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.
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.
The radiologist shortage is definitely here. There are different ways to approach the market, but balancing short-term vs long-term plays is nontrivial. Leverage is great, but using too much can amplify negative downstream second-order consequences too.
What’s happening now varies and what will happen is anyone’s guess, but this anonymous op-ed “Radiologists need to be realistic about the job market” is absolutely worth reading.
…Hospitals quite literally cannot operate beyond a few hours without diagnostic radiology. We are the bottleneck for all inpatient care. All service lines run through us. Any radiologist can easily take one of the hundreds or thousands of teleradiology jobs, which offer less commute, less non-interpretive work, and often higher pay per hour. Hospital systems simply have no leverage against their radiologists except fear of the unknown.
We work in interesting times:
A group of radiologists is severely understaffed, reading far beyond what they normally would. Radiologists are overextended, and high-volume readers are threatening to quit unless something is done. The group is unable to afford hiring radiologists in the current market. Many other unsolvable issues, such as retirements, interpersonal issues, poor work ethic, interventional radiology (IR) vs. diagnostic radiology (DR) squabbles, and [plug in your practice’s problems here] plague the group. Negotiations with the hospital have yielded minimal results. What is a group to do? Take the money, or continue the negotiations?
Again, imagine all of the unsolvable problems this group may face: recruitment, billing issues, MIPS, exploding volumes during nights and weekends, older partners wanting to cut down or retire, cantankerous partners who are indispensable, ad infinitum. More money can’t solve all of these problems, because in this labor market, an exclusive contract is a massive liability. The group decides to turn these liabilities into leverage: They walk away from the contract and tell the hospital they can hire them as employees for base + productivity, or see you later.
The tables have immediately been turned. Suddenly, all of the issues that were unsolvable now become points of leverage. Can’t recruit? More leverage for us. Can’t staff weekends? More leverage for us. A couple of people retired? More leverage for those who stayed. Volume too high? I’m on productivity, or I’ll read slowly and take my base salary. Billing sucks? Not my problem. Overnight services increased their rates? Not my problem. Want to find another group? Good luck, there’s nobody else. We have three months of trailing AR to keep us fed until we get credentialed literally anywhere else.
Guess who wins?
Another paper suggesting that clinicians prefer some structure (but not too much structure) in radiology reports. There are always edge cases where structured reporting becomes cumbersome–and overly parsed reports are also inefficient/unreadable–but there’s no denying it’s so much easier for me to scan a prior report when it’s not narrative free text.
A reader asked if anyone had successfully started a new radiology private practice recently, particularly one that involved financing, opening up new imaging centers, and fresh payor contracts. There is a vacuum in some areas, especially with the PE-exacerbated instability, and therefore a clear opportunity to those who can muster the manpower (no easy feat).
As a follow-up, I thought I’d ask (on their behalf): is anyone who has willing to mentor other upstarts?
The battle between Radiology Partners and UnitedHealthcare has ended with United as the victor.
The summary:
The $153 million award would really have only been an extra $94 million since United had already paid for the work at a lower rate. (Author’s note: That’s quite the contract.)
Phase III–that awkward fraud question–just finished. The ultimate findings of the panel (free login required):
In the Phase I Decision entered on April 2, 2023, the Panel made the following finding: “The Panel finds the 1998 contract to be the operative agreement between the parties.” The Panel confirms this finding.
In Phase II the Panel entered the Interim Award On Singleton’s Arbitration Demand on September 26, 2023. The Panel now vacates that Interim Award.
The difference between the amount United paid on claims pursuant to the rates specified in the 2020 Agreement and the amount it would have paid pursuant to the rates specified in the 1998 Agreement is $94,275,324.00. United’s underpayment of Singleton’s claims at the rate specified in the 2020 Agreement was a breach of the 1998 Agreement.
Because of its breaches of the 1998 Agreement and its other acts and omissions, Singleton is not entitled to recover this difference and underpayment or any other relief against United. Because of its breaches of the 1998 Agreement and its other acts and omissions, United is not entitled to any other relief against Singleton. The Panel determines that the evidence fully supports these decisions at law and in equity.
Translation: you are both jerks, you are both wrong in your typical unique and despicable ways, please go away forever:
United was wrong to unilaterally use the incorrect contract to determine payments. RP was wrong to hide its ownership and then essentially pretend that every group in the region it owns was Singleton when they clearly weren’t.
(For more description/backstory, see the previous two posts: United against Radiology Partners & United is Still Fighting Radiology Partners.)
For those keeping score at home, United’s lawyer was correct when they said, “We do not agree that Singleton will recover an award from UnitedHealthcare.”
In other news, whether or not they were right, United is still a terrible company.
Or, “Why Independent Radiology is different from most job boards (but also still boring)”
So recently I created a simple, small website called Independent Radiology. It’s a boring job board, but it’s also different from most job boards.
Jason Fried from 37signals (makers of Basecamp, HEY, and other stuff) argued years ago that software should be opinionated. A random WordPress website isn’t software per se, but I feel as a random dude on the internet with a full-time job, family, writing avocation, etc that anything extra worth doing in this sphere is only worth doing if it’s going to help someone and is unabashedly done the way I would do it. It’s a project that reflects my biases, preferences, and mission. It’s idiosyncratic. It’s opinionated.
When I first thought seriously about the issues with the ACR job board earlier this year that inspired this project (now significantly improved, you’re welcome), I was partly irritated by disingenuous job listings from Radiology Partners that were masquerading as independent private practices. But I was also struck by several things:
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Something happened to the field of Radiology.
Actually, a lot of things have happened and are happening to Radiology all the time, but one of those things has been that the proliferation of corporate and private equity-backed radiology practices over the past decade has been followed by a historic radiologist shortage, a subsequent piping-hot radiology job market, and a challenging zero-sum game to hire on-site and even remote radiologists.
There are thousands of rad jobs available in the country and more work than the field can handle, but only a fraction of those positions are at independent radiologist-owned and controlled private practices. A lot are not.
That’s why I’ve temporarily been posting a radiology job ad on this otherwise very personal site, and that’s why I’ve just launched Independent Radiology.
From the “Why?” page:
The thriving independent private practice of radiology is critical to the future of the field. 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.
This site exists to help those radiologists looking for the real deal.
You don’t have to agree with me, and you also don’t have to care. Not everyone needs or wants to work in private practice, and of course that’s fine. I also believe in the academic mission, and there’s nothing inherently wrong with being an employee. I also don’t want to just glamorize a practice model. Models aren’t destiny, and a private practice isn’t necessarily a good practice.
But, I do believe every radiologist should hope for the success of independent radiologist-owned private practices. The ability to join a thriving independent practice where doctors get paid for the full amount of their professional work and have the autonomy to choose how to do it is what forces employers to compete. It’s the anchor. It’s the BATNA that every hospital and corporate suit knows you have. It’s what keeps them honest.
By another analogy, the employment model is the renting to a partnership’s buying. There’s nothing wrong with renting. Renting can be great! Sometimes, based on your finances, the available options, and the local factors, renting is simply a better, safer option than buying. It’s undeniable. Not every house is a good purchase. And, when you have a good landlord, who charges you a fair market rate and is quick to fix the things that break down, renting can be an easy low-friction experience.
But we are stronger as a field when ownership is a real possibility. And, like homeownership, when you buy a good property, in the long run, you generally end up ahead. You have to deal with some upfront costs and the upkeep–oh, the upkeep!–but you also have more say about the property and you’re not reliant on someone else’s goodwill or business savvy. You have a good place to live: a home, not just a house. For the renter, the landlord can always change. They can always call your bluff and see how far they can push you before you decide to move. That’s why viable options are important for the whole market.
So, I wanted to make some space online to help those who want to join and help build a practice to find what they’re looking for. And, I wanted to build a place to showcase true independent radiologist-owned private practices in order to help them find radiologists in this challenging market.
I hope it’s helpful.
Here’s a little compilation of posts from the last few years about getting started as a new radiology resident.
Approaching the Radiology R1 Year and its short companion post: How to be a First-Year Radiology Resident.
Want something a little more controversial? You Should be Correlating Clinically.
Book Recommendations for First-Year Radiology Residents (and some further recommendations for when there’s extra book fund to burn).
You can round that out with some more general thoughts on studying during residency. Then try my deeper dive: ultralearning radiology.
Also, residents from across the country in the ACR Resident and Fellow Section came together and assembled a nice collection of free radiology learning resources from across the interwebs including lots of videos.