Private practice IRs out-earn academic peers, but fuller comparison suggests a wash on quantifiable pros and cons

Interventional radiologists in private practice work slightly fewer hours per week than their academic counterparts, 50 vs. 52 (median), yet they earn considerably more per year—$573,000 vs. $451,000 (by median figures for tenured and partner radiologists).

The academics turn the tables in median starting salaries, edging out the privates $380,000 to $374,000 while also working fewer weekly call days (five vs. six).

The findings are aggregated from 357 members of the Society of Interventional Radiologists who completed a 60-question survey. Respondents represented 258 practices—100 academic, 158 private—in 40 states.

The project is described in a study published online Oct. 17 in JACR [1].

Corresponding author Lola Oladini, MD, MBA, of Stanford and colleagues further found private IR practices accruing significantly more work relative value units from diagnostic reads than academic groups.

Here the privates collectively attributed 26% of their total wRVU output to diagnostic interpretations while academics reported a cumulative 7%.

Also, academic practices indicated significantly higher case percentages of interventional oncology and complex hepatobiliary intervention, while private practices had significantly higher percentages of musculoskeletal intervention.

The only other metric showing marked separation between the two fields was in clinical fulltime equivalents. Here, unsurprisingly, academic IR groups reported significantly more cFTEs—five to private practices’ three.

The authors surmise this difference largely owes to nonclinical duties for academicians, not least teaching and research.

 

Total Absence of IR Clinic for 6% of Academics and 16% of Privates

Other findings of interest from the survey:

  • Hospital/healthcare system ownership of primary practice sites was nearly a sweep among academic groups, 97%, while 71% of private groups had that ownership structure.
  • Private groups evidenced more variation in ownership structure for primary practice sites, with 14% reporting ownership by the IR or IR/diagnostic radiology group, 8% other (variable arrangements), 3% joint venture between the IR or IR/DR group and hospital, and 3% joint venture with another specialty (e.g. vascular surgery, interventional cardiology).
  • No significant differences emerged in local admitting privileges between academic and private-practice groups (87% vs 80%), and monthly days spent in clinic were similar between the two.
  • Private practices were more likely to allow for buying and selling of call shifts, with 58% of private practices and 25% of academic practices allowing this.
  • The buy/sell rate for a weekend of call was similar between academic and private practices that allowed it, with the average rate for academic practices being $2,873 and the average rate for private practices being $3,653. The reported buy/sell rate for a weekday of call was an average of $545 for academic and $1,331 for private practices.
  • Interestingly, 6% of academic IR groups and 16% of private IR groups reported a total absence of IR clinic in their practice. This aligns with Balthazar et al.’s findings of low billing of E/M services by self-designated IRs in the United States [2].

 

Next Time: CMS Data, Business Management Participation

The authors point out that, overall, their survey results accord with findings from prior studies that used Medicare claims data, “suggesting that the surveyed cross-section may indeed be representative of a larger cross-section of practicing IRs in the U.S.”

More:

Given differing expectations and priorities with variable practice types and settings, the IR community at large may find benefit from [the present] survey of its members attempting to self-quantify differences in practice structure, productivity and compensation. … Future work should emphasize comparison of self-report IR practice data to available CMS data to examine the accuracy of self-report data for IR practices and should also directly recruit IR business managers to participate in survey completion.”

Dave Pearson

Dave P. has worked in journalism, marketing and public relations for more than 30 years, frequently concentrating on hospitals, healthcare technology and Catholic communications. He has also specialized in fundraising communications, ghostwriting for CEOs of local, national and global charities, nonprofits and foundations.

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