Compensation for Radiology Gigs: Verboten Numbers or Show Me the Money?

There was a clever little game from a New Year’s Eve party I once attended. Arriving guests were given a few poker chips and advised that, if they caught anybody else saying the word “drink,” they could confiscate a chip for it. Each hour, another word was announced as an addition to the speak-and-you-lose-a-chip list. Much like “drink,” each word was chosen for its common usage at parties and/or New Year’s Eve celebrations. Some sort of prize awaited whoever had the most chips at night’s end.

You’ve already played this game even if you didn’t have fun with it at the time. There was something on your mind, and perhaps on the mind of everyone else around you, just begging to be discussed but you’re not supposed to talk about it. (Shades of Austin Powers struggling not to utter the word “mole.”)

In particular, I have been amused how the radiology job market goes through all sorts of contortions to talk about everything except how much a prospective employee might be paid. This bit of info just happens to be one of the most important variables to everyone involved.

Way back when, before I even completed residency, someone explained the rationale to me: We’re supposed to be high-minded professionals, doing what we do for “love of the game,” intellectual satisfaction, and the betterment of our fellow humans. There’s a pretense that getting paid for what we do is an ugly secret, and we should be embarrassed by it. A physician openly seeks the best pay he or she can get? This is low-class, bordering on unethical behavior.

When this bit of wisdom was laid upon me, however, I noticed that job listings in psychiatry were including actual salary numbers. The explanation was that psychiatry employers were desperate to recruit and pulling out all the stops. Even some radiology recruiters were doing the same for positions in “geographically undesirable” places, struggling to entice radiologists to relocate, since teleradiology wasn’t a thing yet.

This game’s rule had an exception: We weren’t supposed to talk about compensation unless we were desperate. In this case, the veneer of professionalism was allowed to fall away. Either that, or one clung to the notion that job listings with numbers were inherently low-class and borderline unethical.

A couple of decades later, the trajectory of my career has given me more than one occasion to peruse job listings. I have seen the rules continue to evolve. Happily, I report my favorite change thus far: Prospective employers can showcase numbers upfront if they just don’t want to waste anybody’s time.

An example of the opposite: A promising lead from LinkedIn caught my eye. I inquired, and there were a few emails back and forth. Next was a telephone interview followed by a second-round interview. Nearly a month later, the prospective employer finally revealed the proposed compensation in a “DocuSign” contract sent for me to formally accept the job. The number was so laughably low that I politely advised the employer it wouldn’t even be worth the time to try negotiating. I wished the job poster the best of luck in filling the position.

If the original, numberless job listing hadn’t contained other details of particular interest to me, I wouldn’t have clicked on the post in the first place. We would have saved each other over two hours of our time. The prospective employer could have spent that time finding another candidate willing to take the gig; modifying the listing after it attracted no applicants; or, go figure, conducting the company’s actual business.

I certainly wouldn’t have minded being able to focus more on other jobs I was considering. As it was, this time waster served as a wild card. No matter how enticing other jobs appeared, there was always the possibility that this one might be better, so I played for time with the others until I knew for sure what this one entailed.

Some employers and recruiters try to get cute with their job listings by talking about numbers without saying any. Here is a helpful tip to any of them who might be reading this: When you say your compensation is “excellent” or “competitive,” you don’t impress people. Using more words does not help. “Excellent compensation,” for instance, tells me nothing less than “Very competitive compensation model!” The wordier, more hyperbolic ones are marked down a peg in my eyes; they seem more like pitches from used-car salesmen than professionals with whom my career might soar.

I (and I suspect more than a few other job seekers) tend to believe that if a prospective employer has excellent/competitive comp to offer, the employer will proudly display it to attract as many great applicants as possible. When I see words instead of numbers, it tells me I’ll have to spend my time and trouble delving into an application process just to find out the comp numbers. I have less reason to do that when adjacent job listings come right out and, to coin a phrase, “show me the money.”

Some folks try calling their mystery comp things like “top percentile.” Sounds more science-y but these are still words instead of numbers. And prospective rad recruits have been educated about statistics, including how they can be fudged. Most of us also know just how inaccurate salary surveys can be in the health-care world. Percentile rankings based on sketchy data don’t mean much.

I’m not saying a job listing without numbers is DOA. Interest in a gig depends on multiple factors. Further, as I’ve mentioned in previous columns, there are strategies factoring into the negotiation process that depend on who names the first number and how the other party reacts to it. For that to happen, numbers need to be spoken, not written. Sometimes a good strategy even includes playing coy when asked for a number.

Still, if a would-be employer has some reason not to post numbers up-front, I think the employer would do well to address that. Acknowledge that there’s an elephant in the room, and you’re less likely to appear afraid of or embarrassed by it. Say something like “Variable compensation, depending on candidate’s experience and skillset, will be directly addressed during or shortly after the first interview.” At least then, applicants can know that the issue isn’t being avoided.