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  • #16
    Originally posted by jacoavlu View Post

    not meaning to be “hostile” but yes

    if where you want to live the jobs suck so bad that being a 1099 is your only option then yeah you’re a commodity
    not to be pedantic, but obviously it's not 1099 vs w2 since the same job could pay you both ways, i imagine being a commodity (or at least feeling like one) has to do with the particular job you find

    you obviously know far more than i do, but it seems to me like a lot of more traditional rads look down on telerads as being inherently worse and commodities. im sure many telerad jobs are like that, more than regular jobs, but im not sure its fair to basically say 100% of telerad jobs are filled by meek radiologist commodities. if a person would be happier working from home as a telerad than doing any normal job around them i feel like it would be silly to pursue the latter over the former. and are we assuming that no radiologists with normal jobs (whether pp or corp) act and/or feel like commodities?

    nevertheless, my understanding is my desired location is actually decent for PP so its all theoretical. but like i said, a lot can change in 10+ years...

    Comment


    • #17
      Originally posted by Turf Doc View Post

      not to be pedantic, but obviously it's not 1099 vs w2 since the same job could pay you both ways, i imagine being a commodity (or at least feeling like one) has to do with the particular job you find

      you obviously know far more than i do, but it seems to me like a lot of more traditional rads look down on telerads as being inherently worse and commodities. im sure many telerad jobs are like that, more than regular jobs, but im not sure its fair to basically say 100% of telerad jobs are filled by meek radiologist commodities. if a person would be happier working from home as a telerad than doing any normal job around them i feel like it would be silly to pursue the latter over the former. and are we assuming that no radiologists with normal jobs (whether pp or corp) act and/or feel like commodities?

      nevertheless, my understanding is my desired location is actually decent for PP so its all theoretical. but like i said, a lot can change in 10+ years...
      you’re mixing the issues

      i didn’t say 100% anything. i am a small group PP owner and feel like a commodity plenty

      “happier” is a term which complicates the issue beyond that which can be reasonably explored on this forum

      Comment


      • #18
        Originally posted by jacoavlu View Post

        you’re mixing the issues

        i didn’t say 100% anything. i am a small group PP owner and feel like a commodity plenty

        “happier” is a term which complicates the issue beyond that which can be reasonably explored on this forum
        you said that if you choose to do telerad you're choosing to be a commodity. i guess you didnt specifically say 100% but your original comment didn't seem too flexible...

        i think the ideal would be a pp job where you're partner but can work from home a few days a week. is that setup common?

        Comment


        • #19
          Originally posted by Turf Doc View Post

          you said that if you choose to do telerad you're choosing to be a commodity
          you’re choosing to infer broad meaning from what i said, which is different than what i actually said

          go back and read the thread.

          i was responding to statements from you with specific qualifications, which is different than what you are inferring

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          • #20
            Originally posted by Turf Doc View Post

            you said that if you choose to do telerad you're choosing to be a commodity. i guess you didnt specifically say 100% but your original comment didn't seem too flexible...

            i think the ideal would be a pp job where you're partner but can work from home a few days a week. is that setup common?
            It should be. The best groups are already adapting to this. Work on site when needed, maintain your presence in the hospital. WFH when you can, for optimal productivity and flexibility. Some rads prefer always going to the hospital to get out of the house, and they enjoy interacting with the techs, staff, and colleagues. Ironically, some of these rads also get triggered by those that opt to WFH.

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            • #21
              Originally posted by jacoavlu View Post

              you’re choosing to infer broad meaning from what i said, which is different than what i actually said

              go back and read the thread.

              i was responding to statements from you with specific qualifications, which is different than what you are inferring
              if you're referring to "your not on site and not doing IR and not going to meetings" i agree that's why the telerads must be paid less than a normal rad but at a personal level, im not sure that doing those things is necessary to not feel like a commodity. as far as realistically being a commodity, i feel like if you're an employee for a PP or corp you're kind of a commodity too. doesn't seem to me like rads is the best specialty to choose if overly concerned about being or feeling like a commodity

              Comment


              • #22
                Originally posted by chucki View Post

                It should be. The best groups are already adapting to this. Work on site when needed, maintain your presence in the hospital. WFH when you can, for optimal productivity and flexibility. Some rads prefer always going to the hospital to get out of the house, and they enjoy interacting with the techs, staff, and colleagues. Ironically, some of these rads also get triggered by those that opt to WFH.
                this is great and makes the most sense to me. there's no doubt that you're going to be able to read more from home, but also that you want to have a presence and need to have one for some things. but not every person needs to be there for all the things all the time.

                you're saing the ones who are unhappy about WFH those who don't even want to WFH but feel like those who are get too good a deal or something? seems like bad dynamics...

                maybe wfh shifts could be paid less and/or have people bid them down (to some sort of floor) or some sort of lotto that could be sold...

                Comment


                • #23
                  Originally posted by Turf Doc View Post

                  if you're referring to "your not on site and not doing IR and not going to meetings" i agree that's why the telerads must be paid less than a normal rad but at a personal level, im not sure that doing those things is necessary to not feel like a commodity. as far as realistically being a commodity, i feel like if you're an employee for a PP or corp you're kind of a commodity too. doesn't seem to me like rads is the best specialty to choose if overly concerned about being or feeling like a commodity

                  i was referring to specific statements you made not me

                  Comment


                  • #24
                    Originally posted by Turf Doc View Post

                    not to be pedantic, but obviously it's not 1099 vs w2 since the same job could pay you both ways, i imagine being a commodity (or at least feeling like one) has to do with the particular job you find

                    you obviously know far more than i do, but it seems to me like a lot of more traditional rads look down on telerads as being inherently worse and commodities. im sure many telerad jobs are like that, more than regular jobs, but im not sure its fair to basically say 100% of telerad jobs are filled by meek radiologist commodities. if a person would be happier working from home as a telerad than doing any normal job around them i feel like it would be silly to pursue the latter over the former. and are we assuming that no radiologists with normal jobs (whether pp or corp) act and/or feel like commodities?

                    nevertheless, my understanding is my desired location is actually decent for PP so its all theoretical. but like i said, a lot can change in 10+ years...
                    its a much more complex issue than that. It's also an inherently perverse reimbursement situation. You get paid for how fast you go, so you are incentivized to go fast, and some likely go too fast. I can call every 18 yr old headache head CT normal in 10 seconds and make a lot of money but the 1 of a million of those cases where there is actually a finding, you made a difference. overall it's just not a good thing for radiology as a field and makes you a commodity behind a screen and you could be halfway across the world if there weren't regulations to prevent it. It does stem for PP radiologists failure to innovate and respond to demand, ie cover nights internally or work together with other neighboring groups. They also failed to innovate in terms of remote workers and/or flexible work hours, things which tele capitalizes on.

                    the perverse reimbursement for speed thing is the biggest critique overall. I didn't sign up to run on a wheel and read as much as I can, as fast as I can. I am very fast tbh like numerous peers comment on it and volumes read are through the roof relative to others but some of the numbers I read on aunt minnie from telerads people just make you blush and wonder how it can be safe. There are some people who can produce at 99th percentile and be really good but there are far, far more people who produce at 99th percentile because they produce 5th percentile quality reports and miss important stuff left and right.

                    It can't be reduced just down to if you want to work from home or not and is a very complex thing.

                    Comment


                    • #25
                      Originally posted by jacoavlu View Post


                      i was referring to specific statements you made not me
                      reading back, i have no clue what those were, lol

                      Comment


                      • #26
                        Originally posted by Panscan View Post

                        its a much more complex issue than that. It's also an inherently perverse reimbursement situation. You get paid for how fast you go, so you are incentivized to go fast, and some likely go too fast. I can call every 18 yr old headache head CT normal in 10 seconds and make a lot of money but the 1 of a million of those cases where there is actually a finding, you made a difference. overall it's just not a good thing for radiology as a field and makes you a commodity behind a screen and you could be halfway across the world if there weren't regulations to prevent it. It does stem for PP radiologists failure to innovate and respond to demand, ie cover nights internally or work together with other neighboring groups. They also failed to innovate in terms of remote workers and/or flexible work hours, things which tele capitalizes on.

                        the perverse reimbursement for speed thing is the biggest critique overall. I didn't sign up to run on a wheel and read as much as I can, as fast as I can. I am very fast tbh like numerous peers comment on it and volumes read are through the roof relative to others but some of the numbers I read on aunt minnie from telerads people just make you blush and wonder how it can be safe. There are some people who can produce at 99th percentile and be really good but there are far, far more people who produce at 99th percentile because they produce 5th percentile quality reports and miss important stuff left and right.

                        It can't be reduced just down to if you want to work from home or not and is a very complex thing.
                        seems like as long as we have fee-for-service you're going to get those negative incentives. it's just that in rads because there's so much less BS involved you can see the consequences of it more easily. if i want to go unsafely fast in other specialties i have to find that number of patients, i still have to walk to them, chat with them, chart, etc. but if you're a rad you can do the most important part of your specialty (interpreting) slow or quick and that's affecting your pay and read quality inversely (at a certain point)

                        how does that affect if you want to work from home or not though? also if youre referring to slacman on auntminnie hes talked about it a lot, hes a fast reader and also does a bunch of super easy prelims

                        Comment


                        • #27
                          Originally posted by Turf Doc View Post

                          seems like as long as we have fee-for-service you're going to get those negative incentives. it's just that in rads because there's so much less BS involved you can see the consequences of it more easily. if i want to go unsafely fast in other specialties i have to find that number of patients, i still have to walk to them, chat with them, chart, etc. but if you're a rad you can do the most important part of your specialty (interpreting) slow or quick and that's affecting your pay and read quality inversely (at a certain point)

                          how does that affect if you want to work from home or not though? if youre referring to slacman on auntminnie hes talked about it a lot, hes a fast reader and also does a bunch of super easy prelims
                          It's unrelated to working from home but just a general critique of tele. Yes nearly everyone wants to work from home and PPs are increasingly offering people to work from home to varying degrees.

                          Yes its different in rads re fee for service because all other specialties have built in buffers which are inherent. You have to physically walk through the hospital to see a consult, you have to wait for the OR to spend 40 min to turnover (unless you're ortho or spine and they give you 2 rooms)

                          PACS lines studies up where the only limiting factor is basically how fast your internet works, truly. It would be like if there was a general surgeon who had people carted to him/her in the same operating room and they just removed the appendix all day, rinse and repeat, a race to see who can remove the appendix the fastest. That's how PACS is and it enables people to go too fast if they want to.

                          Comment


                          • #28
                            Originally posted by Turf Doc View Post

                            reading back, i have no clue what those were, lol

                            Originally posted by Turf Doc View Post

                            if the only options in my desired location were crappy corporate jobs anyway i'd prefer to be a commodity who could at least work from home...
                            desired location
                            crappy corp jobs

                            there you go

                            Comment


                            • #29
                              Originally posted by jacoavlu View Post




                              desired location
                              crappy corp jobs

                              there you go
                              gotcha. i agree that if you're tied to a location no matter what that's desirable and/or has bad jobs you're more likely to be treated as a commodity

                              Comment


                              • #30
                                Originally posted by Panscan View Post

                                It's unrelated to working from home but just a general critique of tele. Yes nearly everyone wants to work from home and PPs are increasingly offering people to work from home to varying degrees.

                                Yes its different in rads re fee for service because all other specialties have built in buffers which are inherent. You have to physically walk through the hospital to see a consult, you have to wait for the OR to spend 40 min to turnover (unless you're ortho or spine and they give you 2 rooms)

                                PACS lines studies up where the only limiting factor is basically how fast your internet works, truly. It would be like if there was a general surgeon who had people carted to him/her in the same operating room and they just removed the appendix all day, rinse and repeat, a race to see who can remove the appendix the fastest. That's how PACS is and it enables people to go too fast if they want to.
                                yep, totally agree. it's obviously the reason why rads get paid a lot. if other specialties could work how rads does they'd get paid more too.

                                Seems like PACS is a blessing and a curse for the field. one reason i'm interested in radiology though is because im a big tech person so i think i'd like post-PACS rads more than when it was all film

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