Experiencing the transitions in the field of radiology has made for many ups and downs.
Roughly 15 years ago when I decided to pursue a career in radiology, I had a fairly good idea of what to look forward to. From what I had seen in medical school, to doing rotations in the hospital, to speaking with attending physicians, I felt confident that I would be getting into a field that was really interesting, constantly changing, and always seemed to be at the epicenter of patient care, while at the same time providing a comfortable financial life, in a low stress environment.
After finishing residency and fellowship, I joined a small group at a local community hospital. This was during the time of the “soft” job market when there were plenty of jobs, and not enough radiologists. It wasn’t uncommon back then for me to get about five to six e-mails every week describing practice opportunities that offered $500k starting salaries, offers to fly me in a private jet (no joke) to places like Ketchum, Idaho for an interview, and other offers from groups offering $10k to cover moving expenses. Whether these carrots on a stick were actually truthful or not, who knows, but certainly times were different back then.
The decade from 2000–2010 was great, and I loved my job and the practice that I was in. I really had my mojo going! The diversity of cases kept me interested, the people I worked with were happy and glad to come to work every day, and our department was always one of the highest revenue generating departments in the hospital; year in and year out. From a financial perspective, I still couldn’t believe it when I saw my paycheck every month, after living on a resident/fellow salary of $45k per year. Every day, it seemed like there was something new to learn, and the field seemed to be growing exponentially with the development of 64 detector, then 128 and 256 detector CT, cardiac CT, PET/CT, newer applications for MRI, the increased utilization of ultrasound, and on and on.[[{"type":"media","view_mode":"media_crop","fid":"41656","attributes":{"alt":"","class":"media-image media-image-right","id":"media_crop_1965549669989","media_crop_h":"0","media_crop_image_style":"-1","media_crop_instance":"4423","media_crop_rotate":"0","media_crop_scale_h":"0","media_crop_scale_w":"0","media_crop_w":"0","media_crop_x":"0","media_crop_y":"0","style":"height: 180px; width: 200px; float: right;","title":"©Sign N Symbol Production/Shutterstock.com","typeof":"foaf:Image"}}]]
My passion for radiology and being constantly active spilled over into other areas as well, and I was active in hospital politics, teaching residents, writing articles for journals, and participating in radiology advocacy and leadership at the local and regional level.
Then there was a gradual change for the worse. Our hospital and its governance came to the realization that, financially, it couldn’t exist as a stand-alone hospital in the volatile health care market, and it eventually succumbed to the takeover by a large health care network. Our hospital closed and we (literally speaking, as the last few patients were transported by ambulance!) moved to the next town to set up shop in a newly constructed, state-of-the-art tertiary care center.
We soon realized that our previous model of autonomy, independence, and happy atmosphere was quickly extinguished. Practicing radiology became very corporate and regimented, and it seemed like every day we were given another rule or mandate to follow. We not only lost vacation time, experienced a salary cut, lost our half day off per week, and the ability to make our own call schedule, but our work hours increased, our call increased, we were charged with driving to outpatient facilities, and our caseload increased significantly. All for the benefit of the “network”, with no doctor appreciation on the back end.
Right before my eyes, before I could read the writing on the wall, my mojo had been taken from me! And it wasn’t just confined to the radiologists. Technologist morale took a nosedive. I would often hear them arguing, back stabbing, and finger pointing at one another when something went wrong, rather than before, when they would all help each other out. This corporate culture of “my way or the highway” spread to other physicians as well, with many dedicated, competent, and well-respected physicians from our former hospital, either flat out quitting, being forced into early retirement, or being fired.
I was desperate, frustrated and depressed. How could things have taken such a turn for the worse? What happened to my passion for radiology? Every day, I felt bored, un-motivated and a lot like Fred Flintstone at the stone quarry; just going through the motions. To exacerbate things, while the decade was coming to a close, the job market had turned polar opposite. Jobs were now scarce, good radiology residents graduating from solid programs couldn’t find jobs and were being forced to either do a second fellowship or accept job offers in undesirable locations or for significantly less money. I was looking at the distinct possibility of having to move my family, doing locums work, or (egad!) leaving radiology altogether to work in industry.
I poured over all the job market websites; I dug deep into my contact list to ask around for possible opportunities, I asked for favors from former associates. No stone was left unturned. There was one glimmer of hope, though. I had a friend who was the director of a small group at a tiny hospital for whom I had done some moonlighting for, earlier in my career. We had managed to keep in touch and I had always had a great deal of respect for her. Her group was also undergoing some changes and although she wasn’t quite ready to commit to offering me a job, I continued to keep in touch with her, and basically kept nagging her. Deep down inside, I knew something would break. Sure enough, she thresholded over, and the offer came.
Although the salary is less, and the commute to work is longer, I definitely made the right choice. I am back to loving my job, I enjoy working with the staff, and even more importantly the leadership has respect for my opinions, and for me as a physician, rather than a mere laborer. I am reading the modalities that I enjoy reading, doing procedures that I am interested in, and have re-discovered my passion for radiology. To sum things up; my mojo is back!
The Reading Room: Artificial Intelligence: What RSNA 2020 Offered, and What 2021 Could Bring
December 5th 2020Nina Kottler, M.D., chief medical officer of AI at Radiology Partners, discusses, during RSNA 2020, what new developments the annual meeting provided about these technologies, sessions to access, and what to expect in the coming year.