Current radiology resident interested in private practice with a few questions:
1. With a trend toward PP groups selling out, is there anything you’re aware of that could help protect a new guy like me interested in the partnership track in those gap years before I reach partner? I wonder if there’s anything I can include in the contract.
Unlikely. Your best bet is to do your homework on the groups you're applying to and get a sense of vibe re: a private equity buyout. Some groups have gauged the market and realized that a buyout would screw themselves long-term (though others still go ahead with it). Some groups are (crazy thought) likely too big to be bought out. Some of those 120-150 rad groups might cost well over $500m to buyout.
Also, **** happens. If you join a group and they get bought out before you become partner that's just tough **** in most cases. It happened to a ton of people over the last decade.
2. I’ve been told one of the most important things to know going into a job and negotiating contracts is to know your worth. Unlike most other specialties, radiology seems relatively straightforward since we can connect RVUs read to average RVU payout with the payor mix. Is this oversimplified? What other aspects of a radiologist’s worth do I need to consider? (Particularly in regards to PP - I will not be going academic.) Willingness to take night/weekend call? Experience?
RVU's to compensation is way over simplification of the considerations. There's a ton of things to consider in RVU's to compensation
Production:
- RVU's per year and per day are good surrogates to look at. "knowing your worth" means it may not be worth it go generate 90%ile RVUs for a 50% compensation job. I think that's what you're referring to.
- That being said, not all RVU's are created equally. What's your job's case mix going to be like? are you slinging a lot of barium and reading a ton of plain films and DEXAs? Are you doing a bunch of low RVU procedures? Or are you reading a lot of high-RVU MRI and low-effort CT calcium scores? Are you joining a productivity leaning group where the older guys cherry pick and expect their newbs to clean up all the time-suck, garbage studies?
- What hours are you working to generate said RVUs? How many evenings, nights and weekends are you expected to cover? How long are the day shifts? a 10hr work day (excluding commutes) is considerably more work over time than an 8 hr day
Compensation:
-Total compensation has to be the comparative factor, not just salary. What are the benefits like? What tax-advantaged retirement options does the job offer? How much does the job contribute towards your yearly retirement account (if at all).
-How many weeks of paid time off (PTO) are you getting? 4-6 is standard in academics, 8 weeks is the minimum in PP and some PP groups go significantly higher in PTO. Does getting more salary and PTO justify working 10-11hr days vs 8 hr days?
Basically:
Production: How much are you working, how hard you are working and when you are working vs
Compensation: How much are you making and how often are you off
3. Last, now that you’ve done this for a while, do you have any words of wisdom to offer to a fresh radiology grad searching for a new group to join? Anything to look out for or consider beyond the obvious?
Appreciate your time.
-Try as much as possible to clarify what the expectations of your job are. Then gauge from the more recent hires how good the group is on delivering on those expectations. Are you going for a more sub-specialty job or general job? Mammo and light IR or not? I was personally sold on my group as all neuro with some occasional plain film shifts. Then in my first year I did a fair amount of body at times. Lol, then later on in a neuro section meeting people asked what body studies new hires should be comfortable reading and I had to speak up and say "hey you guys recruited me with the promise of all neuro, this is a bait and switch". I was eventually weaned off body shifts as I got more senior but it was unpleasant as a junior to be tossed into body whenever the need arose. Thank goodness mammo was never on the table.
-Commutes matter. The 8hr work day can easily turn into 9.5hr days with bad commutes. (and the 10hr work day can creep towards 12hr).
-Larger groups can sometimes operate as section fiefdoms. My section is large and for the most part decently well run. Some of the other groups are dumpster fires. A junior associate told me our section runs competently while other sections are terrible and that's mostly been true.