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Implosion of small radiology private practice

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  • Avatar Panscan 
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    Joined: 03/18/2017
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    I remember just a few years ago all my radiology friends could not find jobs and now there’s a shortage of radiologists? So weird.

    Click to expand…

    The radiology job market is cyclical. The last trough to the most recent ?peak represents the largest swing I have seen in my 23 years of practice. Bring on AI, and bring on the robots. We need all hands on deck to get the work done.

    Click to expand…

    Rad job market has been either hot or very cold during my 20 yrs which is suboptimal.  This “shortage” is different in that many of the jobs are undesirable, employed, corporate, poor pay for the amount of work, bad hours, etc.   I bet that once the academic departments scream shortage we will have some sort of short sighted fix which will be bad for the field. The shortage will hopefully kill all the corporate skimmers including universities taking over community hospitals.  They have been getting too good a deal for too long.

    My colleagues and I entertain the idea of switching but have worries about jumping from bad to worse given the current conditions.  You will likely join an understaffed department with new problems, malignant a holes, malignant admin. Have to learn things you haven’t done in years and learn a new system.   If you join a partnership they may sell to corporate or be one of those tiered or scam partnerships.  Fun times!

    Click to expand…

    Covering my ears and screaming “lalalala I cant hear you* (About to start the rad job hunt). JK 🙂

    I’m wondering about the academic side of things, too. A few weeks ago, no less than SIX rads announced their departure from my husband’s training institution in one week–seemingly mostly headed to PP. The pay differential is too great and their workload has increased–I don’t blame them. The change in attitude has been pretty stunning. ~2 year ago when my husband interviewed for fellowship, they told him if he wanted to stay at the institution, he would need to do a 2nd fellowship. He flat out (nicely) told them that wasn’t going to happen. Then they had a bunch of people in that division leave and they are now asking him to stay, 2nd fellowship be damned. “We can train you in the areas we need in house!” We’ve been watching job listings for 2 years now and noticed a similar trend in other academic depts. The job listings used to require that 2nd fellowship. Now the exact same listings have done away with the wording altogether or changed to “2nd fellowship preferred.”

    On that note, I came across this “gem” last night. UVA is gettin’ creative! https://jobs.acr.org/job/instructor-non-trainee/47855003/

    That being said, we have found some seemingly good opportunities. Mostly through networking and outside of major cities.

     

     

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    must be a malignant institution if 6 people decided to leave within a short period of time. a statement like needing a 2nd fellowship to stay there confirms it. not sure I really understand that anyway. If they are a big academic place then they are mostly 100 % reading their fellowship stuff so why would a 2nd help you in that situation? a 2nd fellowship would help more for a more private practice gig where you are reading outside your fellowship frequently.

    #206297 Reply
    Avatar MSooner 
    Participant
    Status: Spouse
    Posts: 190
    Joined: 02/25/2016

    I remember just a few years ago all my radiology friends could not find jobs and now there’s a shortage of radiologists? So weird.

    Click to expand…

    The radiology job market is cyclical. The last trough to the most recent ?peak represents the largest swing I have seen in my 23 years of practice. Bring on AI, and bring on the robots. We need all hands on deck to get the work done.

    Click to expand…

    Rad job market has been either hot or very cold during my 20 yrs which is suboptimal.  This “shortage” is different in that many of the jobs are undesirable, employed, corporate, poor pay for the amount of work, bad hours, etc.   I bet that once the academic departments scream shortage we will have some sort of short sighted fix which will be bad for the field. The shortage will hopefully kill all the corporate skimmers including universities taking over community hospitals.  They have been getting too good a deal for too long.

    My colleagues and I entertain the idea of switching but have worries about jumping from bad to worse given the current conditions.  You will likely join an understaffed department with new problems, malignant a holes, malignant admin. Have to learn things you haven’t done in years and learn a new system.   If you join a partnership they may sell to corporate or be one of those tiered or scam partnerships.  Fun times!

    Click to expand…

    Covering my ears and screaming “lalalala I cant hear you* (About to start the rad job hunt). JK 🙂

    I’m wondering about the academic side of things, too. A few weeks ago, no less than SIX rads announced their departure from my husband’s training institution in one week–seemingly mostly headed to PP. The pay differential is too great and their workload has increased–I don’t blame them. The change in attitude has been pretty stunning. ~2 year ago when my husband interviewed for fellowship, they told him if he wanted to stay at the institution, he would need to do a 2nd fellowship. He flat out (nicely) told them that wasn’t going to happen. Then they had a bunch of people in that division leave and they are now asking him to stay, 2nd fellowship be damned. “We can train you in the areas we need in house!” We’ve been watching job listings for 2 years now and noticed a similar trend in other academic depts. The job listings used to require that 2nd fellowship. Now the exact same listings have done away with the wording altogether or changed to “2nd fellowship preferred.”

    On that note, I came across this “gem” last night. UVA is gettin’ creative! https://jobs.acr.org/job/instructor-non-trainee/47855003/

    That being said, we have found some seemingly good opportunities. Mostly through networking and outside of major cities.

     

     

    Click to expand…

    must be a malignant institution if 6 people decided to leave within a short period of time. a statement like needing a 2nd fellowship to stay there confirms it. not sure I really understand that anyway. If they are a big academic place then they are mostly 100 % reading their fellowship stuff so why would a 2nd help you in that situation? a 2nd fellowship would help more for a more private practice gig where you are reading outside your fellowship frequently.

    Click to expand…

    Eh, not malignant. Just academic surrounded by PP that pays more.

    2nd fellowship=pediatric subspecialties. Mostly Pedi Neuro or Pedi IR.

    #206307 Reply
    Avatar Panscan 
    Participant
    Status: Resident
    Posts: 902
    Joined: 03/18/2017

    And 6 people decided to leave at same time for greener pastures? Meh probably more to story.

    #206314 Reply
    Liked by adventure
    Avatar GoBlueMD 
    Participant
    Status: Physician
    Posts: 76
    Joined: 05/27/2017

    Peds rads is very different from the rest of radiology, especially in the major academic centers. If you wanna do academic (or even PP) peds Neuro or peds IR, you have to do a second fellowship on top of peds rads. There’s even 2nd yr peds msk, chest and Nucs fellowships. It doesn’t lead to more salary (that I’m aware of), so you must really like the sub specialty.

    Corporate groups were able to buy out or take over many small to medium practices due to promise to hospital admin of subspecialty coverage 24/7. One even promised “3D imaging” from Harvard (failed horribly). Many takeovers have not been successful due to lack of boots on the ground from unhappy rads departing after the takeover. They get by with telerad coverage, but that’s not palatable for the hospital and ordering docs. There should be a face with radiology.

    Corporate groups have now pivoted to buying out mega private practices (50+ rads) across the country, many in prime locations. This indicates that they aren’t going anywhere soon as some rads won’t have many options if geographically restricted. I wouldn’t ever take a job from them. But I know some who have due to lack of choices. The current good job market is bad for corporate groups, let’s hope they get out of radiology.

    #206332 Reply
    Liked by childay, MSooner, Tim
    Avatar MSooner 
    Participant
    Status: Spouse
    Posts: 190
    Joined: 02/25/2016

    Peds rads is very different from the rest of radiology, especially in the major academic centers. If you wanna do academic (or even PP) peds Neuro or peds IR, you have to do a second fellowship on top of peds rads. There’s even 2nd yr peds msk, chest and Nucs fellowships. It doesn’t lead to more salary (that I’m aware of), so you must really like the sub specialty.

    Corporate groups were able to buy out or take over many small to medium practices due to promise to hospital admin of subspecialty coverage 24/7. One even promised “3D imaging” from Harvard (failed horribly). Many takeovers have not been successful due to lack of boots on the ground from unhappy rads departing after the takeover. They get by with telerad coverage, but that’s not palatable for the hospital and ordering docs. There should be a face with radiology.

    Corporate groups have now pivoted to buying out mega private practices (50+ rads) across the country, many in prime locations. This indicates that they aren’t going anywhere soon as some rads won’t have many options if geographically restricted. I wouldn’t ever take a job from them. But I know some who have due to lack of choices. The current good job market is bad for corporate groups, let’s hope they get out of radiology.

    Click to expand…

    Thanks–good feedback!

    Luckily the 2nd fellowship doesn’t seem to be flying anymore for ped rads. There are always going to be a few that want to do it, but the job market doesn’t seem to be demanding it anymore (except for Peds IR and man those are hard to find)

    #206402 Reply
    Avatar Roentgen 
    Participant
    Status: Physician
    Posts: 66
    Joined: 03/02/2018

    You looking for a job in the midwest?  What’s your specialty?

    #206699 Reply
    Avatar photon 
    Participant
    Status: Physician
    Posts: 13
    Joined: 01/18/2019

    if You look at the big picture like the happy philosopher alluded to, there really is no way out on a national level. Corporate employment means some guy who thinks he’s smarter than you bc he is at a venture capital firm is going to try to convince you that you need to work longer,harder, and faster so he ensures he gets a cut for his brilliant optimazation of your increased workflow.

    #206791 Reply

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