Give Yourself a Raise: Goals and Systems in Your Radiology Career, Part 2

Last time around, I shared a philosophy for achievement that I’ve pretty much always instinctively lived by, but had been nicely described by author/cartoonist/podcaster Scott Adams: Goals are for losers, systems are for winners.

I can’t think of any area where it doesn’t apply. Being a radiologist and writing this column in a blog on Diagnostic Imaging, of course, I turned the focus to our corner of the professional/healthcare world.

Now, I’m going to narrow it further, to the matter of giving yourself a raise. More specifically, how I’ve given one to myself a few times, since I think my situation is hardly unique. You may see some parallels in your own situation, and thus borrow from (or improve on) my experiences.

Long-term readers of this column may already be familiar with the different phases of my career. Otherwise, a glance at my CV would tell you that I’ve worked in 4 different rad groups since my fellowship in 2005. Seeing that many gig-switches in a 16-17 year interval might strike some as a warning-sign. Especially back when it was the rule rather than the exception that a decent rad would complete training, join a practice, prove himself to the group’s satisfaction, and thus earn partnership or other such equity.

To the folks who protest that last statement: No, I’m not saying real partnerships are extinct. They do exist in some places, just not where I’ve lived or plan to. One makes one’s choices and lives with them; I chose not to relocate.

If you’re a non-partner employee/contractor, you’re probably on the unfavorable side of a rad group’s compensation system. Yes, they have systems in place, which is why you should too!

With non-per-click systems, you come onboard working for a set salary or hourly rate. If you perform well and stick around, you get a raise after your first year, maybe your second and/or third. But at some point, you max out. (And if you’re per-click, you max out the moment you attain your personal-best rate of productivity.) Ask for more and you’re told things like “you’re at the top of our pay scale,” or that you’re already making almost as much as some partners.

That’s the crux of such systems: To keep partners/shareholders on a level above everyone else. Which isn’t inherently evil; it’s a big piece of the reason why people want to become such insiders.

The system lets those insiders tap into the group’s overall success. They share its upside (just like they share the risk of downside in bad times). Unlike an employee/contractor whose comp has a ceiling, theirs can theoretically increase forever—indeed, automatically will as long as the group grows and thrives.

Sure, a non-partner can still ask for raises after hitting his ceiling, especially if the group is visibly doing well…but there’s only so often one can make such inquiries, whereas the partners have a limitless ability to say “no.” Whether or not coupled with reasonable-sounding excuses. And, if they ever say “yes,” any increase they permit will be a healthy amount below what they retain for themselves.

If there’s no likelihood that you’re going to get inside that system, such that you grow along with the practice (reliable annual bonuses, for instance), your only forthcoming raise may be one you give yourself: Leave to join another group that treats you better.

Even if you just switch to another group where you’ll be up against a new comp-ceiling in a year or three, if that group starts you at or above where you are now, all your bank account knows is that you’re getting above the ceiling that was previously trapping you. Plus, your new group may appreciate what you bring to the table more than your previous one did…to the point that they find a way not to trap you under another ceiling.

This is exactly what I’ve done, each time I changed jobs. Each new gig paid me more than the previous, and each time there was at least lip-service given to other upsides such as moving up a hierarchy. That even included an offer of partnership in my second post-fellowship job, although longer-term readers may recall the “partnership” was a sham, prompting me to move on.

Another type of “raise” that can be of interest, and you should always keep in mind: Not everything is monetary. A new gig might pay you the same or even slightly less than you’re getting now, but with quality-of-life improvements to the schedule (an 8-hour day instead of 9, no nights/weekends, etc.). Your new digs might let you do more of the type of work you want, and less of what you don’t. Perhaps they promise to make you Section Chief after a trial-period; even if you don’t climb their hierarchy any further, such a title will enhance your CV for the rest of your career.

How can it be possible to keep meriting better deals—financial or otherwise—from new employers? Most important is another system I’ve utilized, and recommend: Always be improving yourself over the course of your career. The rad you are when you apply for your next job should be more competitive than you were when you got your current gig. That can mean reading faster or more accurately (ideally with documentation to prove it). It can mean reading more types of imaging-studies, or doing hands-on procedures. Or taking on non-clinical roles of which you can later boast: Sitting on the QA committee, helping with recruitment, etc.

As with all good systems, your potential gains are not solely from future employers: Increasing your value might just convince your current group to give you a raise or higher ranking after all. Not to mention the “payout” of simply making your work more multifaceted and intellectually satisfying to you.

Another facet of most systems is that they aren’t a one-and-done kind of affair. Their utility is cyclical; each iteration can build on the last, or fill in spots that previous rounds missed. In next week’s finale to this mini-series of columns, I’ll outline the cycle that has steadily helped me move onward and upward in my career, with (and without) the help of my four employers.