You KNOW you can’t take your Bulldog on a 5 mile run in the morning. You KNOW that a Doberman won’t just laze around on the couch, acting all cuddly then rally the fans at a UGA game. Bulldogs are not interchangeable with Dobermans. Step 9 in finding happiness as a veterinary radiologist is to determine if you are Bulldog or a Doberman. Screw up this step and you will be left unfulfilled with your career choice.
Just as it would be moronic to think that a Bulldog could act like a Doberman (and vice versa) it is also moronic to condemn the Bulldog or Doberman. Stated another way, a Doberman is no better (or no worse) than a Bulldog because they act the way they do. A Doberman is just a Doberman and a Bulldog is just a Bulldog. No better. No worse. Dogs are dogs and that is just the way it is.
What does this have anything to do with finding happiness as a veterinary radiologist you ask? The career options of veterinary radiologist fall into one of two main categories. These are independent (e.g. work for themselves – Doberman radiologists) and corporate (e.g. work for someone else Bulldog radiologists)*. Just as you cannot ask a Bulldog to act like a Doberman you cannot ask a radiologist who is hard-wired to be to work for herself to work as a corporate radiologist; and there is no cattle prod or incentive that can get a radiologist who would be satisfied working for someone else to do what it takes to work as an independent radiologist.
The trick to finding happiness as a veterinary radiologist, therefore, is to figure out if you are wired to be independent or corporate. That decision, however, can be difficult because many radiologists do not understand the REAL differences between working as an independent radiologist vs. corporate radiologist.
The attraction of corporate radiology has nothing to do with perks and bennies
In a recent thread on the ACVR list serv, the benefits of corporate radiology were described as follows:
“health care benefits, paid vacation, CE allowance, colleague collaboration, platform and technical support systems, computer work stations, scheduling flexibility, marketing, accounting, legal counsel, 401k retirement savings plan, life and long term disability insurance, professional liability coverage etc. etc, which accompany generous salaries with added production based earning potential.”
The truth of the matter is that some of these benefits are largely insignificant and other can be duplicated by independent radiologists. These benefits should have little influence on whether or not a radiologist chooses corporate employment. Here is why in more detail:
- Health care benefits: For most radiologists, medical insurance is not that expensive and it is usually available to the independent radiologist for a few hundred bucks per month. This benefit is often only worth a few thousand dollars a year. The greater salary that can be achieved by the independent radiologist can easily cover the costs of health care. Moreover, radiologists must check the fine print when it comes to health-care benefits. In many cases, health care is not all-inclusive. Family plans may not be covered. You may have to pay extra for PPO coverage, etc.
- Paid vacation: Depending on the fine print, this benefit may or may not actually be a benefit. When I was working for a corporate entity “paid vacation” actually meant I could leave but I would have to “work back” the money I received when I was away. Stated another way, vacation put me in a “production hole.” As such, some “paid vacations” are, in actuality, the equivalent of working as an independent radiologist. Even if you have a real paid vacation, you are limited in the number of days you can take, you will have to ask permission in advance (do not be surprised if there are “black out days” during busy seasons), and as with most of the benefits listed here, the far greater income that can be generated as an independent radiologist will pay for the vacation you take on your own dime.
- CE Allowance: Continuing education is a benefit of little monetary value (usually less than $2000/year). The independent radiologist has the potential to pay for this benefit many times over by the increased income he can generate.
- Colleague collaboration: Communications and community among radiologists is very easily achieved by using free Internet tools such as Google talk and Skype, email, web conferencing platforms, etc. Small groups of radiologists do this every day with no assistance from anyone. In general, information technology is reducing the advantages of centralized organizations and changing the landscape of our profession.
- Platform and technical support systems: In truth, there is essentially no barrier to entry to run your own teleradiology business, and the radiologist does not need to know anything about the technical aspects of running a business to get started. Platforms such as www.dvminsight.com make it easy (and free).
- Computer workstations: Just about any off-the-shelf computer has the ability to run all of the software needed for effective radiology/teleradiology, DICOM software such as OSIRIX and Clear Canvas are free, and consumer-grade monitors likely do as good of a job as medical-grade grayscale monitors. This benefit is worth maybe $1000.00 and you probably already have a computer at home that you can use.
- Scheduling flexibility: In reality, flexibility is relatively limited by corporate employment. Granted you might be able to request vacation days when you want them, and you might be able to alter your weekly schedule with permission from your boss, but the flexibility offered by independent radiology means that you can do what you want, when you want, without asking anyone for permission and this can only happen as an independent radiologist.
- Marketing: The most important long-term benefit of marketing is goodwill in the form of customers. But who owns that benefit? The corporation. The corporation markets itself, not individual employees or contractors. This is part of what we have in the past characterized as “commoditization” of the veteinary radiologist. Search Google for “commodity teleradiology” and you will see about 32,900 hits about this subject as it is an issue in human and veterinary radiology.
- Accounting: I am not really sure what this means but if it means keeping track of which cases you read and billing for them, this is a perk that really amounts to only about 2 hours (or less) of your time a month and it is a task that can easily be contracted out to a bookkeeper for a few bucks per month. Using a platform such as DVMinsight (www.dvminsight.com) makes accounting easy.
- Legal council: PLIT and insurance for a radiologist costs less than $800/year. This is a benefit of minimal worth.
- 401K: retirement plans allow saving with certain tax benefits. Similar and perhaps better plans and savings accounts are available to independent radiologists.
- Generous salaries with added production-based earning potential: Without a definition of generous** this statement cannot be listed as a perk of working for a corporation. Also, at least with the corporate radiologists I talk to, they are pretty well cooked by the end of the day so added production does not amount to all that much. I would also contend that radiologist who is inclined to work harder or longer to make additional production are the same radiologists who prefer to work as an independent radiologist. They are Dobermans. In general, the income of a successful independent radiologist exceeds the income of a corporate radiologist. As you will see below, however, even though the income between corporate and independent radiology is different, income is not a good reason to choose independent over corporate radiology.
So, what is the main attraction of corporate radiology?
Corporate radiology can be very attractive for many veterinary radiologists. The main attraction of corporate radiology is stability and security.
With a guaranteed caseload and a guaranteed salary, corporate radiology gives the radiologist the ability to live a peaceful, stable, and (relatively) worry-free life. All you really need to do as a corporate radiologist is show up for work, do what you are told and don’t make waves. If you do that even marginally well, you should be all set. If that’s you, live it; love it; BE your inner Bulldog.
The importance of making a salary from day one and not worrying about the month-to-month fluctuations in salary that are inevitable as an independent radiologist cannot be overstated. When radiologists who try to go it alone fail, it’s usually because they do not account for the long time it takes to ramp up a successful independent practice and develop a clientele sufficient to fully support them.
Corporate radiology therefore, makes sense for any veterinary radiologist who either wants or needs immediate income and cannot take the time to build a business or who does not want the headaches or is not willing to do the work it takes to run her own business.
Corporate radiology seems like a pretty good gig – why even consider becoming an independent radiologist?
Truth be told, if you are debating becoming and independent radiologist and you need me or anyone else to tell you why - you are likely not one. Independent radiologists (as all entrepreneurs) have that spark or need or whatever to go it alone. Building a business (with all of the headaches and rewards) is not optional. Most independent radiologists know what they want to do almost as if the decision was made for them a long time ago. It’s innate, like the Doberman’s need for a hard run in the morning. If this is you, embrace your inner Doberman; don’t let fear or minor considerations deter you.
The fact that independence and entrepreneurship are hardwired is a point that is difficult for corporate employers and Bulldog radiologists to understand. Some feel (and I would contend that many in the higher levels of the ACVR feel this way) that independent radiologists are motivated by greed, but that is simply not the case. For many independent radiologists the process of building the business, having a loyal tribe of clients, and owning their own life is a benefit in and of itself EVEN IF the financial rewards ultimately only equal that of a corporate radiologist AND if the road to get there was more difficult and tortuous (and it will be).
Fortunately, in most cases, the financial rewards and the satisfaction of running their own business far outweigh what can be achieved working in corporate radiology. Moreover, once success is achieved it is difficult for anyone, or any corporate entity to take away.
Where the corporate radiologist is attracted to the immediate reward of stability and security and a lower salary, the independent radiologist risks (significant) short-term headaches as he builds his business with hopes of the long-term benefit of a higher income and increased flexibility and control over his life.
Bottom line: If you try to take a Bulldog radiologist and have him run his own business, he will crack. Similarly, if you take a Doberman radiologist and plunk her down behind the desk, her innate need to build, grow, and flourish independently will leave her unfulfilled and wanting for more.
The good news for everyone is that the future is bright for both the Bulldogs and the Dobermans. In my estimation, most of the veterinary radiologists (and veterinarians in general) are Bulldogs who are perfectly happy and content working for a corporation because of the stability it provides. Fortunately, for the Dobermans, it is very easy to capture as much business as they want so they can find all the excitement and upside for working for themselves should they elect to put in the time and energy.
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*The old breakdown was private practice vs. academia. In modern times, the financial rewards of working in academia and for a large, corporate, referral practice are not that much different. Wrap your mind around that because that is the reality in the post-digital world of veterinary radiology.
**Do not expect your salary to be all that generous (at least when compared to working as an independent radiologist. If you think that this is a knock on corporate employers you are bats. Truth be told, you do not deserve to make unlimited dollars working for a corporate employer. They put in a lot of time, money, and risk into building their business (not yours) and they (not you) get rewarded for that investment.