6 things every radiologist should consider before signing with a new practice

The job market for radiologists has never been better, with fewer medical students pursuing a career in radiology and a considerable number of physicians nearing retirement. And those trends only compound the systemic issues of an aging population and the ongoing physician shortage.

Adam Jones, a physician recruiter with 25 years of experience, confirms “it’s definitely a candidate’s market” for radiologists who may be considering a job change.

“The demand for radiologists is absolutely huge,” Jones says. “If you’re a radiologist, you can go almost anywhere in the country right now and have multiple opportunities to choose from.”

Jones is an expert in this area, working in radiology since 2007 and spending the last two years recruiting teleradiologists for vRad. He studies how each new trend and technological breakthrough impacts the job market, working with both radiologists and the practices who employ them to gain a broad understanding of everyone’s wants and needs.

One potential side effect of the exceptionally strong job market, Jones warns, is that radiologists can get caught up in the excitement, overlook key details, and end up making a decision they regret. What appears to be the perfect job at first can sometimes be a disaster in disguise.

This is where Jones’ long history in the healthcare industry pays dividends. He’s seen market changes come and go and understands the value of doing your homework.

Jones recommends every radiologist ask specific questions before committing to a new practice:

1. Is the potential employer financially stable? What does its future look like?

Investigating the financial health of a potential employer is crucial, Jones says. The changing healthcare market, with decreasing budgets and shift toward more consolidation, has already affected providers throughout the country—and that’s before you even consider the impact of COVID-19.

“This pandemic has made financial stability more important than ever,” Jones says. “As strong as the job market is, there are some radiology practices and rural hospitals that may not survive this.”

Radiologists should ask around to gain more information about the current status of any practice they consider. Could a merger be on the horizon? How might that impact the practice’s employees? Perhaps some peers or a mentor may be familiar with the area and could provide some guidance. Any information you can learn about the practice’s future, even the smallest detail, can be helpful.

Jones also encourages radiologists to learn about the health of the practice’s clients. Does the practice you are considering only work with one hospital? If so, how stable is that hospital? If it closes, that would be bad news for anyone interpreting its imaging exams.

“I go out of my way do demonstrate our practice’s financial stability with every candidate I speak to—it’s a very important topic,” Jones says.

2. Who will you be working with? What are the practice’s demographics?

Demographics can affect a practice in unexpected ways. Say, for instance, you’re a relatively young radiologist thinking about joining a group and about half of the other radiologists are close to retirement age. Once those older physicians start to retire, what will it mean for you as a member of that team?

“The average time to fill an open physician position is over 200 days,” Jones says. “So, if your colleagues start retiring, that will lead to more work for you. It will mean more call coverage, more exams to read and more problems to solve.”

Radiologists need to consider if that is a desirable opportunity or not given his or her family dynamics and personal goals.

Something else to keep an eye on is how a practice handles scheduling. Will you be on equal footing when it comes to time off or will radiologists with seniority enjoy more flexibility? Will those with families receive preferential treatment when it comes to taking time off during the holidays?  It’s yet another way that a practice’s demographics can impact its physicians.

3. How does the practice assign work?

Getting a tactical understanding of workflow is completely appropriate, Jones says. The incoming radiologist should understand before joining the group how studies are allocated. Perhaps the radiologists take turns focusing on different modalities, for example, with the duties shifting each day or week. Or the entire group may work from a centralized work list, which means there is a potential for some radiologists to cherry-pick or simply do the minimum amount of work possible.

Jones emphasized that radiologists should clarify the work assignment process during the interview and think about how they would prefer work to be assigned—and if they could handle a situation where it was assigned differently. You don’t want to join a new group just to find out you aren’t compatible with its day-to-day workflow.

4. How does compensation work? Are other benefits like malpractice “tail coverage” included?

While some larger practices and hospitals will pay radiologists an annual base salary, that isn’t necessarily always the case. At vRad, for instance, the team of teleradiologists is “paid per click,” meaning your salary is based on how many interpretations you perform, while considering the relative work effort for different types of exams.

“If you like to read a lot of exams quickly and get paid more, you can, provided your quality remains solid,” Jones says. “If you want to read slower, you can. This compensation structure allows radiologists to work at their own pace. Most organizations, however, aren’t like that.”

When radiologists are paid a base salary, of course, there is still plenty of room for variation. At some practices, for instance, the team is simply expected to keep up with one another and work at a reasonable pace. At others, though, you may be expected to stay at work until every study on the work list has been completed, regardless of urgency. Radiologists may wish to ask about other opportunities to earn, such as taking on administrative roles like medical director or lead interpreting physician.

Another potential perk some practices offer is “tail coverage” for their medical malpractice insurance. This benefit extends coverage for the radiologist past their term of employment if they choose to leave the practice in the future. Radiologists are often surprised with a large bill for tail coverage if it wasn’t included in their original contract.

“A bill for $15,000 is not uncommon. I’ve seen them as high as $90,000,” says Jones. “That can really complicate matters for a radiologist hoping to change jobs.”

Large signing bonuses are common as well, and younger radiologists may find themselves drawn to the possibility of a bonus that can knock out a large chunk debt in a matter of seconds. Accepting perks like a bonus or loan forgiveness will come with a requirement to repay it if you leave the practice before a certain number of years.

“I advise radiologists to carefully consider these offers,” Jones says. “It’s like that old cliché: if something sounds too good to be true, it probably is. During the interview process, ask specific questions to uncover what income level you can expect once the term of the initial contract period is over. Future salary, the day-to-day environment, and work distribution deserve equal consideration to the sign-on perks.”

5. Does the practice embrace newer technology, including AI?

Don’t shy away from asking about your potential employer’s technological capabilities. What imaging equipment do they use? Which PACS is installed at their workstations? Do they have their own in-house IT department that can quickly troubleshoot issues? Can you work from home, if desired? These are key questions that will give you an idea of how much stock the practice puts into using state-of-the-art solutions. 

At vRad, radiologists gain access to a PACS and RIS that were developed in house by a team of dedicated developers.

“Just recently we actually had a radiologist return within nine months of leaving vRad because he quickly realized how important a robust technology platform was to his productivity,” Jones says.

AI is another major area for job applicants to consider. At larger practices or academic centers, advanced algorithms may manage worklist prioritization, alert radiologists about inadvertent errors, or even identify clinical findings. Smaller practices or rural hospitals, on the other hand, may be years—or even decades—away from using AI on a regular basis.

6. How does the practice act under pressure?

One valuable way to learn more about an employer during the interview process is asking how they handled the COVID-19 pandemic. The exact question Jones suggests is, “During the pandemic, how was the practice’s volume affected, and how did you respond to that change?”

This can be incredibly informative, he says, because some outpatient imaging providers had to temporarily close their doors in April and May 2020 as the pandemic escalated. Other providers, meanwhile, continued coverage but furloughed some staff.  When considering a job change, especially if you’re looking at numerous options in the same region, finding out how they handled the pressure could be quite helpful.

“What happened with COVID-19 was certainly unpredictable,” he says. “But now that we’ve all experienced it, practices should be developing a plan in case we have a similar situation in the future. If an organization isn’t already starting to prepare for the next time, that tells you a lot about how it is managed.”

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About Adam Jones

A 25-year physician recruiting veteran, Adam Jones has earned multiple recognitions for superior achievement and performance, including the vRad Above & Beyond Award. He is passionate about helping radiologists make thoughtful career decisions and achieve their professional goals, employing an intimate knowledge of the vocation and a vast network of personal connections to match each individual with their ideal practice.