They used to say academics was less production/pay and private practice was high stress/high comp. The gap has narrowed because the academy is demanding much more, lots of rads are just nonacademic employees of the university behemoth working a generic job, and the labor shortage means hospitals/universities need to pay more to compete in the job market.
Perhaps counterintuitively, strong private practice in the face of the labor shortage is one of the factors driving up academic compensation.
Add this to the list of things that I should have had ready for launch day back in August: the Independent Radiology Newsletter. Sign up now to receive monthly job updates from the world of private practice radiology.
Bill Watterson, who created the best comic strip of all time (Calvin and Hobbes), gave the commencement address at Kenyon College back in 1990, which he titled, “Some Thoughts on the Real Word by One Who Glimpsed It and Fled“:
It’s surprising how hard we’ll work when the work is done just for ourselves. And with all due respect to John Stuart Mill, maybe utilitarianism is overrated. If I’ve learned one thing from being a cartoonist, it’s how important playing is to creativity and happiness. My job is essentially to come up with 365 ideas a year. If you ever want to find out just how uninteresting you really are, get a job where the quality and frequency of your thoughts determine your livelihood. I’ve found that the only way I can keep writing every day, year after year, is to let my mind wander into new territories. To do that, I’ve had to cultivate a kind of mental playfulness.
I love that line: “If you ever want to find out just how uninteresting you really are, get a job where the quality and frequency of your thoughts determine your livelihood.” Of course, Watterson had the constraints he placed on himself by his chosen medium. I don’t know if it’s easier or harder long term to do permutations pivoting around a central premise or to bounce from thing to thing as you tire and exhaust the low hanging fruit of its potential. I think they’re probably both really hard.
We’re not really taught how to recreate constructively. We need to do more than find diversions; we need to restore and expand ourselves. Our idea of relaxing is all too often to plop down in front of the television set and let its pandering idiocy liquefy our brains. Shutting off the thought process is not rejuvenating; the mind is like a car battery-it recharges by running.You may be surprised to find how quickly daily routine and the demands of “just getting by” absorb your waking hours. You may be surprised matters of habit rather than thought and inquiry. You may be surprised to find how quickly you start to see your life in terms of other people’s expectations rather than issues. You may be surprised to find out how quickly reading a good book sounds like a luxury.
I was traveling for a talk the other day and this came up with someone in the audience. I make time for the writing and the projects and the teaching/mentoring and everything else because that’s the variety that makes the more routine, potentially tedious stuff tolerable.
Yes, time management is impossible, but it doesn’t mean I wouldn’t fill more precious time with garbage if I wasn’t trying to be deliberate.
Creating a life that reflects your values and satisfies your soul is a rare achievement. In a culture that relentlessly promotes avarice and excess as the good life, a person happy doing his own work is usually considered an eccentric, if not a subversive. Ambition is only understood if it’s to rise to the top of some imaginary ladder of success. Someone who takes an undemanding job because it affords him the time to pursue other interests and activities is considered a flake. A person who abandons a career in order to stay home and raise children is considered not to be living up to his potential-as if a job title and salary are the sole measure of human worth.
You’ll be told in a hundred ways, some subtle and some not, to keep climbing, and never be satisfied with where you are, who you are, and what you’re doing. There are a million ways to sell yourself out, and I guarantee you’ll hear about them.
To invent your own life’s meaning is not easy, but it’s still allowed, and I think you’ll be happier for the trouble.
A Man for All Markets by Edward O. Thorpe is a fascinating memoir from the mathematician/gambler/investor who solved card counting and essentially invented modern quantitative investing strategies.
While reading, I was struck by two things: One, unsurprisingly, Thorpe is/was curious, industrious, and clearly a genius. Two, that his life as a latchkey kid in the early 20th century, which included buying dangerous chemicals and making amateur explosives at home could not seem more distant than the modern American screen-based and scheduled childhood.
A few standout passages:
Regarding the need to have both a desired outcome and an expected outcome in mind when making a new decision:
If you do this, what do you want to happen?
If you do this, what do you think will happen?
The problem of moral hazard in the modern US economy:
Our corporate executives speculate with their shareholders’ assets because they get big personal rewards when they win — and even if they lose, they are often bailed out with public funds by obedient politicians. We privatize profit and socialize risk.
On negotiating to “win”:
It doesn’t pay to push the other party to their absolute limit. A small extra gain is generally not worth the substantial risk the deal will break up.
The information food chain:
Be aware that information flows down a ‘food chain’, with those who get it first ‘eating’ and those who get it late being eaten.
Regulation matters, but only when simple and effective and not crafted by the schmucks making all the bad choices:
Nassim Taleb asked why, after a driver crashes his school bus, killing and injuring his passengers, he should be put in charge of another bus and asked to set up new safety rules.
How much leverage is enough?
The lesson of leverage is this: Assume that the worst imaginable outcome will occur and ask whether you can tolerate it. If the answer is no, then reduce your borrowing.
The gambler’s approach to life:
In the abstract, life is a mixture of chance and choice. Chance can be thought of as the cards you are dealt in life. Choice is how you play them.
And finally, what old people always say but young people can’t seem to internalize:
That acknowledgment, applause, and honor are welcome and add zest to life but they are not ends to be pursued. I felt then as I do now that what matters is what you do and how you do it, the quality of the time you spend, and the people you share it with.
Medical surveys are an easy way to make a few bucks at a good hourly rate (well, maybe at least for a resident), and there are multiple sites offering surveys to physicians. The caveat is that, of course, most survey sponsors are typically looking for board-certified physicians with multiple years of experience, particularly in sub-specialties. The less experience you have, the more you need to be prepared to get screened out of what seem like promising survey opportunities.
This article was originally posted way back on Feb 26, 2014 and last updated November 2024. This page contains referral/affiliate links (thank you for your support).
Curizon has been in the business a long time, but they just completely revamped their website and platform. It’s a trusted site for well-paying healthcare surveys for physicians as well as other healthcare professionals. Five new sign-ups per month will win $100.
One of the biggest survey sites is Sermo (also an online healthcare community), which is now offering my readers a $10 welcome bonus. The survey experience has been recently revamped, and once you maintain a balance of $100 in honoraria, you get preferentially invited to more surveys.
ZoomRx is also excellent and has a nice app and better/shorter-than-average surveys. No sign-up bonus for you, but there is a referral one for me if you’d like to support the site!
One of my very favorites is InCrowd, which has a slick mobile-friendly site and will send you survey opportunities by email or text message. These are always of the very short and painless variety (the fastest of all in my experience), so the payouts are small, but it’s good money for the time and basically effortless. You do have to respond quickly before surveys fill up, but you even get a buck when you get screened out. Being referred (like signing up through that link) will earn you a $10 bonus after you answer your first two microsurveys.
M3 now has three separate very active research companies under its umbrella: M3 Global Research, M-Panels, and All Global Circle. Each is currently offering its own $10 sign-up bonus for twelve select specialties (Hematology-Oncology, Surgery, Urology, Neurology, Family Medicine or General Practice, Psychiatry, Ophthalmology, Endocrinology/Diabetes, Dermatology, Radiology, Rheumatology, Allergy and Immunology, Otorhinolaryngology/ENT, and Pulmonology).
At the resident level, one of my old favorites has been Brand Institute, which almost exclusively sends out short surveys about potential drug brand names. Payouts are always on the smaller side ($15), but each one is quick (about $1 per minute or more) and screen-outs are rare. So if you get invited to a survey, then you can generally complete it and get the honoraria. No BS. The main style/format is nearly always the same, so you pick up speed as you do more of them. And that honoraria size is also significantly larger than what one can generally pull as a non-physician (e.g. SurveySavvy, the biggest most popular survey site around, usually pays a measly $2 per survey). The website, however, is clunky and terrible. You’ve been warned.
Additional legitimate additional survey sites, many of which are significantly less active, are below:
I believe in the importance of thriving independent private practices for the field of radiology. True private practice–where doctors control the organization, are responsible to their peers and patients, and earn the full fruits of their labor–is the benchmark that sets the market and provides the anchor against exploitation from unscrupulous employers.
My group, like most groups in this market, is hiring. Here are 10 more 100%-independent radiologist-owned private practices across the US that are recruiting. If you’re in the market for a new position, consider reaching out with your CV. (Click the triangles for more information.)
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Established in 1917 and fiercely independent, MRA is a well-respected subspecialized practice of 60 radiologists and growing. They especially take pride in their group culture (seriously, there are some really nice people in that group including one of my old senior residents).
Partnership track:
Employee track:
Learn more at www.meckrad.com/recruitment.
Contact: Charlene Eichinger at ceichinger@meckrad.com
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Independent and long-standing group covering a diverse mix of financially sound hospital partners, outpatient imaging centers, an ASC/OBL, clinics, and a multi-specialty group. 50+ radiologists and 10+ midlevel providers. In-house and experienced IT, Credentialing, HR, and Admin team including dedicated Radiology Liaison support 24/7/365.
Recruiting for Body, Breast, Cardiac, Neuro, IR, and General.
Partnership Track:
Employee or Contractor:
Learn more at http://risimaging.com.
Contact: Alice Varnadore, Executive Assistant at avarnadore@risimaging.com
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STRG is a well-established, expanding, independent subspecialty practice of 70+ radiologists serving 15 hospitals, multiple freestanding ED facilities, and a large outpatient imaging practice (STRIC). Both onsite and remote positions are available.
STRG is a forward-thinking practice with a strong and cohesive culture. Multiple AI projects are in place and in progress to improve efficiency and quality. Internal moonlighting opportunities are available.
Shareholder Track:
Emergency Radiology Track:
Learn more at https://stric.com/.
Contact: Waynea Finley at wfinley@strg-pa.com
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Large 175+ subspecialized practice with 17 weeks of vacation. Two-year shareholder track for new graduates and a one-year track with experience.
Positions (On-site):
Positions (Remote):
Learn more at www.midwestradiology.com.
Contact: Barry.Lindo@MidwestRadiology.com
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A growing Central Florida private practice, rare for the region, with 70+ radiologists looking for an on-site general radiologist.
Learn more at https://raocala.com.
Contact: Dr. Vivek Kalra at Vivek.Kalra@raocala.com
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Established in 1938, GTR is a 100% physician-owned and operated private practice in a four-season resort town on the bays of Lake Michigan.
Needs: Body, Breast, ER/General, and IR
Learn more at https://www.grandtraverseradiologists.com
Contact: Dr. Anthony Livorine at alivorine@gtradiologists.com
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40+ radiologists covering 20+ sites with a multi-subspecialty mix of inpatient, outpatient, and ED imaging. Robust reading room assistants and IT presence to promote peak efficiency including a unified reading list/PACS (no switching stations or PACS to read other sites) and RadAI automated impressions to improve efficiency.
Greatest needs are IR, mammography, body imaging, MSK, and nuclear medicine, but all subspecialties and general radiologists are welcome.
Partnership track:
Employee track:
Learn more at http://rapaxray.com/
Contact: recruitment@rapaxray.com and Dr. Brandon Kelly at bkelly@rapaxray.com
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34-radiologist subspecialized collegial private practice with long-term stability providing coverage to 30 locations across Central and North Central Iowa. Ownership of several outpatient imaging locations yields distributions from technical fees, and Des Moines is one of the fastest-growing areas in the country with a low cost of living, excellent schools, and low taxes.
Partnership track:
Employee track:
Learn more at http://www.iowaradiology.com
Contact: recruit@iowarad.com
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A congenial team of 25 sub-specialized radiologists in New York’s scenic Hudson Valley that understands the importance of work-life balance. Since the 1970s, HVR has been respected in the community and known for its entrepreneurial spirit and excellence in patient care, currently providing services to five local hospitals and multiple outpatient imaging centers.
Learn more at https://www.hvrads.com/
Contact: Dr. Evan Kurz at esk@hvrads.com
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The largest 100% radiologist-owned and operated group in the country, serving the greater North Texas area since 1937. 290+ radiologists, 30+ APPs, and robust business staff support. Low turnover, healthy culture, ownership mentality, work-life balance, reasonable call schedules, and unlimited voluntary internal moonlighting (both scheduled shifts and anytime when not scheduled). 24/7 neuro and pedi subspecialty support.
The practice is organized into four distinct areas within DFW and seven distinct regions outside the Metroplex. This allows for practice opportunities ranging from small & intimate to large & subspecialized.
Positions (On-site):
Positions (Remote):
Learn more at https://radntx.com/radjobs
Contact: Todd Howard @ radjobs@radntx.com
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If you’re a group looking to advertise, get in touch. The monthly post here is limited to just 10 groups at a time, but in August I launched Independent Radiology as a resource for the broader community, a dedicated private practice radiology job board with 90+ groups so far. If you’re in the market, please also check it out for your job-hunting needs.
Henrik Karlsson, from “Scraping training data for your mind,” on the need for the right kind of information to learn new skills:
[You] want the input you observe to be as closely connected to a practice as possible. You want to see the process, not just the results. The results are often misleading. If you are a musician looking at successful bands, you might get the impression that you need to make music videos to succeed, whereas, in fact, a video only makes sense after you have achieved a certain level of success—so imitating that will lead you to misallocate your time.
You will also be led astray if you rely on advice and explanations unconnected to an ongoing process. Experts can rarely articulate the behaviors that allow them to perform at a high level. The knowledge is tacit. The explanations are post-hoc rationalizations; they do not produce the results.
But if you look at the performance, if you get close to it, it is all there.
Looking at the final product to reverse engineer the process can be an impossible task. This is why seeing doctors and surgeons practice medicine and operate is so important. Why it’s so critical to have good readouts when you first start radiology training.
You need to be exposed to the unfiltered expert approach. The “teaching” isn’t just the discrete teaching points and other pearls; it’s seeing the expert practicing natively that helps create the scaffolding to incorporate book learning, real world experience, and ultimately be able to learn the most from the emotional microtraumas of repeated failure that are an unavoidable part of medical training.
Some passages on what makes a job “good” from The Happiness Hypothesis by Jonathan Haidt:
Psychologists have referred to this basic need as a need for competence, industry, or mastery. [Psychologist Robert] White called it the “effectance motive,” which he defined as the need or drive to develop competence through interacting with and controlling one’s environment. Effectance is almost as basic a need as food and water, yet it is not a deficit need, like hunger, that is satisfied and then disappears for a few hours. Rather, White said, effectance is a constant presence in our lives: Dealing with the environment means carrying on a continuing transaction which gradually changes one’s relation to the environment. Because there is no consummatory climax, satisfaction has to be seen as lying in a considerable series of transactions, in a trend of behavior rather than a goal that is achieved.
This reflects the importance of developing the craftsman mentality.
The effectance motive helps explain the progress principle: We get more pleasure from making progress toward our goals than we do from achieving them because, as Shakespeare said, “Joy’s soul lies in the doing.”
Believing the opposite was coined as “the arrival fallacy” by psychologist Tal Ben-Shahar, who wrote the best-selling Happier. (As in: I’ll finally be happy when I finish that big exam or project. No, when I graduate! Or get that promotion! No, when I retire!)
Contrast the effectance motive with the many narrowly defined clock-in clock-out closely supervised jobs that limit personal choices:
In 1964, the sociologists Melvin Kohn and Carmi Schooler surveyed 3,100 American men about their jobs and found that the key to understanding which jobs were satisfying was what they called “occupational self direction.” Men who were closely supervised in jobs of low complexity and much routine showed the highest degree of alienation (feeling powerless, dissatisfied, and separated from the work). Men who had more latitude in deciding how they approached work that was varied and challenging tended to enjoy their work much more. When workers had occupational self-direction, their work was often satisfying.
My profession of radiology can easily fall into this trap in the wrong environment. You have to carve out ways to take ownership of both the process and product.
It’s an incredible privilege to work at a place and live in a country that is willing to set aside money to answer these existential questions. I heard a phrase the other week, existential humility, and I really liked that. We’re this complex life form that has evolved over billions of years to the point where we can ask these questions — and yet we’re perhaps not the only ones in the universe. And if we could know that for certain, that would be humbling in the most wonderful possible way.
– Astronomer Vanessa Bailey in Dave Eggers’ “The Searchers,” a profile on NASA’s Jet Propulsion Lab.
If you haven’t yet read an explainer on “AI”, I consider Jeremiah Lowin’s “An Intuitive Guide to How LLMs Work” to be a good one.