Mammo benefits improve, but recruiting remains big challenge

It's been a year since practice manager Lorna Vaughan took out an ad seeking a breast imager to work on the Jersey Shore. To her surprise, a "dream-come-true, fee-for-service, patient-focused, personal and compassionate practice with partnership and ownership opportunity" has been a hard sell.
 

"We're a new company, so we are at our breaking point," Vaughan said of HerSpace Breast Imaging Associates, a spalike facility founded by Dr. Beth Deutch. "We can't accommodate any room for growth without adding another breast imager."
 

She's turned the recruiting task over to professionals, hoping that headhunters will have access to a wider swath of candidates. They do, but problems persist.
 

Breast imagers command "huge deals," said Lauren Krebs, a radiology recruitment specialist with American Medical Recruiters, a company based in Florida.
 

Women's imaging subspecialists can walk in the door expecting big salaries-anywhere from $200,000 to $500,000, depending on education and experience-along with generous vacations equal to those of partners, no call, no nights, and no weekends.
 

"They don't want to do anything else but 100% breast imaging," Krebs said.
 

Yet supply and demand dynamics prevail across the country. Job ads from Georgia to California, offering everything from malpractice coverage to gym memberships, suggest that no particular region alone is a magical draw.
 

The shortage of fellowship-trained women's imagers plagues hospitals and academic institutions as well. Data on academic vacancies published in the July issue of the Journal of the American College of Radiology indicate this subspecialty is in highest demand.
 

"As of last summer, breast imaging was in the worst shape in terms of not being able to fill academic positions," said study author and ACR research director Jonathan Sunshine, Ph.D.
 

The study found that, in 2007, the largest numbers of vacancies in academic departments were in breast imaging (15% of all vacancies), followed by interventional radiology (13%), neuroradiology (11%), pediatric radiology (11%), research (11%), musculoskeletal radiology (8%), and abdominal imaging (8%).
 

"To state the obvious, academia is the training ground for future radiologists," the study said. "If academic departments cannot staff adequately, that threatens the ability of the radiology profession to provide the volume of imaging and interventional services patients will need in the future."
 

LAWSUIT RISK SCARES OFF PROSPECTS
 

The fact that breast imagers face higher malpractice risks and lower Medicare reimbursement than their counterparts makes it easy to understand why young radiologists avoid this important work.

"Missed breast cancers are the commonest source of lawsuits against radiologists, which makes life as a breast imager uncomfortable,"Sunshine said.

Adding to that problem has been a reduction in the number of mammography facilities. Of all mammography that's done in the country, only one-third of it is performed by radiologists trained in breast imaging, he said.

Though mammography is as demanding as any other field, it has suffered from a reputation as being a less exciting career pursuit. Experts predict, however, that technical advancements and new imaging developments could inspire a shift in that perception, which could in turn increase the pool of qualified breast imagers in the job market.
 

"Some of the high-tech activities are growing, with nonsurgical biopsy and breast MR having become important," Sunshine said.

In a recent article on womensimagingonline.com, Dr. Marcia C. Javitt, section head of body MRI and genitourinary radiology at Walter Reed Army Medical Center in Washington, DC, reported that breast imagers could soon find themselves using new and more advanced tools. These include tomosynthesis and breast CT, CAD for digital mammography, mammography with intravenous contrast, and molecular imaging.

"We are seeing an upswing in fellowships filling up," Kreb said. "Breast MR and PET are making it exciting again."

Ms. Wrong is feature editor of Diagnostic Imaging.