‘Modern hospital systems have never dealt with the type of leverage that radiologists currently wield’

“Modern hospital systems have never dealt with the type of leverage that radiologists currently wield,” an anonymous physician charged in an essay published Oct. 5 by KevinMD.com. 

Radiology staffing challenges since the onset of COVID-19 have been well-documented, with rising imaging volumes and other factors combining to strain the specialty. Compensation is “exploding,” the writer noted, as hospitals are forced to offer salaries almost double what they were five years ago. 

Imaging serves as the lynchpin of most healthcare services, and the editorialist believes radiologists should seize upon this “unheard-of leverage.” 

“Hospitals quite literally cannot operate beyond a few hours without diagnostic radiology,” the physician noted. “We are the bottleneck for all inpatient care. All service lines run through us. Any radiologist can easily take one of the hundreds or thousands of teleradiology jobs, which offer less commute, less noninterpretive work and often higher pay per hour. Hospital systems simply have no leverage against their radiologists except fear of the unknown.”

Once “near the bottom of the totem pole,” radiologists now find themselves “at the top.” With this shifting landscape, the writer noted, radiology will soon ascend to the most expensive labor in the inpatient setting, hospital contracts will become a liability, and rads can only lose by competing with one another. The editorialist urged members of the specialty to consider sharing contract details with local rivals, walk away from exclusivity provisions and consider offering services as an independent contractor. 

“The only thing holding us back is fear—mostly due to a lack of knowledge in the market and antiquated thinking,” the writer concluded. “I don’t blame any radiologists out there for failing to recognize this new moment. It’s hard to realize how irreplaceable you are when you’ve been treated as an afterthought for decades. It is long past time for our specialty to stop taking on all of the liabilities of exclusive contracts for pennies on the dollar, shielding hospitals from the realities of the market as our volumes explode and our practices disintegrate.”

Members of the specialty took to social media this week to discuss and share the piece.

Every radiologist should read this, and then act on it,” Scott Truhlar, MD, MBA, an Iowa-based physician and financial educator, wrote Wednesday.

“If you haven't seen it yet, good read from an anonymous radiologist about the current market,” Ben White, MD, a Texas neuroradiologist and blogger, shared Oct. 9

“How much leverage is the right amount for radiologists to use against hospitals in the current market?” White asked in another post

“All of it,” Truhlar responded. “Take every last dollar of marginal profit the hospital has. Hospital admins and ‘systems’ would 100% do it to every radiology group and be rewarded for it with increased stock price and end-of-year bonuses.”

“You need a hospital partner that will negotiate. Unfortunately, from what I've seen and read, our greatest leverage comes after the hospital loses service and is frantically scrambling for coverage. For many groups it's too risky to play that level of hardball,” added Ned Holman, MD, an Alaska-based radiologist. 

Read the rest of the essay from the anonymous physician here: 

Marty Stempniak

Marty Stempniak has covered healthcare since 2012, with his byline appearing in the American Hospital Association's member magazine, Modern Healthcare and McKnight's. Prior to that, he wrote about village government and local business for his hometown newspaper in Oak Park, Illinois. He won a Peter Lisagor and Gold EXCEL awards in 2017 for his coverage of the opioid epidemic. 

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