The increasing stress that radiologists face

The increasing stress that radiologists face

In the past, the radiology profession was seen as a very financially successful specialty, but as every businessperson knows, success often has peaks and valleys.  Radiology residencies are some of the most competitive to obtain, which is due to the combination of expected financial compensation and the assumed quality of life.

In the early 1990’s, when financial pressures first appeared on the frontier of radiology, it was suggested that hospital based physicians divvy up a portion of their financial pie. It was during that time, and again in the early 2000s, that radiology began to see a dip in American graduates showing interest in the field. The nice 9-to-5 lifestyle and never being on call started to fade away, making the stress associated with radiologists lives become more apparent.

Compensation for practicing also started to become severely affected, this applies to both hospital based radiologists and independent imaging center radiologists. Hospitals used to pay a generous stipend to their radiologists, however they are now facing increased financial pressures such as the shutting down of hospitals, emergency room patients being cared for without paying and harsh Medicare cuts.  With all of these stressors, hospitals are additionally requiring 24-hour coverage by radiologists to account for better patient care, while teleradiology services seem to have undercut most hospital based radiologists.

Challenges associated with pre-certifications, decreased reimbursement, decreased referrals due to radiation fears and self-referrals have also been contributing factors to decreased compensation, but more importantly, those radiologists’ morale has begun to suffer. Particularly in the case of outpatient imaging centers, where income reductions in some areas have been as much as 50-75%.

Radiologists are working longer hours and taking less vacation time, which seems miniscule, except that you must take into account the fact that this was unheard of in years past. These same radiologists are now delaying retirement, which leads to the delay of hiring new, younger radiologists. In the cases where positions are offered, the starting salaries in some states have been reduced by as much as 40%. Of course in certain areas of the country, like New York City, this is more threatening and prevalent.

It is hard to look at healthcare in our country and understand where our problems start and where they end, but as healthcare professionals, it is necessary to take a step back and examine these changes from the care providers’ perspectives. It will help us determine where we are, how far we have come and what next frontier we will conquer.

Matthew D. Rifkin is a radiologist and Chief Medical Officer, Atlantic Health Solutions.

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  • buzzkiller

    How big a deal is teleradiography, sending images to India or somewhere? It seems to me than you still need a rads doc around to stick needles in abscesses and that means the hospital’s bargaining power is limited. “If I don’t get to read the MRIs, I won’t needle your patients.”
    Anyway, that’s how it kinda sorta looks from the outside. What am I missing? Any info from radiologists out there would be appreciated.

    • Sara McFarland

      Working with radiologists, I’ve heard that for hospital based radiologists, teleradiologists can be seen as a better option and often times they are undercut by the hospital’s decision to outsource. Of course when we work with independent radiologists at outpatient centers, they are less concerned with teleradiology because they are focused on treating patients in their own practice and wouldn’t outsource due to the way the patient experience would be compromised. The best example I can think of for this would be Rosetta Radiology in Manhattan. They pride themselves on the fact that every one of their patients gets face-to-face time with their radiologist.

  • Suzi Q 38

    I thought radiologists were still in demand and commanded a very high salary.
    I wonder what the future holds for this specialty, one of many in the medical field that I appreciate and respect.
    When I needed an MRI for my spine in 3 areas (cervical, thoracic, and lumbar), I got a phone call from my PPO insurance company.
    This is one of the largest insurance companies in our state.
    They told me that the imaging center at my teaching hospital was charging $25K for the 3 images….would I please go to another imaging center off hospital??? The cost saving would be significant…$6K for all 3.

    I thought about it, but only because I thought that there would be not much wrong with my spine. I asked: “Are the images and evaluations going to be equal???” “Yes!” They said emphatically. When I was given the name of the off-site imaging center, I called them directly and asked who was going to read the imaging. They thought I was a little nuts to inquire at all.
    My thinking was maybe not all radiologists were equal.

    Anyway, I tried it, and imagine my surprise when it was discovered that I had spinal stenosis in my cervical spine….severe.

    When I moved to a neuro hospital, they said that the images were not clear for some reason, so I had to take them again.

    This time they were read by a neuroradiologist and the report findings were far more detailed.

    I called back the insurance company and told them that they should not be calling patients like me and taking them into going the cheaper route when it involves the spine or brain. Maybe the machines were different, as well as the expertise of the radiologist reading my MRI’s.

    I told them that I was protesting the first set of MRI’s, as two physicians complained that they were not very clear. I had to demand a review of the first scans.

    I successfully got another set.

    I will be careful when allowing this to happen again.
    I like to save my insurance company money, but sometimes, I need the better MRI machine and radiologist.

    • Save On Medical

      As for what the future holds for the specialty, we are predicting more independent radiologists being bought out by hospitals due to their inability to keep their practices running. If you shopped for cost savings, you’d see that often times those independent centers have significantly lower prices than at hospitals, which patients often misconstrue as a difference in quality. It’s just not the truth. It’s important to compare the price and quality of a radiology provider and with the rise of transparency in health care, you will start to see hospitals and outpatient practices alike, starting to list their prices so patients can make more economical decisions.

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