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How radiologists can find stability during economic volatility

With the amount of volatility and uncertainty in the U.S. economy, it’s no surprise that even radiologists, who are used to being in high demand, are starting to wonder: How would a recession affect my current employment?

In addition to macroeconomic challenges, financial headwinds such as the recently passed No Surprises Act continue to put pressure on healthcare providers. Groups and their radiologists may start to feel the impact of cost-saving actions taken by hospitals and other radiology referrers as they attempt to navigate these challenges.

Those of us involved in the hiring process have unique insight into how the current climate is already affecting the radiologist job market. As a vRad Medical Director, I’m directly involved in our recruitment and interviewing process. Combined with my experience living and working through the 2008 recession and the pandemic, I’m sharing some predictions about what headwinds radiologists may be facing at any stage in their career, and suggestions on how to navigate them.

Deteriorating working conditions

For those practices that intend to keep employment at current levels, many are asking for more from their radiologists to absorb increasing reading volumes without increasing staffing.

That may mean working longer hours, more time on-call, and less scheduling flexibility for radiologists who were often already overwhelmed. The practices who find themselves in this place typically don’t fare well, either. I’ve interviewed radiologists who describe destructive downward spirals, where longer hours and increasing study volumes lead to one radiologist leaving, which leads to even more difficult conditions for those who remain. That feeds into a cycle of more radiologists leaving — eager to get off what one candidate told me felt like a “sinking ship.”

Fewer openings to fill

The Great Recession provides key insights for all radiologists, including residents and fellows fresh on the job market — a category that I myself fell into at the time. During those years, older radiologists saw their stock portfolios decline in value and decided that maybe they weren’t as close to retirement as they thought. That led to a dearth of jobs for recent graduates and others looking for a change. With this year’s stock market performance thus far, and the general volatility, it’s easy to imagine this phenomenon repeating itself.

Lessons from the past: Which practices are most resilient?

Under economic stress, some practices are at greater risk than others. Look at factors such as case mix, practice size, and historical performance to assess the potential resilience of your current work situation.

  • Emergent imaging

During the pandemic, practices focusing on non-emergent work reported large decreases in imaging volume. Emergency imaging volumes, on the other hand, were relatively more stable. At our practice, where 80% of volume is emergent, we experienced a sharp drop like all groups in March 2020, but had rebounded to over 90% of pre-COVID baseline volume within only four months.

While patients may put off follow-up scans, outpatient screenings, and other non-emergent imaging during an economic downturn, emergency department imaging will always be in high demand.

  • Practice size and number of clients

Macroeconomic factors may force hospitals to make changes that impact their physician provider groups. A small or mid-size radiology practice may be forced to conduct layoffs if they lose even a single hospital contract.

However, large practices that serve hundreds or even thousands of clients are well-placed to shoulder the burden of losing clients without radiologists feeling the brunt of the loss. During the pandemic, for example, we actually added 15 radiologists to our practice, and we didn’t let a single one go.

  • Performance during previous downturns

For more clues on how your own practice will fare, look even further into the past to see how they did between 2007 and 2010; it’s a good indicator of how “recession-proof” your practice is. (At vRad during these years, we added 60 new radiologists, didn’t let anybody go, and saw a 79% increase in study volume.)

In addition to considering where your practice falls in the categories above, ask the right questions to your current or prospective employer to find out if they are “recession-proof.” Whether you’re fresh out of residency or you’ve been at the same practice for years, here’s what you need to know to get a better idea of your potential fate:

  1. What is the attrition rate? (How many radiologists left your practice within the past year?)

  2. Did your practice reduce its headcount during the Great Recession or recent pandemic?

  3. How many radiologists are practicing and how will you handle volume if your rads leave?

  4. What is your current volume and what will the group do if volume grows or drops?


Preparing for the unknown with a pivot toward stability

Even in a downturn, radiologists may have more wiggle room than their colleagues in other specialties. The radiologist shortage likely isn’t going away anytime soon, and I don’t think that radiologists will find themselves unemployed. Instead, they may have to adjust expectations and pivot toward practices that will be better able to withstand economic hardships.

In fact, I made a pivot of my own when I was a new fellow seeking a position during the Great Recession. Instead of taking an offer to work overnight hours for a small local practice, I started looking at other options. Ultimately, I began working from home doing teleradiology for vRad. For all of the reasons described above, I viewed it as a practical and virtually recession-proof choice — the high volume of emergent cases, the broad client base, and the focus on growth. And it continues to be a stable practice environment that allows me to practice my subspecialty and have the flexibility I love.

Based on my own experience, here’s my advice to all radiologists: use the guidance and the questions above to help find employment that will work for you no matter what’s going on in the economy. With a little bit of planning, you too may be able to turn a challenge into an opportunity.

It’s never too early to start planning. Get in touch with one of our recruiters today to learn how a career at vRad can help you “future-proof” your job against a potential economic downturn.

Author Scott Baginski, MD

Medical Director, vRad



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