Will Radiology become salaried?

[Dongzhuo]

As we know, pathologists in Ontario have become salaried at 300,000 or something. Since radiologists make quite a bit of money, would the government try to do the same thing to radiologists and make them salaried physicians with a fixed salary?

 

Thanks!

[Lactic Folly]

At first, I thought the title of this thread referred to working for a teleradiology company..

[spaceprobe]

I don't know....but even though i'm interested in rads, i think they should become salaried. Health care is an expensive burden on the public as is....and no, i don't think their work is worth so much more than any other doctor.

 

Pay should not be disproportionately changing with changing technology.....just because, for example, doing CTs (and reading them) became so much faster because the engineers were hard at work improving the scanners and creating fast telecommunications systems (and same thing with cataract surgery!) doesn't mean that should translate into the doctor making more cash (and the engineer left dry!)!

[crockett]

For instance, it would take one man one week to build a car, but would take one hundred men one hour to build the same car.

 

So if they worked a 40 hour work week...the 100 men would only build 40 cars instead of 100?? haha, i know what you meant though, and that was actually a very good post (i totally agree with you), just messing around...

[JCTulip]

That is actually a pretty good option.

 

Nowadays, at least in academic centers, time going to multi-disciplinary rounds and teaching and research are viewed as unproductive because it is not generating revenue for the group.

 

Some radiologists are taking shortcuts so they can get through studies fast.

 

If being salaried is an option, then people can really take their time to properly do a study, have nice breaks in between etc while doing other activities.

 

Of course pay has to be comparable with level of training to be fair. Fellowship trained radiologists with 6-7 yrs of post-grad training should be higher than say, family doctor or general internist.

[Dongzhuo]

Putting radiologists on a salary would possibly save the government a bunch of cash, but seems unfair. Could possibly lead to a bunch of lazy radiologists who really take it easy and leave behind a bunch of unread studies all day?

[Handsome88]

Putting radiologists on a salary would possibly save the government a bunch of cash, but seems unfair. Could possibly lead to a bunch of lazy radiologists who really take it easy and leave behind a bunch of unread studies all day?

 

Unfair? It seems totally fair to me. Why are they even earning upwards of 600k? Is their work really worth that much?

 

Come on, you think that getting paid 300k would make radiologists lazy? Look at IM docs saving lives at less than that.

 

 

...oops didn't notice this is a year old thread.

[Simeon Lewis]

Radiology Technicians now a days are paid a good salary but it varies from place to place . And also depends on the work experience. While searching for the salary details of a radiology technician I found the following site please go through the site you may get some information about Rt's salary : http://www.bls.gov/oco/ocos105.htm

[apache]

if that's unfair, they could just cut down the amount they pay them per study

 

the typical response you're going to get is that paying on a per slide basis cuts down the time/quality of time spent per study because there's a financial interest in seeing more studies... whereas people on salary would do more quality work... it's all theoretical anyways, it really depends on the person. i'd prefer to be salaried and take my time, sip on my starbucks and make sure i get the diagnoses right... it really depends on your personality.

 

Putting radiologists on a salary would possibly save the government a bunch of cash, but seems unfair. Could possibly lead to a bunch of lazy radiologists who really take it easy and leave behind a bunch of unread studies all day?

[rmorelan]

Isn't part of the problem here that there is a extreme shortage of radiologists - with projections that the shortage will actually continue to worsen over the decade at current levels? Kind of hard to actually reduce pay of people in such a situation - you are always afraid that they are going to walk. Pretty sure a lot of them take the US board test as well which I would think would make it even easier(?)

[olecranon]

there's a shortage of radiologists in rural areas but definitely not in urban centres. good luck finding a job in the lower mainland for example. even if there is a spot unless you have 2-3 fellowships forget it.

[rmorelan]

there's a shortage of radiologists in rural areas but definitely not in urban centres. good luck finding a job in the lower mainland for example. even if there is a spot unless you have 2-3 fellowships forget it.

 

I am just projecting out - the OMA projects there will be a overall fairly massive shortage in Ontario at least at our current recruitment levels if I am reading this report over correctly. I would think that is what they are bring to the table when talking about this sort of stuff.

[Ian Wong]

I think there is currently still a shortage of radiologists, but like many/most other physician specialties, there is an oversupply in urban areas, and undersupply in rural areas.

 

Getting a job in a metropolitan area like Vancouver or Toronto is extremely difficult. A lot of it boils down not just to qualifications, but also networking and close contacts. The vast majority of the recent hires in Vancouver that I can think of (in the last three years that would include 1 person at Lions Gate, 1 at St. Pauls, 3 at Royal Columbian, 2 at Surrey Memorial Hospital, and 3 at Richmond Hospital/Burnaby Hospital), have all done their med school, residency, or fellowship at UBC. Most of these people have 1 fellowship under their belt, but at least a few of them have been hired without a fellowship. However, the non-fellowship people all did residency at UBC, and concensus is that they were extremely strong residents. The groups in town all want the same thing, which is an efficient radiologist who is friendly and good to work with, and is willing to read all modalities requested by the group. That's far more important than fellowship certificates when you are job-searching.

 

While it may seem like a good thing in theory to sub-specialize in your reads, for scheduling and call purposes, it's important that people in the group read multiple subspecialties and modalities. The group will be hosed if you have a "prima-donna" MSK specialist who wants to read only extremity MRI's, and doesn't feel comfortable reading an OB ultrasound on call, or refuses to do mammography in the clinic. As an example, I did an MSK fellowship, but probably will only spend (just guesstimating here) around 5-15% of my time doing MSK MRI. The bulk of the other time is plain films, U/S, mammo, body CT, neuro, and light interventional work.

 

Yes, a person that does 100% mammo will almost certainly do it better than someone who doesn't, but when that person takes off for vacation, the mammograms still need to be read. That's where the idea of being a generalist is so important. I can cover hospital or clinic shifts for basically anyone in the group, and in turn, they can cover for me. However, if there's a wierd, tough MSK case, they can contact me to read it, in the same manner that if I encounter a challenging mammo case, I will seek advice.

 

As far as salarying radiologists, I have to admit that I am a neophyte when it comes to billing. However, I am sure that the majority of radiologists would resist this, in the same way that most other physicians would resist going to a salaried model. It substantially reduces incentive to work. You'll see physicians start doing things they typically don't do (but other salaried healthcare workers do constantly), such as regularly scheduled coffee breaks, "smoke" breaks, hour long lunches, taking all allotted sick days, etc. Trying to get cases added on to the end of a work day will likely get a lot harder to accomplish. In the US, their VA hospitals (Veterans Administration) hospitals typically employ radiologists on salary, and the throughput in cases is dramatically lower than in a non-salaried system. A former staff of mine related the same thing in the British NHS system.

 

If the government were to try to put a salaried system in place, I believe you would see resistance from the radiologists, and probably all the other physician specialties as well, for if one group gets forced into a salaried model (which is just a thinly-disguised attempt at a global pay cut), it's just a short time until every other specialty is as well.

 

Ian

[cheech10]

Agreed. If they get salaried, they can only be compelled to work normal hours with no incentive to see as many films as possible. This will lead to a backlog and long wait times.

[quackster]

Unfair? It seems totally fair to me. Why are they even earning upwards of 600k? Is their work really worth that much?

 

Come on, you think that getting paid 300k would make radiologists lazy? Look at IM docs saving lives at less than that.

 

 

...oops didn't notice this is a year old thread.

 

1. If they made $600K/year it's because they read enough studies to make that much (fee for service). Good on the guy for working so much and doing the patients a favour! The real waste is the guy who orders unnecessary tests, but that's a discussion for a different day.

 

2. Radiologists contribute to the saving of lives too. They may not be pushing the epi, but they're identifying all kinds of life-threatening pathologies...can we say "team effort"?

[Monaco]

This is how I (unofficially) gauge the subtle differences in desirability between specialties and/or professions.

 

Anecdotal, but I'm finding out that a lot of radiologists and people who work closely with them and know the inner workings, REALLY really encourage their kids into radiology.

 

Whereas other specialties will be open to "whatever the kid wants", or even actively discourage their progeny against their particular area.

 

Not a secret that radiology is desirable, but I found this interesting.

[Ian Wong]

I think radiology is a fantastic specialty. Most of the radiologists I've asked would choose it again if they had the opportunity to go back in time.

 

Once you are in community practice, the hours tend to be relatively predictable. Starting hours are usually pretty humane; the work day has always started somewhere around 8 am for the private practices I know, as well as both my residency and fellowship. IR and Neuro-IR would be the exceptions to that rule, but I'm not in either of those fields, and many radiologists opt out of those fields for lifestyle reasons. As I've mentioned before in other threads, I think one of the most powerful aspects of a specialty is the ability to do shift-work. Only a few specialties can legitimately do this, where they are able to leave at a set time and turn off the pager. Those fields include radiology, anesthesiology, emergency medicine, and pathology. Some other fields can get close to this, by nature of not having a lot of on call emergencies within their specialty, such as dermatology and radiation oncology. However, most clinical fields including medicine, surgery, and their subspecialties cannot do this, due to continuity of care. Once you operate on a patient or see them in the ER, you own that patient, and need to follow them through. In radiology, continuity of care is much less of an issue intrinsically, since you can typically get through most cases within minutes. Once that dictation is done, you have moved on to the next patient.

 

Reimbursement is very good for radiologists at present, although a large part of that is due to increased workloads. The average radiologist today is cranking out substantially more cases, and is working substantially longer hours than before. During residency, my older staff would reminisce about the "good old days" where it was rare to be paged while on call. Knocking out 10-15 CT's or MRI's in a day was a long day. You performed your own ultrasounds, and the number of cases was therefore limited to whatever you could handle.

 

Now, a radiology on call shift is a hectic affair, and typically in an average hospital, you are getting slammed from the minute the rest of your radiology colleagues go home, until sometime in the early morning when the ER finally quiets down and all the clinical specialties have gotten caught up on their admissions. Whenever a clinical specialty is getting hammered either on the floor or in the ER, it's a guarantee that radiology is probably getting hit as well. Knocking out 10-15 cross-sectional cases is something that now needs to happen in 2 hours rather than 1 day in order to keep up with the workload. It's now the rare exception that a radiologist gets involved with ultrasound scanning a patient. Rather, a single radiologist is now parsing through the work of 4-6 ultrasound techs, so the workload of looking through images and dictating has increased accordingly.

 

When a clinician comes down to the reading room, things generally look pretty chill compared to the hectic chaos on the floors. However, running a department well enough that things look smooth and easy actually takes a ton of hard effort and concentration. It's no different than how the best surgeons make a difficult operation look easy, or how a skilled anesthesiologist suddenly becomes even more calm as the sh*t starts hitting the fan in the OR. The reading room is a constant source of interruptions, with techs coming in and out to review findings and obtain protocols for studies, clinicians visiting to review cases, phone calls going both in and out for stat exams or exams with unexpected critical findings, procedures such as fluoro studies or interventional cases which require radiologist involvement, etc. The best radiologists are those who can handle all of the above, while still accurately handling cases and congenially working with the clinicians. I can tell you from personal experience that this can be really hard to do well, especially on a busy day when every minute spent not dictating is getting you further and further behind a stack of cases.

 

My whole point is that while the radiologist often looks like he/she is chilling in a dark room (which they are, to a degree), it's also very likely that they are working their tails off as well. In the current medical environment, the only way you can bill high amounts of money is if you are working proportionately as hard. A high percentage of income in radiology comes from interpreting the high end cross-sectional imaging, such as CT and MR. Those exams routinely contain hundreds of images, and you are responsible for each and every one of them. It is not easy to read a series of these exams in a row without frying your eyes or your brain. If you are able to accurately and safely get through a high number of them, while still providing good service to the clinicians, then I think you have earned whatever income you are receiving. My personal opinions, which are admittedly biased given that I'm a radiologist!

 

Ian

[Applemanv3]

Radiology Technicians now a days are paid a good salary but it varies from place to place . And also depends on the work experience. While searching for the salary details of a radiology technician I found the following site please go through the site you may get some information about Rt's salary : http://www.bls.gov/oco/ocos105.htm

Radiological Technologists (or radiographers) is the more appropriate term in Canada.

 

According to our national association, the CAMRT, we are entitled to make a minimum of about 29-31$ per hour.

 

Roughly speaking, before taxes, this is about $55,000 a year.

[Applemanv3]

Radiological Technologists (or radiographers) is the more appropriate term in Canada.

 

According to our national association, the CAMRT, we are entitled to make a minimum of about 29-31$ per hour.

 

Roughly speaking, before taxes, this is about $55,000 a year.

LOL! Sorry, I kind of derailed the flow of the thread there, but I had to comment, since the OP had addressed my future field.

[carebear15]

Dear premedical student,

 

You obviously have no idea what a radiologist does and what their work day and call is like.

Who is ordering all the studies that the radiologist is reading? It's every other physician, and hence you get these astronomical number of studies that need to be read everyday, at all hours, which enhances the radiologist's income.

Do you think an internist could save a life without any form of imaging?

I would refrain from speaking on any topic in the future, unless you have had real personal experience or expertise on the subject.

[DeeDoc]

Dear premedical student,

 

You obviously have no idea what a radiologist does and what their work day and call is like.

Who is ordering all the studies that the radiologist is reading? It's every other physician, and hence you get these astronomical number of studies that need to be read everyday, at all hours, which enhances the radiologist's income.

Do you think an internist could save a life without any form of imaging?

I would refrain from speaking on any topic in the future, unless you have had real personal experience or expertise on the subject.

 

This x 1000.