact.
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I’m thinking about this post too much because it deeply bothers me.
25 wRVU/hr is roughly
13 CT A/Ps per hour, or
29 CT Heads per hour or
17 Cervical MRI per hour or
42 renal ultrasounds per hour or
139 chest xrays per hour.
And maintain that every single hour.-
Even if this was a job where it is “acceptable” to have reports that just say:
Findings: None
Impression: Normal
You still have to look at all the images…-
Something got lost in translation here.
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Sounds like a meat grinder.
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Ive seen ER rads 1 on 1 off with 30 k rvu, actually 2 in one group!
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Thanks for the input. I do not have much knowledge about the one on two off night shift expectation. I was so confused earlier thought maybe I’m missing something that they could achieve this goal easily while I am feeling it so hard.
Just did the calculation for the mentioned “ER rads 1 on 1 off with 30 k rvu” which translates into about 164 RVU per shift. This job seems to be much higher than that.
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Let’s go at the low end of your numbers and say it is 200 wRVU/8 hour shift. That is 25 wRVU per hour for the entire shift.
Perhaps there was some sort of misunderstanding with the numbers they quoted you. The numbers you are discussing are, IMO, not possible to do safely. How much are they offering? At a reasonable $/RVU you should be over 1M/year.
Quote from DocZ
Recently a private practice offered me a night position asking for 145 working unit per 8 hour shift with 7 on 14 off schedule. That practice working unit each equals to about 1.3-1.8 wRVU, so it is essentially 188-261 wRVUs per 8 hour shift. I was told their average productivity is 160 work units per 8 hour shift. I understand it is more of ER and IP cases, which might make it faster, but I still feel it to be too much for a safe shift. Currently I am a Neurorad in a private practice and we have 100 RVU goal for each 8 hour ER shift. I would like to hear from you what do your practice RVU goal is? Any suggestion if I should consider this position (I personally like the 7 on 14 off schedule).
Thanks!
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Quote from DocZ
Recently a private practice offered me a night position asking for 145 working unit per 8 hour shift with 7 on 14 off schedule. That practice working unit each equals to about 1.3-1.8 wRVU, so it is essentially 188-261 wRVUs per 8 hour shift. I was told their average productivity is 160 work units per 8 hour shift.
First of all you should confirm you aren’t doing the math backwards.
Obviously it depends how they worded it, but 1 work unit might equal 1.5 wRVUs (to pick a number towards the middle of the range), in which case you need to divide by 1.5.
If that’s how it is, then 145 work units is 96 wRVUs per shift, thats busy but could be doable with simple ER cases and lots of easy non con head CTs, body US etc.
If 145 work units is truly 200+ wRVUs per shift, then yes that’s an absurd ask as a baseline goal.-
Quote from Radsoxfan
First of all you should confirm you aren’t doing the math backwards.
Obviously it depends how they worded it, but 1 work unit might equal 1.5 wRVUs (to pick a number towards the middle of the range), in which case you need to divide by 1.5.
If that’s how it is, then 145 work units is 96 wRVUs per shift, thats busy but could be doable with simple ER cases and lots of easy non con head CTs, body US etc.
If 145 work units is truly 200+ wRVUs per shift, then yes that’s an absurd ask as a baseline goal.
This. Sounds like somehow it’s backwards.
95wRVU for an 8hr shift would be stiff but doable with low complexity ER work (and without interruptions to hold Lucy the green US techs hand or the need to wait on the phone until some ER ‘provider’ decides to take report on a head bleed).-
Initially I had the same suspicions that I might calculate it backwards, but I asked the second radiologist and get the same result. Both of them told me it is not easy to calculate directly since they were using their own working unit calculation method.
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Just ask the value of each individual study. It will be easy to figure out.
I’m almost positive the math is backwards or there is something else you are missing. wRVU vs RVU or something.
Plenty of awful groups out there but no one is expecting 25 wRVU/hr as a minimum requirement for a job.-
Rads are bad at math and many don’t know the basic concepts of professional vs. technical and professional vs. work RVU. Talk to their business person to clarify. If they truly expect 25wRVU/hr thank them for their time and move on.
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I honest do not know if they were referring to wRVU or RVU.
About their internal working unit there are a few examples:
Head CT without contrast 0.81
CTA head neck 2.9
Body CT 1.7 – 1.8
C spine CT 1
T spine 1.2So for 145 working units per shift, of it were all head CTs, it’s about 179 head CTs or 22.4 head CTs per hour.
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So you probably did the math backwards as these are at or slightly above wRVU values.
Head CTs are one of the most inflated studies so they probably keep it close to the actual wRVU while other cases get a bigger bump. I would bet X-rays are much more than the actual 0.15-0.2 wRVU.
Obviously it depends which cases you are reading but if it’s a random sampling I would bet it’s in the 100 wRVU/night. Still pretty bad.
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My experience is CTA head neck is 3.5 RVU in my current practice, while they only give 2.9 which is below RVU. Body CT is about the same as our RVU, both are 1.8. I will try to ask about their x-ray number tomorrow.
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Quote from DocZ
So for 145 working units per shift, of it were all head CTs, it’s about 179 head CTs or 22.4 head CTs per hour.
That seems outside of the normal range.
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Regardless, that sounds like a terribly underpaid position that will be a brutal slog and anyone would probably quit after a short time. That is not structured to be a long term position.
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Nightrad here. Our 1:2 8 hour shifts have a productivity target of 100 RVUs (150 cases, half cross sectional). This is easy for all of our nightrads to achieve and exceed since we have an efficient system with fast image load times and physician extenders taking the phone calls and calling out results. We give an RVU bonus (~$20/RVU above 100) so on busy nights our most productive rads can make an extra $1000/shift. Our group is looking for one more nightrad, so anyone is interested, DM me.
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What do you get for the first 100 wRVUs? Hope more than $20/wRVU (2k/shift)!!
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Burns me up to see this since we average probably 85-90 rvus per hour at an academic shop for our 1on 2 on night rads. Could use much greater throughput but probably 30% of our time is used wrestling with our reading stations. Giant institution though and nothing gets done. Pay is great but I like to kill lists.
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Quote from brickydragon
Burns me up to see this since we average probably 85-90 rvus per hour….
Per hour ? The equivalent of 100 head CTs per hour ? -
Whoops. 8.5-9 rvus per hour.
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Quote from brickydragon
Whoops. 8.5-9 rvus per hour.
That sounds about right if those are wRVU numbers.
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Thanks all. Now I have a better picture. It seems to be a too demanding and underpaying job.
The group told me the reason that they can be that productive is because their software is so much more efficient. They are using the vrad software which integrates image displaying and dictation modules. One of the rads claim it can increase their efficiency by 1.5-2 folds. I am wondering if any of you have an experience with the vrad software. -
PE job. We finally get the answer to the question…
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Quote from DocZ
Thanks all. Now I have a better picture. It seems to be a too demanding and underpaying job.
The group told me the reason that they can be that productive is because their software is so much more efficient. They are using the vrad software which integrates image displaying and dictation modules. One of the rads claim it can increase their efficiency by 1.5-2 folds. I am wondering if any of you have an experience with the vrad software.
I would ask the group what they are making per wRVU (should be between $50-70). Then negotiate an off-site discount but also work in an after-hours premium, so maybe like a 20%/wRVU discount. Given todays market, I don’t see why you should be considering a job that requires high volume with low wRVU. -
Quote from DocZ
The group told me the reason that they can be that productive is because their software is so much more efficient. They are using the vrad software which integrates image displaying and dictation modules. One of the rads claim it can increase their efficiency by 1.5-2 folds. I am wondering if any of you have an experience with the vrad software.
That is the sales pitch for their software. I don’t see how a software integration could give that kind of boost above a good integration of any other RIS/PACS/SR. A bad one can slow you down, but after that I doubt software alone does the trick.
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The idea that you can solve long lists simply with efficiency is silly.
You still have to look at the images, process them, and make a decision.
Those numbers are past efficiency, into a danger zone.
Also, being a little inefficient now and then is what makes a day fun.
Working in factory like brutal conditions is not a career.
Also, we all process at different speeds, which physiologically slows down past 30, whereas crystallized knowledge accretes. Where do you stand?
Anyway, this is why PE is so dangerous. They ram these conditions down your throat.
We of course can learn from their efficiencies to make our lives better by our choice, but not to make them money. -
Yes. I have the same feeling. The modem PACS software are similarly in efficiency. I used to use the ancient GE PACS during the residency which does feel to slow you down by a lot.
Appreciate the input. Now it seems to be a consensus that this is a pretty awful job. I know what to do now.
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What does the “PE” mean? Sorry for my ignorance.
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Private equity.
Private investors within a corporate shell buying practices to profit. Given radiology practices biggest cost is salary, that is where the money is made. Personnel costs need to be minimized, and efficiency through software is one of the ways to increase profits. So are extenders, and of course AI.
All these things can make our lives better as radiologists and improve patient care, but unfortunately that is not how they are used.
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Quote from DocZ
Recently a private practice offered me a night position asking for 145 working unit per 8 hour shift with 7 on 14 off schedule. That practice working unit each equals to about 1.3-1.8 wRVU, so it is essentially 188-261 wRVUs per 8 hour shift. I was told their average productivity is 160 work units per 8 hour shift. I understand it is more of ER and IP cases, which might make it faster, but I still feel it to be too much for a safe shift. Currently I am a Neurorad in a private practice and we have 100 RVU goal for each 8 hour ER shift. I would like to hear from you what do your practice RVU goal is? Any suggestion if I should consider this position (I personally like the 7 on 14 off schedule).
Thanks!
I assume the OP isnt a troll (not 100% certain). I worked as an overnight telerad for 2 years a while back. If busy, I got up to 100-120 wRVU per 9 hr shift. What this company is asking you to produce is unreasonable. In particular, with the way the market is so tight for rads right now.
There are better alterative positions or ways to approach a similar nightrad position than just keeping to this offer. Tell this or other overnight positions that there is a unique premium for overnight work performed by a radiologist, perhaps 20-50% more than what is being paid to daytime rads. This should be true even if you are somewhere in the middle regarding how quickly you read imaging since its now significant harder to recruit for overnight positions. Just tell this company (or other overnight companies) that you desire a flat rate of 300-350/hr if you are going to fill this position. If they dont like your speed despite committing to working for a particular company, then you can have a parting of ways. But try to stick to the flat rate demand.
I suggest another approach that is much better for the ecosystem of radiology, and likely for yourself as well. IMHO, it would better to contact individual PP radiology groups to see if you can help them with their daytime or evening work. More PP groups are open to the idea of a remote reader helping with ever-growing work-loads. Strike your own deal with a PP group. Usually the younger partners in the practice have to convince older partner to come to grips with bringing a remote rad on board, but they will if you have good habits (i.e. timely and thorough work production and high sense of professionalism).
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I don’t think OP is a troll. New rad most likely. I see it all the time with residents I work with, they have very vague idea of job market and PE tactics. They are often excited to be aggressively recruited by vRAD and such while in training and go down the path of least resistance.
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