10 reasons I’m a vRad lifer

Looking back on my career as a radiologist—now in its 22nd year and counting—I see three themes consistently guiding my “work-life balance.” These would be control, culture and lifestyle. Let me explain.

I spent 11 of the best years of my life and career in the U.S. Army, eight of them as a radiologist. I loved that job and probably would have stayed until retirement, but I eventually concluded the trajectory of my career path was too far beyond my control. The culture was great, but control and lifestyle were somewhat lacking.

When that awareness sank in, I left the military and entered private practice, joining a 17-radiologist group in a major city. Unfortunately, I was disheartened there nearly every day. Sadly, it took me three years to realize that the collective attitude was about the individual, not the team. The practice was more concerned with maintaining the status quo than with improving and evolving the practice.

When I left that practice and its toxic culture in 2009, I reached out to an old friend, vRad CMO Dr. Ben Strong, who had encouraged me over the years to consider vRad. I decided to temporarily withhold judgment on teleradiology—I’d always considered it a copout—and hear what he had to say.  After a dinner with Dr. Strong, I was persuaded to see vRad for myself make a visit to the headquarters in Eden Prairie, Minnesota.

Perception vs. Reality

Wow, was I wrong about teleradiology! Or at least vRad’s version of it. One day observing the Operations Center in Minnesota was all it took. Despite having another job offer on the table, I signed with vRad that day and have never looked back. I had found the perfect mix of culture, control and lifestyle.

Because of its size and approach, vRad is absolutely accommodating to a wide variety of lifestyles, including mine.

My career has always been lifestyle-oriented with a heaping dose of the Great Outdoors. I spend as much time as I can playing outside whenever possible. As my life has evolved to include my wife and two wonderful and attention-demanding children, vRad allowed my career to evolve with these changes.

vRad is ideal for all of that and more. I joined in 2009 and, 12 years later, still consider the technology, their approach to teleradiology and its lifestyle opportunities the best way to practice radiology.

In no special order, here are 10 reasons I expect to continue working here for many more years to come:

1. vRad’s practice culture is one of unforced esprit de corps. Despite being thousands of miles apart, vRad employees enjoy a wonderful culture and camaraderie. That goes not only for radiologists but the entire support staff too. At my prior practice, there was plenty of cherry-picking, RVU fights and complacency. The worst part was the cultural inertia. When anyone would try to get process improvements going, the group preferred to passively accept the dysfunction as normal. By contrast, vRad is the very definition of continuous process improvement. The frequent enhancements make my job easier, moving the needle toward greater efficiency, quality, and compensation. Small nuances, like reminding me with a popup message if I’ve forgotten to mention the pleural spaces on a chest XR—or a simple mouse click to contact a provider—make me more efficient, effective and just a better radiologist. The entire system is designed to support what I do best and like to do—interpret radiology studies.

2. I can consult with a subspecialist colleague in seconds Although I may be on an island—quite literally, I’m blogging from my second reading station in Hawaii—I’m anything but cut off. The colleagues I consult with on a nightly basis have done fellowships at Yale, UC-San Diego, Harvard, and UCSF. These, of course, are some of the top academic radiology institutions in the world. Interestingly, I work more closely with a lot of these people than I did with my colleagues a few feet away in private practice. This point deserves special emphasis. vRad has an unbelievably robust and efficient consult and instant messenger system. I’m able to consult somebody within 25 or 30 seconds. There are always subspecialists working, so we have the ability to consult any time. If you believe a case is too complicated or outside your area of expertise, you can find someone to transfer the case to and they get compensated. 

3. vRad is inherently family-friendly. I work a 4 p.m.-to-midnight shift, so I’m up in the morning when the kids are getting up. I can help get them ready for their day and then, once they’re off to school, step outside and enjoy the outdoors. In the evening, I’m working, but I’m only one room over. My presence makes the kids happy. If they need me, I can pop out between cases for a couple of minutes to solve a toy crisis or change a battery. I get to have dinner with them every night and help put them down at night. I don’t feel like I’m missing out at all.

4. vRad pays me a very competitive salary. When it comes to radiologist salary and where you practice, no two comp models are the same. My salary at vRad is very competitive. I really appreciate having a compensation plan to match my income goals and lifestyle. I can choose my number of contracted hours per year. I work at my own pace. There are plenty of opportunities to add or extend shifts if I want to make more money.

5. I’m in control of my environment. One common misconception is that working from home means dealing with a lot of distractions. On the contrary, I don’t have the typical private-practice distractions. I don’t get interrupted by techs or nurses. I don’t have people wanting to come in and show me pictures of their kittens. I have no coworkers who loudly chomp food. If I want a little soft music playing in the background, great. There’s no one there to object. Whatever the details, it’s all about control—control of time, control of my own autonomy, control of location and work environment. In fact, I have worked for vRad in Oahu, Maui, San Diego and even Steamboat Springs. Nothing like getting a few snowboarding runs in, grabbing a quick lunch and hot tub, and then going to work in my own office. And that’s my work week, not my week off!

6. vRad’s support team is nothing less than phenomenal. The administrators, the Operations Center, the people in scheduling and licensing and credentialing—it’s through all of their hard work that I’m able to be successful. They’re all so good at their jobs, they not only assist me but inspire me too. They help bring out the best in me, making me more focused and therefore a more accurate radiologist. (And by the way, as good a salesman as Dr. Strong can be, it was seeing the Minnesota support staff and Operations Center in action that really made vRad a no-brainer for me back in 2009.)

7. vRad’s proprietary worklist platform and algorithms help find the right radiologist for the right read at the right time. A radiologist opting out of a study doesn’t affect the practice’s workflow at all. All studies appear on the worklists of multiple radiologists, which are prioritized according to patient need. Urgent and emergent studies get prioritized for me. Compare this with my prior practice, where studies might languish for hours (and sometimes days) because of a short bench or a work list open to colleagues shopping for the most desirable studies.

8. vRad is incredibly adept at enabling radiologist autonomy and schedule flexibility. If you want to get your MBA and classes are 7 to 9 at night, they’ll try and find a way to work around your classes. You have the ability to request changes to your schedule, and there is a whole department dedicated to your schedule and making sure our clients have coverage.  If you do need a schedule change, those folks will do everything in their power to try to approve your request. That’s a lifestyle feature unparalleled in medicine. I can confidently say that more than 98% of my requests for schedule changes have been OK’d.

9. vRad wants its radiologists reading studies. Period. One of the best things about vRad is the way they view radiologists. They know you’re highly trained. They believe you should be doing what you’re highly trained to do—interpret images—and nothing else. That’s how they maximize efficiency and keep their radiologists happy. We radiologists do what we’re good at, and vRad gets other people to do licensing, credentialing, paperwork, support—the things they’re especially good at. They’ve also built a reading platform that cuts out nearly every non-clinical task for the radiologist. I just read. I really love that.

10. vRad has given me the chance to expand beyond the typical job description. I realized a few years ago that I wanted to use my training to give back to medicine. With vRad’s unwavering support, we were able to start a charity called the First Read Initiative. This charity provides a platform for everyone at vRad, both physicians and support staff, to come together and support radiology charities and medical missions all over the world. You don’t donate money. You don’t fly off to another region of the globe. You just read films as usual and the professional component of your first case of every shift goes to radiology nonprofits doing amazing work.  From ultrasound projects in Southern Africa to improving access to mammography in Appalachia, the First Read Initiative has already raised and distributed more than $350,000 in less than four years. More information on the First Read Initiative can be found here. 

vRad leadership has not only supported this philanthropic work but has also been integral in helping me   develop our own academic conference, Practical Radiology: Core Concepts in Emergency Radiology.   Now in its 10th year, the conference has grown to more than 120 attendees from around the country and   working both outside and within vRad.

Hear more from vRad radiologists 

If you’re intrigued by any of these points, I’d highly recommend that you take a few days and come to the vRad CME conference Practical Radiology: Core Concepts in Emergency Radiology in Las Vegas February 10 to 13. You can chat with me or with any of the 50 different vRad radiologists with 50 different stories and 50 different opinions. (While also availing yourself of some great CME opportunities while you’re there.)

There are a lot of misconceptions about teleradiology and vRad in the radiology blogosphere. But over the past 12 years, I’ve found my career at vRad very satisfying and have thoroughly enjoyed the autonomy that teleradiology provides. vRad is a technology leader and I truly believe it to be the best teleradiology (and maybe the best radiology) practice around. You owe it to yourself to check it out from every angle.

Around the web

The patient, who was being cared for in the ICU, was not accompanied or monitored by nursing staff during his exam, despite being sedated.

The nuclear imaging isotope shortage of molybdenum-99 may be over now that the sidelined reactor is restarting. ASNC's president says PET and new SPECT technologies helped cardiac imaging labs better weather the storm.

CMS has more than doubled the CCTA payment rate from $175 to $357.13. The move, expected to have a significant impact on the utilization of cardiac CT, received immediate praise from imaging specialists.