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  • Tele for private practice

    Posted by Unknown Member on January 26, 2021 at 12:31 pm

    Everyone is very bearish on Teleradiology for a corporate entity. What about doing teleradiology or remote reading for a private practice? I see many of the larger and more progressive private practices advertising for remote readers. Some even offering partnership. I think this is the future and a good way to take back radiology from private equity.

    buckeyeguy replied 11 months, 2 weeks ago 19 Members · 62 Replies
  • 62 Replies
  • radiologistkahraman_799

    Member
    January 26, 2021 at 12:35 pm

    What would be ideal would be a large network where anyone could log on at any point in the day or night and read some studies.  Not any assigned shifts.  Work as little or as much as you want.  People would come in droves.  

    • william.wang_997

      Member
      January 26, 2021 at 12:42 pm

      Yep….basically like uber. Flexible schedules ! That trend will continue with millennials and generation after. 

      • Unknown Member

        Deleted User
        January 26, 2021 at 1:05 pm

        would be a credentialing nightmare

        • Unknown Member

          Deleted User
          January 26, 2021 at 2:01 pm

          @OP,

          I think that is a much better situation to be in than corporate Telerad, and even more so if the group is offering it as associate track to partner. And even better if that job involves you physically going in a certain number of days a month to be in the on-site rotations where you will come to know, face-to-face, the other Radiologists , techs, and referring docs.

          Out of sight is out of mind, so if an employee or partner of a private practice group is 100% remote and never shows their face, there simply isnt going to be the same degree of influence and perceived value as somebody else who shows their face all the time and has their ear to the ground such that they are aware of issues affecting the group in terms of workflow, complaints from clinicians, etc.

          • Unknown Member

            Deleted User
            January 26, 2021 at 2:06 pm

            [Deleted by Admin]

            • Unknown Member

              Deleted User
              January 26, 2021 at 2:10 pm

              “Amazing” to me would be over 3/3.5 K per shift

              • Unknown Member

                Deleted User
                January 26, 2021 at 2:11 pm

                [Deleted by Admin]

              • Unknown Member

                Deleted User
                January 26, 2021 at 2:14 pm

                >3K or 3.5K / shift for an overnight at a large enough PP group should not be too unusual.

                • Unknown Member

                  Deleted User
                  January 26, 2021 at 2:15 pm

                  [Deleted by Admin]

                  • vuonganhhmuk112_783

                    Member
                    January 26, 2021 at 2:54 pm

                    3.5k for a 7 hour shift? Where do I sign?

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 3:33 pm

                      I was referring to around 10 hours, I’ve covered some groups overnight. Never got 3K for a 7 hour shift.

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 5:01 pm

                      [Deleted by Admin]

                    • bradford.gildon

                      Member
                      January 26, 2021 at 5:08 pm

                      Tell me about that overnight tele for 3100 for 7 hrs , I accept pms)

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 5:09 pm

                      [Deleted by Admin]

                    • leann2001nl

                      Member
                      January 26, 2021 at 5:12 pm

                      Doesnt the Uber model pretty much sound like telerad ?

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 5:29 pm

                      Quote from TheSLACman

                      I know a pp with 5000$ per night haha. But they do it internally. Some pp have it good!

                       
                      Me too 🙂  My friend is partner in a group like that, three letter abbreviation, starts with a B.  But if I recall correctly, it’s 12 hours and a buttload of work. 

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 5:31 pm

                      [Deleted by Admin]

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 6:41 pm

                      Did you train in those parts? Those are my old stomping grounds, spent a decade out there. Left after training to settle down closer to my parents and brother. If not for that, I might have joined that group or another big one in area, as I have a lot of contacts there.

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 6:45 pm

                      [Deleted by Admin]

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 6:48 pm

                      [Deleted by Admin]

                    • Unknown Member

                      Deleted User
                      January 26, 2021 at 9:35 pm

                      Nice that you have a connection to that solid group, and to the group you are reading MSK for. 

                    • Unknown Member

                      Deleted User
                      January 27, 2021 at 5:41 am

                      [Deleted by Admin]

        • ruszja

          Member
          January 27, 2021 at 6:08 am

          Quote from Sir Read Alot

          would be a credentialing nightmare

           
          Not if the operator of the network is a JCAHO accredited organization. All the clients are allowed to use that organizations credentialing by reciprocity.

          • Unknown Member

            Deleted User
            January 27, 2021 at 7:10 am

            We overpay partners for internal moonlighting. It motivates and available to all, so a zero sum game in a sense. No leakage from the Corp.
            Cant use such figures to compare external rates.

            • Unknown Member

              Deleted User
              January 27, 2021 at 7:43 am

              I think in most cases it’s much better to do tele for a pp than corporate telerad, though may lack scheduling flexibility which might be there w corporate (? anyone dong corp tele confirm this?). Our group has hired people for daytime remote work on partner tracks, not sure we would have gone that route had the job market not been so tight, as the remote partners really have no responsibilities other than clinical work.

              • ruszja

                Member
                January 27, 2021 at 11:27 am

                Quote from olliemctuffy

                I think in most cases it’s much better to do tele for a pp than corporate telerad, though may lack scheduling flexibility which might be there w corporate (? anyone dong corp tele confirm this?). Our group has hired people for daytime remote work on partner tracks, not sure we would have gone that route had the job market not been so tight, as the remote partners really have no responsibilities other than clinical work.

                 
                Working for PP as an off-site is driving a limo for a private individual. Working for corp telerad is driving an Uber.

                • qi_si1988

                  Member
                  January 27, 2021 at 12:29 pm

                  Some groups are figuring this out…if you treat remote rads as offsite members of your group, you can attract good people and not lose them to a better offer with vagaries of the market.
                   
                  Some groups are stumbling as their onsite members try to have their cake and eat it too–getting telerads in the door but when it comes time to offer them something resembling citizenship, they get stingy and ruin what they were on the verge of creating.
                   
                  The groups that do it right will win. And, until/unless the corporate telerad outfits figure out how to compete by offering their rads a comparable deal, they will suffer horrible brain-drain.

                  • Unknown Member

                    Deleted User
                    January 27, 2021 at 12:56 pm

                    No doubt you need to treat dedicated tetrads fairly, but there has to be a formula.
                    Those on site, going to meetings, procedures, conferences have to be considered. It’s not a fair tradeoff no to.
                    Onsite presence matters on many levels, so those off site need to pay some sort of a tax, maybe more shifts etc, but something.

                    • qi_si1988

                      Member
                      January 27, 2021 at 12:58 pm

                      Absolutely. The trick is to come up with a fair trade-off, which has been the main issue in the group I’m in now.
                       
                      Either they’ll get it right, or I’ll be moving on. (As will at least some of their other telerads.)

                    • Unknown Member

                      Deleted User
                      January 27, 2021 at 1:28 pm

                      +1  to the above.
                       
                      For me, someone who prepares for and attends specialty tumor boards, deals with calls from techs regarding protocol, can be pulled from reading studies rotation to cover procedures in breast when someone calls out sick, and can spend 20 minutes in the morning working on juggling the radiologist schedule when someone calls out sick…   is a partner, and is different than someone offsite who only dictates exams who is more a ‘film reader’ that you would hire as a per diem and not a full-blooded partner. 
                       
                      Some allowance must go into the equation for someone who – yes, is taking the nights so will work fewer overall days/hours than on site partner radiologists  – but doesn’t have to deal with the other “crap” and reads an easier case mix of ER/inpatient exams overnight.  
                       

                    • g.giancaspro_108

                      Member
                      January 27, 2021 at 1:46 pm

                      .

                    • Unknown Member

                      Deleted User
                      January 27, 2021 at 1:58 pm

                      Eventually this will have to be solved. This is the future of radiology and the only to save the entire profession from being “corporatized” to the lowest bidder.

                    • benoit.elens

                      Member
                      January 27, 2021 at 8:52 pm

                      I think it evens out.  The hardcore readers are doing a ridiculous amount of mind-numbing production.  The guys doing procedures, conferences are doing a lot of work, albeit different kind.  The days of docs stopping by to go over films are almost nonexistent so the argument of in-house necessity is now far less.  I could do 99% of my job remotely honestly  — I sit alone in my office and pump out studies all day long.  Also everybody in our group gets interruptions by phone — whether reading on or off-site.  
                       
                      I also find that most rads in our group would not read remotely even if/when they had the chance.   Saw this firsthand during the pandemic.  A lot of people just like to get out of the house.  I am thinking for the most part the home/on-site breakdown would likely workout organically.  If there is a haircut for remote reading, not sure what it would be, but not a huge % IMO.  I think a lot of people arguing for this haircut are the same rads who would prefer to come on-site anyways and also the ones who prefer meetings, etc to actual reading of films.  YMMV.

                    • Unknown Member

                      Deleted User
                      January 28, 2021 at 6:39 am

                      I disagree. If i could find a platform that allowed me to log in anytime and read as much or as little as i wanted, make as much as i wanted… that would be something I would love to do in addition to my primary gig. The Vrads and rad partners tele of the world invest so much in on-boarding and credentialing that they have to use shift work and minimum productivity benchmarks.

                    • Unknown Member

                      Deleted User
                      January 28, 2021 at 7:33 am

                      Quote from Sir Read Alot

                      I disagree. If i could find a platform that allowed me to log in anytime and read as much or as little as i wanted, make as much as i wanted… that would be something I would love to do in addition to my primary gig. 

                      Business doesn’t work that way. 

                    • Unknown Member

                      Deleted User
                      January 28, 2021 at 10:43 am

                      [Deleted by Admin]

                    • radiologistkahraman_799

                      Member
                      January 28, 2021 at 3:44 pm

                      Quote from drad123

                      Quote from Sir Read Alot

                      I disagree. If i could find a platform that allowed me to log in anytime and read as much or as little as i wanted, make as much as i wanted… that would be something I would love to do in addition to my primary gig. 

                      Business doesn’t work that way. 

                       
                      Sure, not right now.  Then again, 10 years ago iPhones barely existed.  You couldn’t hail a cab from a smartphone nor could you get food delivered to you without calling.  “Things change Mox”

                    • radiologistkahraman_799

                      Member
                      January 28, 2021 at 4:03 pm

                      If someone could get the contracts, then would be fairly easy to set up in terms of rad retention.  Just set it up like a “frequent flyer” program, where everyone starts out at a base level.  The longer you work with them, you can climb tiers and get paid more per tier/study.  Have minimum cutoffs to read each month.  

                    • leann2001nl

                      Member
                      January 28, 2021 at 4:17 pm

                      Sure but thats a tough system to implement where stuff needs to be ready timely and you have no guarantee of peoples contribution . Youd need to start it off with a group of core rads and then wean them off as the tele people pick it up

                    • radiologistkahraman_799

                      Member
                      January 28, 2021 at 4:24 pm

                      Never said it had to start at a level I trauma center.  Could start with outpatient focused.  Could consider “surge” pay to incentivize.  

                    • ruszja

                      Member
                      January 28, 2021 at 8:23 pm

                      Quote from IR27

                      Sure but thats a tough system to implement where stuff needs to be ready timely and you have no guarantee of peoples contribution . Youd need to start it off with a group of core rads and then wean them off as the tele people pick it up

                       
                      It’ll be like Uber with surge pricing.

                    • Unknown Member

                      Deleted User
                      January 29, 2021 at 6:52 am

                      Quote from fw

                      Quote from IR27

                      Sure but thats a tough system to implement where stuff needs to be ready timely and you have no guarantee of peoples contribution . Youd need to start it off with a group of core rads and then wean them off as the tele people pick it up

                      It’ll be like Uber with surge pricing.

                      I think that is the most accurate characterization.
                      If Radiology comes to this, paid piecemeal for volume remotely, it will be trivialized into factory work. How anyone see this as good is beyond me.
                      Look at Uber; it was glorified as a great opportunity initially, and then settled into what it is today, a mediocre job without benefits. 
                      Some are wishing a profession away.
                      It’s hard to watch.

                    • Unknown Member

                      Deleted User
                      February 8, 2021 at 3:52 pm

                      It’s not in our financial interest to have an efficient market for the interpretation of studies, it drives down the amount we are paid per study. 
                       
                      Technologies and organizations that disconnect the time/place an exam is performed and the time/place it is interpreted, thereby increasing the number of potential readers for any given exam is not good for us.  
                       

                    • Dr_Cocciolillo

                      Member
                      February 8, 2021 at 9:47 pm

                      well said Flounce. 

                    • jennycullmann

                      Member
                      January 28, 2021 at 5:20 pm

                      Quote from Sir Read Alot

                      I disagree. If i could find a platform that allowed me to log in anytime and read as much or as little as i wanted, make as much as i wanted… that would be something I would love to do in addition to my primary gig. The Vrads and rad partners tele of the world invest so much in on-boarding and credentialing that they have to use shift work and minimum productivity benchmarks.

                       
                      Yes, this is the ultimate and is the only reason anyone should ever consider getting “lowballed’ for the professional fee, for example.

                    • Unknown Member

                      Deleted User
                      January 28, 2021 at 5:58 pm

                      Pay your bets when you lose

                      Welchers have bad outcomes

                    • Unknown Member

                      Deleted User
                      January 29, 2021 at 7:47 am

                      [attachment=0]
                       
                      [h2]Two Dollars!! You owe me two dollars!! Paper boy in the movie Better off Dead.[/h2]  

                    • Unknown Member

                      Deleted User
                      February 7, 2021 at 8:57 am

                      PM me if anyone is interested in this exactly type of opportunity. It doesn’t matter if you have another gig. You need your own malpractice and it will be a 1099 arrangement. States needs Fl, AZ, NV, CO, CA, IL, TX, NY, Wi, KY

                    • qi_si1988

                      Member
                      February 8, 2021 at 9:13 am

                      Sounds like a logistical nightmare to credential folks for multiple facilities…do you have a minimum requirement in terms of hours/cases for folks to login and work so you know they’ll be worth your while?

                    • Unknown Member

                      Deleted User
                      February 8, 2021 at 2:53 pm

                      Nope! all outpatient. No minimum requirement or shifts. Read what you want when you want. Need to have own malpractice and reading station. PM if interested. 

                    • debra.paulk_16

                      Member
                      February 9, 2021 at 7:42 am

                      [link=https://jobs.acr.org/job/want-to-pick-up-remote-extra-shifts-award-winning-ai-efficiencies-supportive-culture/55807046/]https://jobs.acr.org/job/…tive-culture/55807046/[/link]

                    • Unknown Member

                      Deleted User
                      February 9, 2021 at 7:49 am

                      This is not my advertisment. I would never work for or promote radpartners. WHy not get a few high quality individuals to work for us and allow them to keep their current primary jobs? Offer a flexible work strategy without defined shifts- read what you want when you want. This isnt going to be the EBAY of radiology here. I am mindful of the current autonomy vs PE plight and have been a victim of a hostile takeover in the past. Again PM me if interested. Outpatient general work, not full body oncology workups with comparisons to 5 previous exams!

                    • debra.paulk_16

                      Member
                      February 9, 2021 at 7:56 am

                      I just found the coincidence interesting enough to share. 

                    • Unknown Member

                      Deleted User
                      February 9, 2021 at 8:03 am

                      Yeah but they want you to work for them exclusively. F that lol

                    • Melenas

                      Member
                      February 10, 2021 at 6:58 pm

                      Anyone here do remote telework mostly but come on site at hospital X to help with procedure a few weeks out of the year? 
                       
                       

                    • jennycullmann

                      Member
                      February 19, 2021 at 5:35 pm

                      Quote from Sir Read Alot

                      Yeah but they want you to work for them exclusively. F that lol

                       
                      if you’re in a zero income tax state you pay zero, correct? I don’t even think a lot of the 1099 guys can even determine the “source” of all their studies/income, correct Sir?

                    • buckeyeguy

                      Member
                      August 10, 2023 at 1:03 pm

                      Isn’t this effectively the case until there is overwhelming legislation to change it to be obvious that where you do work is where you get (or don’t get) taxed?

                    • y.rajshekar

                      Member
                      August 10, 2023 at 6:05 pm

                      What if you dictate 1099 from AL for TX? TX does not charge state income, do you have to pay state income to AL for that?

                    • sraghuvanshi1

                      Member
                      August 10, 2023 at 6:33 pm

                      California is the worst for this, it doesn’t matter where you work, if you live in California you’ll file California tax return and likely owe California taxes.

                    • alex.nieto_484

                      Member
                      August 11, 2023 at 4:31 am

                      Quote from golden gate

                      California is the worst for this, it doesn’t matter where you work, if you live in California you’ll file California tax return and likely owe California taxes.

                       
                      Why would it be any different? You pay California taxes because you live there and use their services.

                    • sraghuvanshi1

                      Member
                      August 11, 2023 at 5:25 am

                      Living there and using services related to living there could be covered by property taxes, not income taxes. Some states don’t have income taxes – so it could be different.
                       
                      Take the opposite scenario, where you live in Nevada and do tele reads for a California based practice. You’d still owe California state income taxes. So it’s not really about using local services is it.
                       
                      California is among the most aggressive states in taxing people, sometimes with marginal justifications.

                    • buckeyeguy

                      Member
                      August 11, 2023 at 2:40 pm

                      Quote from DrBoogie

                      What if you dictate 1099 from AL for TX? TX does not charge state income, do you have to pay state income to AL for that?

                       
                      Yes, because (and this is the debated point) the majority position is that where you are physically located and domiciled is where the “work was done.” That means, you pay AL if you are there and an AL resident.
                       
                      I think the reason this effectively doesn’t matter is that it is very, very common for someone to live in say, Nevada as a telerad working there and reading studies from other states. Let’s say those other states included AZ, CA, and CO, just for fun.
                       
                      The rad on his taxes would pay no income tax since he is a resident of NV. Do you think he’s paying, or trying to pay for those share of studies randomly performed in CA or CO? Of course not. Now, could CA (maybe the worst example since they might) come after him as a weird source/nexus, etc? Yes, but there aren’t even clear laws on this, that aren’t trumped by the fact that the rad is a NV resident. And depending on how he gets paid (let’s say it was a big group that pays him as 1099 and they are in AZ), how is that sourced back to CA? I guess theoretically that might be something sought out, but it is a TON of work for something that 10,000 people do. Since the technical fee, if in CA, is going to CA’s pockets, the odds are that they don’t know, don’t care, or realize it’s too hard to get that all if you aren’t a CA resident … so they just let it go unless you are dumb enough to make them aware.