Practices that formerly had no difficulties in recruiting may find that they need to utilize new marketing techniques to attract high-quality candidates. Jonathan W. Berlin, M.D., M.B.A.

In-Demand Radiologists Enticed with Incentives

Radiologists are still highly sought after nationwide, with organizations using a blend of incentives to entice candidates, according to statistics released by a national healthcare search and consulting firm.

According to Irving, Texas-based Merritt, Hawkins, & Associates®, radiology was the third most frequent physician search the firm conducted between March 31, 2005 and April 1, 2006. Of the 2,840 physician and certified registered nurse anesthetist (CRNA) searches conducted by the firm in all 50 states, 237 were for radiologists—a 9 percent increase over the previous year.

These findings come as no surprise to three instructors who taught sessions at an RSNA-sponsored radiology business strategies seminar last year.

“There’s no question there’s a demand,” said David C. Levin, M.D., professor emeritus of radiology at Thomas Jefferson University, who led a session titled “What to Do About the Radiology Manpower Crises.”

 “It might not be as acute as it was 2 years ago, but there’s still a very significant shortage,” said Dr. Levin.

Radiologist Shortage Inevitable

Pablo R. Ros, M.D., M.P.H., said a shortage is inevitable as the number of exams per year—estimated to be 500 million by 2010—continues to increase. The complexity of exams also is increasing, he said, with CT, MR imaging, positron emission tomography (PET) and CT replacing plain films. Dr. Ros is a professor of radiology at Harvard Medical School, executive vice-chair and associate radiologist-in-chief at Brigham and Women's Hospital and radiology division chief at the Dana Farber Cancer Institute. He taught “Motivation and Compensation in Radiology” at the seminar.

The inevitable—and not altogether undesirable—result of the shortage is that radiology practices are being forced to better manage their finances and recruiting strategies, said Jonathan W. Berlin, M.D., M.B.A., a radiologist at Evanston Northwestern Healthcare and associate professor of radiology at Northwestern University’s Feinberg School of Medicine.

“Practices that formerly had no difficulties in recruiting may find that they need to utilize new marketing techniques to attract high-quality candidates,” said Dr. Berlin, who taught “Negotiation Strategies: How to Be a Better Negotiator.”

The Merritt Hawkins report showed organizations are enticing candidates by combining salaries with bonuses, income guarantees and other incentives. The average salary offered to recruited radiologists was $351,000, representing a 1 percent decrease from the year before, but a 12 percent increase since 2002.

Salary and Benefits Not the Only Incentives

An appealing salary and benefit package is obviously important, said Dr. Levin, but he added that employers can sweeten the deal in other ways as well. Of utmost importance, he said, is managing the office workload with such tactics as employing radiologist assistants and having a reliable picture archiving and communication system (PACS).

“A good PACS allows a practice to move images around,” said Dr. Levin. “If you have a radiologist at a remote site where the workload isn’t so high, and you have a good PACS, that person can call up and read images that were done somewhere else and make the whole practice more efficient.”

Using nighthawk services can also have the net effect of attracting new candidates, he said. “If a practice can provide the radiologist with nights free—or at least nights free to some extent—with nighthawk coverage, that can help,” he said.

Dr. Ros said that to recruit quality candidates, institutions such as his must guarantee not only salary raises but also bonuses for a number of years, in addition to an attractive recruitment bonus and special tools such as low-interest mortgages. In other cases, he said, departments will also include college tuition remission and child and elderly care funds.

“Radiology recruitment is tough,” said Dr. Ros. “Even academic departments are routinely using headhunting firms, something unheard of a few years ago.”

While it might seem obvious, Dr. Berlin said employers also shouldn’t forget to capitalize on their specific unique attributes, such as a desirable geographic location, top notch equipment and lifestyle factors.

One RSNA member, who recently searched nationwide for a new position, said the findings in the Merritt Hawkins report were more consistent with her experience in rural areas, which likely attracted fewer candidates than large cities. A practice in a relatively small Midwestern town offered a salary well above the average cited by Merritt Hawkins as well as a guarantee of becoming a partner in 6 months, she said, whereas organizations in large cities offered far less generous packages.
 
According to Merritt Hawkins, internal medicine was the most frequent physician search, followed by family practice. After radiology, rounding out the top 15 searches were orthopedic surgery, cardiology, general surgery, hospitalist, OB/GYN, gastroenterology, emergency medicine, urology, anesthesiology, psychiatry, neurology and otolaryngology.

An incentive package of salary plus bonus was offered in 53 percent of all searches, with an income guarantee offered in 32 percent.

Shortage Causes, Implications Vary

The strong demand for radiologists and other specialists can have a variety of causes, including a fixed-supply of U.S.-trained physicians, changing practice styles, population aging and technological innovation, the firm reported. With these factors at work, the firm projected, the physician shortage will last at least another decade.

Addressing the shortage in the long term, said Dr. Berlin, means finding ways to increase the number of new practitioners being trained. In the meanwhile, said Dr. Levin, radiologists must be proactive about protecting their reputation.

“If radiologists can’t handle the workload, it gives the whole field a black eye,” he said. “People will say, ‘Radiologists don’t schedule patients quickly enough.’ Ideally we would have enough radiologists to handle the workload efficiently and quickly, so when a patient or a referring physician calls up to schedule a case, we say ‘Yes, we can see your patient tomorrow.’ The patient comes in, gets the study done and a report gets issued promptly.”

The shortage also has implications for radiologists retaining control over the procedures they’re most qualified to do, Dr. Levin said.

“It’s not a good situation for organized radiology to have this kind of a shortage, because some radiologists who are overburdened might say to themselves, ‘Well, I can’t handle the workload, so I’ll give away some of this work to the vascular surgeons, or the cardiologists or the urologists or the OB/GYNs,’” he said. “That’s one way we can lose our turf battles.”

Jonathan W. Berlin, M.D., M.B.A.
Evanston Northwestern Healthcare

Pablo R. Ros, M.D., M.P.H.
Harvard Medical School

David C. Levin, M.D.
Thomas Jefferson University