Academic radiologists earn less than peers in the specialty, but the gap is closing

Academic radiologists earn less than their peers working in other healthcare settings, though the gap is narrowing, according to new research published Tuesday. 

As of last year, docs in private practice or other arrangements earned median total compensation about 27% higher than academics in diagnostic radiology and 32% higher for interventionalists. However, since 2014, median pay has increased faster for academic diagnostic radiologists (at about 3.2% annually) versus other DRs (1.9%), experts detailed in JACR [1]. 

In addition, physician compensation decreases in 2020—likely related to COVID-related shutdowns—were significantly less for academics than other radiologists. 

“This suggests that…academic radiologists may enjoy more salary protection than their nonacademic colleagues as downward pressures on radiologist reimbursement continue,” lead author Ajay Malhotra, MD, a professor with the Yale School of Medicine Department of Radiology, and colleagues wrote Nov. 12. “It is important to note, however, that although median compensation has increased for radiologists overall, it has barely kept pace with the U.S. inflation, which averaged approximately 3.5% per year, and medical care prices have grown even faster than prices in the overall economy.”

Researchers analyzed Medical Group Management Association salary survey data spanning 2014-2023 for the study. The sample included 3,769 radiologists, with 2,883 in diagnostics and 886 more in interventional practice. Last year, diagnostic radiologists also worked more, producing greater median work relative value units (RVUs) than IRs by about 53% for nonacademics and 46% for those in teaching settings. But interventional radiologists had higher compensation in both academic (10%) and other healthcare settings (16%). 

Since 2014, IR compensation has increased by about 3.4% per year for academics and 3.9% in other practice settings, the authors reported. Median work RVUs, however, have trended down by -2.4% for those in teaching settings versus -1.5% for IRs working elsewhere. Same for collections, dropping -2.1% for academic interventional radiologists and -4.4% for other IRs. 

“Substantial decline in overall inflation-adjusted reimbursement to radiologists has been shown per Medicare beneficiary in the last two decades,” Malhotra et al. wrote. “Increased RVUs per beneficiary have only partially offset decreases due to both inflation and decline in conversion factor, implying less overall pay for more services per patient. Given the shortage of radiologists, this raises concerns for access-to-care challenges for patients.”

Compensation differences between the two practice settings may be less directly connected to collections or RVU production, they added. Rather, they may be attributed to differences in operational structure and the need to reward other nonclinical contributions in academia.

“These indirect sources of funding outside of immediate collections could vary significantly in scenarios where multiple institutions intersect, such as large academic medical centers where clinical staff may also partially receive compensation from the affiliated medical school,” the authors noted. “Case mix and complexity are other variables that are difficult to incorporate into these calculations as well. However, having knowledge of these variables allows for more nuanced handling of the available data on compensation and associated metrics, both for practice managers and for newly graduating or early career radiologists when assessing job offers.” 

Read more about the results, including potential study limitations, at the link below. Malhotra and colleagues also published a similar study on academic physician compensation last month in the Journal of Interventional and Vascular Radiology.