Interested in Radiology, Is there really doom and gloom?

[suitup!]

Hello!
I have been wanting to post a few questions on this forum and finally got around to doing it. I am interested in radiology. I enjoyed reviewing each imaging study we ordered when on my pulmonary ccm rotation. Also on that rotation, I saw countless patients of ours who benefited so much from thoracenteses. That simple procedure did wonders for their hospital stays. I am curious about the field of radiology and the job market. It seems to be a topic that has been discussed before obviously. I always read about the need to do a fellowship. Can a guy get by with being a general radiologist with light ir? I don't want to live in a big city like New York or San Diego, etc. I see a moderate size city (50k-75k) in the southeast in my future. Is this doable? Additionally, some say rads lifestyles are gone. From what I have seen, rads docs work hard but seem to have a comfortable life as in time outside of work and are happy with their jobs. Would you say 50hr/wk is average to doable? 60hr/wk being too much on a continuous basis but occasional is fine. My philosophy is: time for my family > specialty/pay. I also don't mind working in a pp or being an employee... I think. I would love to read some of your thoughts. Thank you for the help!

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[colbgw02]

To answer your titular question, no.

Not doing a fellowship closes quite a few doors. You can get a job, but it'll be a job that few others want. It's an extra year and probably well worth it.

Lifestyle means different things to different people. In radiology, when people say that lifestyle is gone, they mean that 1) the pace of work in private practice is intense and 2) this is now very much a 24/7/365 field. Radiology still has good things regarding lifestyle. For example, vacation is still generous, and your hours tend to be well-defined.

 

[suitup!]

To answer your titular question, no.

Not doing a fellowship closes quite a few doors. You can get a job, but it'll be a job that few others want. It's an extra year and probably well worth it.

Lifestyle means different things to different people. In radiology, when people say that lifestyle is gone, they mean that 1) the pace of work in private practice is intense and 2) this is now very much a 24/7/365 field. Radiology still has good things regarding lifestyle. For example, vacation is still generous, and your hours tend to be well-defined.

Thank you! I know I am just a student at this point and seem naive. That is why I want to hear the thoughts from people who have experience in this field.

 

[guytakingboards]

While there is doom and gloom in the field right now (mostly from the older attendings), there are still reasonable opportunities to work a more moderate schedule.

Example #1: the VA. A lot of VA's across the country are kicking academic programs out and hiring their own people. At least at the last two VA's I trained at, the VA radiologists worked 8-4:30pm M-F with zero nights, weekends or call. Tele-rads covered the rest. I don't know how much longer that will be sustainable, as VA's are trying to ramp up their imaging services to decrease the wait times for veterans, but right now thats a perfect example of what you want. The pay has gone up recently (~$350k/year) and the benefits I've heard are very strong. Even further more, tort lawsuits/medical malpractice rarely if ever happen in the VA system.

Example #2: one of the neuro attendings at my program with three young kids (ages 1-6) switched over to a tele-rads company. I believe she was guaranteed nearly 100% outpatient neuro CT/MR. Being private practice, above a minimum level its eat what you kill. So if you dictate more you get paid more. If you want to spend more time with family you can dictate less OR work while the kids are asleep or at school. The pay is probably similar to my academic program anyway.

 

[scootad.]

The job market is much better now than it was when I finished fellowship 6 years ago. Lots of openings. The nice thing about rads are the variety of different practice settings. There are the traditional PPs (where you share night/weekend calls vs. one that has nighthawk), academics, VA, telerads, outpatient imaging centers (no call), etc. No question, the days can be busy, but if you don't mind working while at work and not twiddling your thumbs, its a good gig. I'd do it again.

 

[DrfluffyMD]

To be honest, if you really think family is above all else, I recommend a primary care or ED field. The pace and call demand of rads is too much for a family oriented person.

 

[suitup!]

While there is doom and gloom in the field right now (mostly from the older attendings), there are still reasonable opportunities to work a more moderate schedule.

Example #1: the VA. A lot of VA's across the country are kicking academic programs out and hiring their own people. At least at the last two VA's I trained at, the VA radiologists worked 8-4:30pm M-F with zero nights, weekends or call. Tele-rads covered the rest. I don't know how much longer that will be sustainable, as VA's are trying to ramp up their imaging services to decrease the wait times for veterans, but right now thats a perfect example of what you want. The pay has gone up recently (~$350k/year) and the benefits I've heard are very strong. Even further more, tort lawsuits/medical malpractice rarely if ever happen in the VA system.

Example #2: one of the neuro attendings at my program with three young kids (ages 1-6) switched over to a tele-rads company. I believe she was guaranteed nearly 100% outpatient neuro CT/MR. Being private practice, above a minimum level its eat what you kill. So if you dictate more you get paid more. If you want to spend more time with family you can dictate less OR work while the kids are asleep or at school. The pay is probably similar to my academic program anyway.

Thank you for your insight! This is reassuring. I have looked into the VA as a future employer due to my previous federal time that adds to retirement which is a plus.

 

[suitup!]

The job market is much better now than it was when I finished fellowship 6 years ago. Lots of openings. The nice thing about rads are the variety of different practice settings. There are the traditional PPs (where you share night/weekend calls vs. one that has nighthawk), academics, VA, telerads, outpatient imaging centers (no call), etc. No question, the days can be busy, but if you don't mind working while at work and not twiddling your thumbs, its a good gig. I'd do it again.

I do like the ability to change job styles so variety is never a bad thing! I am the type who works hard at work without the foot dragging and enjoys my time when I am off.

 

[suitup!]

To be honest, if you really think family is above all else, I recommend a primary care or ED field. The pace and call demand of rads is too much for a family oriented person.

The idea of 8-5 is nice but I can't stomach the constant patient load of primary care and the high risk of burnout. I won't lie ED has appealed to me in the past. From the other posts, it seems there are jobs for the rads doc who is family oriented. I do appreciate your opinion. I just hope rads can provide the life I want

 

[DrfluffyMD]

The idea of 8-5 is nice but I can't stomach the constant patient load of primary care and the high risk of burnout. I won't lie ED has appealed to me in the past. From the other posts, it seems there are jobs for the rads doc who is family oriented. I do appreciate your opinion. I just hope rads can provide the life I want

If you don't like "constantly working" you may not like radiology. It's one of the most "constantly on" specialty there is. Attendings often have no bathroom breaks. Some don't have downtime between cases.

If you find a low volume practice though it can be more lifestyle oriented. But many of those jobs that have big vacation hours are often very busy.

 

[deleted564680]

Rads is definitely "always on" and in some places the list never ends. One of my attendings just the other day said "I feel guilty for even breathing, let alone going to the bathroom or getting lunch."

 

[badasshairday]

Rads is definitely "always on" and in some places the list never ends. One of my attendings just the other day said "I feel guilty for even breathing, let alone going to the bathroom or getting lunch."

Are you guys even diagnostic radiologists? Attendings or residents? Sure the pace is fast and volume high. But that is true in other specialties as well including outpatient primary care and ED. This whole complaining while at work, "woe is me, can't pee or eat" is not unique to diagnostic radiology.

To answer the OP. Diagnostic radiology is a great field and has a decent to good lifestyle depending on individual practice. You may find a place that requires occasional evening or weekend shifts, or even more rare night shift. But in general most diagnostic rads work their tails off from 8 am to 5 pm Mon-Fri then go home. No pager so you can do whatever you want. No emergencies to wake up in the middle of the night. Most weekends off. A LOT of vacation (which is hard for physicians who have continuity of care with patients to pull) worry about like pushing a ton of paper like in other fields.

Other things that are priceless. Trainwreck patient/case, sucks to read that mri or ct, but once you sign off that report, you are done. None of the drama a patient facing physician has to deal with.

 

[badasshairday]

While there is doom and gloom in the field right now (mostly from the older attendings), there are still reasonable opportunities to work a more moderate schedule.

Example #1: the VA. A lot of VA's across the country are kicking academic programs out and hiring their own people. At least at the last two VA's I trained at, the VA radiologists worked 8-4:30pm M-F with zero nights, weekends or call. Tele-rads covered the rest. I don't know how much longer that will be sustainable, as VA's are trying to ramp up their imaging services to decrease the wait times for veterans, but right now thats a perfect example of what you want. The pay has gone up recently (~$350k/year) and the benefits I've heard are very strong. Even further more, tort lawsuits/medical malpractice rarely if ever happen in the VA system.

Example #2: one of the neuro attendings at my program with three young kids (ages 1-6) switched over to a tele-rads company. I believe she was guaranteed nearly 100% outpatient neuro CT/MR. Being private practice, above a minimum level its eat what you kill. So if you dictate more you get paid more. If you want to spend more time with family you can dictate less OR work while the kids are asleep or at school. The pay is probably similar to my academic program anyway.

#3. A nice established private practice in a small city in the south east. Exactly what the OP wants. This makes the money and lifestyle even better. None of the cut throat rates and competition of the large cities.

 

[suitup!]

Rads is definitely "always on" and in some places the list never ends. One of my attendings just the other day said "I feel guilty for even breathing, let alone going to the bathroom or getting lunch."

I see. What I mean about the constant patient load was the continuous patient interaction every 15min becomes fatiguing after awhile. I was referring to the constant patient contact. I like the aspect of seeing patients through imaging studies/procedures and having time to myself reviewing images. I like coming home after a hard day of work, but once I am home, I am home. As long as I know the end of my shift, I have a pretty high endurance to see the shift through and "being on." But once I'm done, I'm done. Thank you for your thoughts, I'll keep those in mind. I like all the insight I'm receiving from your posts.

 

[suitup!]

#3. A nice established private practice in a small city in the south east. Exactly what the OP wants. This makes the money and lifestyle even better. None of the cut throat rates and competition of the large cities.

Badasshairday you seem to get where I am coming from. I'm not afraid of work as long there is an end in sight. I appreciate your thoughts

 

[DrfluffyMD]

Are you guys even diagnostic radiologists? Attendings or residents? Sure the pace is fast and volume high. But that is true in other specialties as well including outpatient primary care and ED. This whole complaining while at work, "woe is me, can't pee or eat" is not unique to diagnostic radiology.

To answer the OP. Diagnostic radiology is a great field and has a decent to good lifestyle depending on individual practice. You may find a place that requires occasional evening or weekend shifts, or even more rare night shift. But in general most diagnostic rads work their tails off from 8 am to 5 pm Mon-Fri then go home. No pager so you can do whatever you want. No emergencies to wake up in the middle of the night. Most weekends off. A LOT of vacation (which is hard for physicians who have continuity of care with patients to pull) worry about like pushing a ton of paper like in other fields.

Other things that are priceless. Trainwreck patient/case, sucks to read that mri or ct, but once you sign off that report, you are done. None of the drama a patient facing physician has to deal with.

DR resident. No downtime here, list is such that residents are continuously reading at the fastest pace they are comfortable with. Maybe it's different elsewhere but we don't get the 5 min break in between clinic patients.

 

[tco]

DR resident. No downtime here, list is such that residents are continuously reading at the fastest pace they are comfortable with. Maybe it's different elsewhere but we don't get the 5 min break in between clinic patients.

That's my experience, too. We cover inpatient and ER during our ER shifts, and if it's just the resident reading, the list continuously grows. The attending covering the ER has to read some on their own, or we can't keep up.

 

[scootad.]

Big deal. In any specialty you pick you'll be busy. I have friends in IM/FP who are pressured to see a new pt every 15 minutes. You think they can accomplish much in 15 minutes, in a new patient with multiple co-morbidities? Do you think surgeons have any downtime...Heck, even successful dermies pack their schedule to the brim with patients, and run from room to room.

Radiology in the past (I'm talking pre-2005) was a CT every 25 minutes, interspersed with 2-3 US/XR, allowing ample time for coffee breaks, chatting and twiddling thumbs. Those days are long gone, yet we seem to continue to attract soft people into our field with similar expectations. Be prepared to work. At the same time, with experience, you get faster, more comfortable with computer shortcuts and you should be able to manage your time more effectively. As long as you are not lazy, and surround yourself with the right people with similar mindset, this is a satisfying specialty. You do the actual sciency/diagnosing part of medicine without a lot of the other BS. The pay/time off ratio remains quite attractive and the jobs are out there [ACR has 5 x more jobs listed now than 5 years ago]. As long as AI doesn't take off we are in good shape.

 

[scootad.]

It IS good, but why should it be amazing? Amazing is quite a high bar LOL

 

[DrfluffyMD]

Those days are long gone, yet we seem to continue to attract soft people into our field with similar expectations.

Look, on my last 10 hour work shift I've prelimed 30 cross sectional and dictated 70 cross sectional exams (including complicated inpatient MRIs replete with thousands of images) with phone call about once every 5 minutes.

Clearly, it's just that we are all soft people, special snowflakes, etc.

Perhaps it's easier on the attending side (the locum person was napping while I was working full blast), but as a resident I am certainly a lot more "on" whenever I am on.

Hell, I am looking forward to IR. It's less stressful to me.

 

[scootad.]

Post back to us in 5 years, when you are an IR getting called in at all hours of the night with a job that combines IR with diagnostics on your regular day shift. I'm not putting IR down, just saying work is work. Roll up your sleeves and stop complaining. I did residency during the explosion of CT too, I get it.

 

[DrfluffyMD]

Post back to us in 5 years, when you are an IR getting called in at all hours of the night with a job that combines IR with diagnostics on your regular day shift. I'm not putting IR down, just saying work is work. Roll up your sleeves and stop complaining. I did residency during the explosion of CT too, I get it.

Complaining? Oh I am not complaining. I am just stating a fact about volume and you seem to imply that the current trainee is soft.

I take offense to that because many people out of training have no idea what kind of volume are out there in big centers now due to consolidation.

I love diagnostics, and don't mind doing them, as long as there is IR involved. I don't mind being called to do important cases either.

I just cannot deal with mind numbing volumes that can lead to burn out. I am one of the fastest reader in my class but this is not a pace I like to sustain.

If you got a job with good pace, congrats.

 

[scootad.]

Fair enough. I agree we should be honest with trainees about the amt of work involved. It's a tight balancing act between giving a realistic view, scaring quality people off, and attracting the right people into our field.

I just want people to realize that there is no utopia out there where you can expect to make good money and have a stress free day. This is true across all specialties. [Maybe I'm just being Captain Obvious, but sometimes when I read the posts here, I detect a bit of unrealistic expectations which can lead to disappointment later] Best of luck to you.

 

[DrfluffyMD]

Fair enough. I agree we should be honest with trainees about the amt of work involved. It's a tight balancing act between giving a realistic view, scaring quality people off, and attracting the right people into our field.

I just want people to realize that there is no utopia out there where you can expect to make good money and have a stress free day. This is true across all specialties. [Maybe I'm just being Captain Obvious, but sometimes when I read the posts here, I detect a bit of unrealistic expectations which can lead to disappointment later] Best of luck to you.

Agreed. At the end of the day, you are doing interesting stuff (I think probably some of the most cerebral and interesting stuff) in the hospital. Your hours are short but mental exhaustion great, but your job as a diagnostic radiologist gets much easier as time go on as you gain more expertise.

Great gig. As a med student, you gotta decide what kind of "family oriented" person you want to be.

I truly think there are no more real life style specialty outside of PM and R or maybe light psych.

 

[DrBowtie]

Look, on my last 10 hour work shift I've prelimed 30 cross sectional and dictated 70 cross sectional exams (including complicated inpatient MRIs replete with thousands of images) with phone call about once every 5 minutes.

Clearly, it's just that we are all soft people, special snowflakes, etc.

Perhaps it's easier on the attending side (the locum person was napping while I was working full blast), but as a resident I am certainly a lot more "on" whenever I am on.

Hell, I am looking forward to IR. It's less stressful to me.

Why are you staffed by a locum?

 

[DrfluffyMD]

Why are you staffed by a locum?

My center is having a hard time hiring night-time rads, appearently a side effect of improved job market. This is despite a week on two weeks off schedule.

To be honest, I wished for a UCSF like system where seniors prelim cases and take call independently. I know I have the low miss rate to back it up personally. Unfortunate trend across the country is for attending coverage overnight.

 

[DrBowtie]

My center is having a hard time hiring night-time rads, appearently a side effect of improved job market. This is despite a week on two weeks off schedule.

To be honest, I wished for a UCSF like system where seniors prelim cases and take call independently. I know I have the low miss rate to back it up personally. Unfortunate trend across the country is for attending coverage overnight.

You said you prelimed some and dictated others so I assume there is some level of autonomy.

 

[badasshairday]

DR resident. No downtime here, list is such that residents are continuously reading at the fastest pace they are comfortable with. Maybe it's different elsewhere but we don't get the 5 min break in between clinic patients.

I agree diagnostic radiology is busy. But again, so are all fields. You think office based physicians are chilling for 5 min between patients? They are catching up on there notes, following up results, calling patients etc. Diagnostic radiology is not uniquely busy imo. All of medicine is busy. Diagnostic radiology however still has a lifestyle probably in the top third of all of the specialties when you comebine work hours, call, and enormous vacation and no need to for any continuity with patienrs requiring a pager after you go home.

 

[RadsFTW123]

To the OP: you seem like a great fit for radiology. Yes, rads is busy, but those that think radiology has it worse than everyone else, in my experience, don't know many people in other specialties. I think we still have it pretty darn good. AI is the only thing that is concerning for the future. Right now doesn't seem too scary but 30 years of smart tech grads funded by Silicon Valley money.. who knows what could happen. If you're okay with this risk, go rads. If not, do surgery or a procedural medicine specialty. Clinic based specialties are awful, many of these people are checking epic til late at night messaging patients, following on labs, etc - it's no picnic.

 

[deleted564680]

It's like the famous Churchill quote "Democracy is the worst form of government, except for all the rest."

Radiology has gotten worse and some people say it's bad, but it sure beats everything else.

 

[808s&heartbreak]

To the OP: you seem like a great fit for radiology. Yes, rads is busy, but those that think radiology has it worse than everyone else, in my experience, don't know many people in other specialties. I think we still have it pretty darn good. AI is the only thing that is concerning for the future. Right now doesn't seem too scary but 30 years of smart tech grads funded by Silicon Valley money.. who knows what could happen. If you're okay with this risk, go rads. If not, do surgery or a procedural medicine specialty. Clinic based specialties are awful, many of these people are checking epic til late at night messaging patients, following on labs, etc - it's no picnic.

I disagree that surgical specialties are "safe." There are quite a lot of start ups working on surgical systems: verb surgical, cambridge medical robotics, to name a few. Last year, a study showing how an autonomous robotic surgeon outperformed a human surgeon was published in Science:
Autonomous Robot Surgeon Bests Humans in World First

Surgery and autonomous driving are similar. They pose the same engineering problem of 3D navigation using machine learning. Think of autonomous cars; they get better and better the more they observe human drivers drive. Autonomous driving are almost here, and surgery isn't that far behind. I personally prefer the stability and dexterity of the robotic hand than the human hand to stitch me up or to do surgeries that require fine movements such cataract surgeries. I know they can do a better job. Will surgeons get replaced? No. Neither will radiology, as long as the field is willing to adapt.

I do think that the field of radiology needs to be smaller in the future as technology makes us more efficient, which is why now would be a good idea to decrease residency slots in preparation for 5 years down the line.

Non-surgical robotics have also come pretty far. Pretty cool, eh?

 

[tco]

I disagree that surgical specialties are "safe." There are quite a lot of start ups working on surgical systems: verb surgical, cambridge medical robotics, to name a few. Last year, a study showing how an autonomous robotic surgeon outperformed a human surgeon was published in Science:
Autonomous Robot Surgeon Bests Humans in World First

Surgery and autonomous driving are similar. They pose the same engineering problem of 3D navigation using machine learning. Think of autonomous cars; they get better and better the more they observe human drivers drive. Autonomous driving are almost here, and surgery isn't that far behind. I personally prefer the stability and dexterity of the robotic hand than the human hand to stitch me up or to do surgeries that require fine movements such cataract surgeries. I know they can do a better job. Will surgeons get replaced? No. Neither will radiology, as long as the field is willing to adapt.

I do think that the field of radiology needs to be smaller in the future as technology makes us more efficient, which is why now would be a good idea to decrease residency slots in preparation for 5 years down the line.

Non-surgical robotics have also come pretty far. Pretty cool, eh?

This article nearly made me lol with the hyperbole of the title.

They were suturing pig intestines. The robot was basically a smart sewing machine.

This wasn't surgery. There was no pre-operative planning to identify the abnormality, nearby anatomy, any anatomic variants, best surgical approach. This wasn't even a basic medical problem that needed to be solved. It was, figuratively, suturing together a tube that was cut...And humans still had to help it out.

Sorry, I'm still not worried about our robot overlords just yet.

 

[808s&heartbreak]

This article nearly made me lol with the hyperbole of the title.

They were suturing pig intestines. The robot was basically a smart sewing machine.

This wasn't surgery. There was no pre-operative planning to identify the abnormality, nearby anatomy, any anatomic variants, best surgical approach. This wasn't even a basic medical problem that needed to be solved. It was, figuratively, suturing together a tube that was cut...And humans still had to help it out.

Sorry, I'm still not worried about our robot overlords just yet.

I agree with you. I'm not worried either. It's not robots vs humans, it's robots + humans. Point is technology is currently being built for pretty much every specialty. Radiology is just the poster child, and saying that surgery is "safer" than radiology is misinformation. In a radiology forum, people may not know what's brewing in other specialties, and my point is to educate. If I had told you 10 years ago that a new handheld device would revolutionize the world, allowing you to listen to music, play high-def videos, look up all of the world's medical information at your fingertip more than any of your attendings would ever know, would you have believed me? We aren't even 10 years into the iPhone yet.

Medtronic recently came out with closed-loop artificial pancreas that can make titrating insulin a thing of the past (The FDA Just Approved the First Artificial Pancreas for Diabetes). Doesn't mean diabetes management will get automated.

Bottom line: To medical students: Don't worry about radiology being automated, or surgery being automated. Every specialty has its "worries", and if you pick a specialty based on that, you're in for a surprise when you find out such and such technology never happened (or did happen in specialties you thought were "safe".) Pick what you like the most. Silicon Valley has its moments (Intel, Google, etc) but it can also be overhyped (Theranos, Juicero).

 

[Postictal Raiden]

To the OP: you seem like a great fit for radiology. Yes, rads is busy, but those that think radiology has it worse than everyone else, in my experience, don't know many people in other specialties. I think we still have it pretty darn good. AI is the only thing that is concerning for the future. Right now doesn't seem too scary but 30 years of smart tech grads funded by Silicon Valley money.. who knows what could happen. If you're okay with this risk, go rads. If not, do surgery or a procedural medicine specialty. Clinic based specialties are awful, many of these people are checking epic til late at night messaging patients, following on labs, etc - it's no picnic.

If rads continue to attract the brightest minds for the next 30 years, I wouldn't be too worried about AI. Since the birth of this profession, technology has constantly been posing different challenges. I do admit that AI can be much more complicated challenge to overcome, but I also know that current and future rads trainee are much more technological savvy and aware of new innovations and development.

I am a half-glass-full type of guy and I'm very hopeful that AI will enrich the field and help radiologists diagnose things that weren't possible without the combination of breakthrough technological advancements and highly trained radiologists who are not only knowledg in medicine but also experts in utilizing technology to its fullest extent.

 

[Rads312]

If rads continue to attract the brightest minds for the next 30 years, I wouldn't be too worried about AI. Since the birth of this profession, technology has constantly been posing different challenges. I do admit that AI can be much more complicated challenge to overcome, but I also know that current and future rads trainee are much more technological savvy and aware of new innovations and development.

I am a half-glass-full type of guy and I'm very hopeful that AI will enrich the field and help radiologists diagnose things that weren't possible without the combination of breakthrough technological advancements and highly trained radiologists who are not only knowledg in medicine but also experts in utilizing technology to its fullest extent.

Agreed.

I think we're much closer to machines augmenting our jobs ( IE, we'll be expected to read more..probably get reimbursed less ) than machines actually DOING our jobs. That may happen - but all hype aside, unlikely in the next 30 years. In that time frame, who knows what will happen. We may have the cure for cancer.

 

[medgator]

Agreed.

I think we're much closer to machines augmenting our jobs ( IE, we'll be expected to read more..probably get reimbursed less ) than machines actually DOING our jobs. That may happen - but all hype aside, unlikely in the next 30 years. In that time frame, who knows what will happen. We may have the cure for cancer.

AI will prob get closer to doing rads than that happening, but honestly, until an AI or its company can be sued, physicians will still play a role

 

[medgator]

Are you guys even diagnostic radiologists? Attendings or residents? Sure the pace is fast and volume high. But that is true in other specialties as well including outpatient primary care and ED. This whole complaining while at work, "woe is me, can't pee or eat" is not unique to diagnostic radiology.

To answer the OP. Diagnostic radiology is a great field and has a decent to good lifestyle depending on individual practice. You may find a place that requires occasional evening or weekend shifts, or even more rare night shift. But in general most diagnostic rads work their tails off from 8 am to 5 pm Mon-Fri then go home. No pager so you can do whatever you want. No emergencies to wake up in the middle of the night. Most weekends off. A LOT of vacation (which is hard for physicians who have continuity of care with patients to pull) worry about like pushing a ton of paper like in other fields.

Other things that are priceless. Trainwreck patient/case, sucks to read that mri or ct, but once you sign off that report, you are done. None of the drama a patient facing physician has to deal with.

Rad onc is similar in that it's busy days but minimal weekend coverage outside of consults in which you establish contact with the pt but no treatments until Monday (typically, depends on setup).

The patient contact is a nice plus for RO, you use imaging to assist in the planning of radiation treatment and you manage their side effects.

The downside is continuity of care from a vacation standpoint as you mentioned in your post....You need good partners or Locums to fill in while you're gone and it's much harder to take an extended (2+ week) vacation because of it once you are partner. Patients and referrings get used to dealing with you, so your practice takes a hit with extended absences.... Don't get me wrong, I love that aspect as do most in RO, but ER, rads and gas have that aspect beat in terms of being able to finish episodic care and not worry about getting called 2-3 or 6 weeks later. I get calls and texts on vacation lol.

You also have to feel comfortable discussing prognosis and other onc related stuff from time to time (palliative care, end of life discussions).

The other issue is the big elephant in the room, the job market which is getting worse in desirable areas and I don't see a cycle back unlike rads. But if you're ok with less populated areas away from the coast, it's a great well-reimbursed specialty minus the issues above

 

[Light at end of tunnel]

If rads continue to attract the brightest minds for the next 30 years, I wouldn't be too worried about AI. Since the birth of this profession, technology has constantly been posing different challenges. I do admit that AI can be much more complicated challenge to overcome, but I also know that current and future rads trainee are much more technological savvy and aware of new innovations and development.

I am a half-glass-full type of guy and I'm very hopeful that AI will enrich the field and help radiologists diagnose things that weren't possible without the combination of breakthrough technological advancements and highly trained radiologists who are not only knowledg in medicine but also experts in utilizing technology to its fullest extent.

Well the sad reality is that hospital CEOs only really worry about the bottom line; if AI proves more profitable than conventional radiologists, we may be out of luck.

Money makes the world of radiology go round.

 

[Postictal Raiden]

CEO's worry about $$$. Radiologists bring in money. I don't see why they'd want a computer program instead if there's no financial incentive. I can't visualize a scenario where having Dr Watson is a financial gain. You still need to pay for someone to operate it, maintain it, and don't forget the malpractice insurance too. Nothing is more expensive than a lawsuit.

Add to that the fact that the healthcare industry is very very regulated. Any such large scale change would take forever to implement, especially when you have a strong resistance against it (i.e. radiologists and other doctors who understand the value of radiologists). Look at the situation of anesthesiologists and CRNAs. It's been going on forever and, still, anesthesiology is among the most lucrative specialties. CRNA's have yet to replace anesthesiologists in mass numbers despite that their history of practicing anesthesia goes back to the 1950's. These are highly trained professionals who have a very established precedence, and still, we don't see anesthesiologists washing cars for living.

A day may come where diagnostic imaging is 100% done by computers but, hopefully, this won't be in our career life. Also, hopefully by then radiology has taken a new role in healthcare, one that hasn't been created yet.

 

[808s&heartbreak]

deleted

 

[SageRad]

Radiologists bring in money.

Radiologists do not bring in money. They largely feed from the trough that is supplied, directly and indirectly, by primary care. If a CEO can find a solution to have exams read and not deal with the radiologists, most would do it in a heartbeat.

 

[DrfluffyMD]

Radiologists do not bring in money. They largely feed from the trough that is supplied, directly and indirectly, by primary care. If a CEO can find a solution to have exams read and not deal with the radiologists, most would do it in a heartbeat.

We would automate primary care long before we can automate radiology.

Neither of which would happen in our life time.

 

[scootad.]

Radiology machines (not radiologists) bring in money. The technical fee from the MRI scans is the reason for the existence of large corporate teleradiology (so MBAs can skim money off the backs of radiologists) and why many specialties including Ortho, Neuro, etc purchase their own magnets/ultrasound machines and self-refer, etc.

 

[SageRad]

We would automate primary care long before we can automate radiology.

Neither of which would happen in our life time.

Maybe yes, maybe no. Neither will be automated in the time frame of my career. I have 21 years in on July 1 and between one and three years to go.

Any way you slice, radiologists do not bring in the dough, and even radiology does not bring it in like it did in the past. CEOs and CFOs know this, and the influence of radiologists in the hospital or multi specialty practice has waned over time, as a result.

 

[DrfluffyMD]

Maybe yes, maybe no. Neither will be automated in the time frame of my career. I have 21 years in on July 1 and between one and three years to go.

Any way you slice, radiologists do not bring in the dough, and even radiology does not bring it in like it did in the past. CEOs and CFOs know this, and the influence of radiologists in the hospital or multi specialty practice has waned over time, as a result.

Congrats. Given your long stints in the field, I figure you are well familiar with the rapid speed of technology.

I do think radiology is something different, because to fully function as a radiologist, a machine AI need to achieve general inteligence (i.e equal footing of intelligence as an indivdual human being)

In other words, to automate radiology we need singularity.

And radiology is the last of our problems once we hit singularity.

I certainly hope to be beyond this plane of existence before that event occurs.

 

[SageRad]

Congrats. Given your long stints in the field, I figure you are well familiar with the rapid speed of technology.

I do think radiology is something different, because to fully function as a radiologist, a machine AI need to achieve general inteligence (i.e equal footing of intelligence as an indivdual human being)

In other words, to automate radiology we need singularity.

And radiology is the last of our problems once we hit singularity.

I certainly hope to be beyond this plane of existence before that event occurs.

I did not bring up AI...it's not an area of great interest or expertise for me. All I said is that if the hospital CEO could do without the radiology group and still run the place, I would be gone...yesterday. I would not say the same about the internal med docs, oncologists, or spine surgeons--those folks get the people in the door (and into your CT/MR scanners. )

 

[Postictal Raiden]

@SageRad if you were a 4th year medical student with tons of debt applying to residency this year, would you apply to radiology?

 

[SageRad]

@SageRad if you were a 4th year medical student with tons of debt applying to residency this year, would you apply to radiology?

If you like the field and it suits your personality (introverts, especially), I think that there are still good jobs in the pipeline, and the field should be good for the foreseeable 5-10 years. Beyond that, it is really hard to say...about anything.

 

[badasshairday]

@SageRad if you were a 4th year medical student with tons of debt applying to residency this year, would you apply to radiology?

Yeah. Sure. Why not?

 

[Postictal Raiden]

Yeah. Sure. Why not?

Because of all this supposed doom and gloom.

I'm at a crossroad. One is going into the field I see fits me the most and I can do for the rest of my career life (radiology). Or go into another field that I love and it has much much better market than radiology, but I don't see myself doing it day in and day out for the next 35 years.

I also have a tremendous amount of student loans and have a family to support, so things other than my pure interest will play into my decision.