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I left vRad. This is why I came back.

After 11 years as a vRad radiologist – 3 of them as Clinical Chief of Abdominal Imaging – I left in 2019 for a teleradiology position at another well-known national practice. Just 9 months later, I’m back. Here’s why.

What was I thinking?

Why did I leave? My reasons seemed solid at the time, but in retrospect, I'm not so sure. I left partly because I felt I needed a change, and partly to chase a higher level of compensation. What a mistake!

I had mixed feelings when I left vRad. There were a lot of things that I knew I would definitely miss. To me, the radiology platform at vRad is the best in the industry, and I knew it would be difficult, if not impossible, to find something comparable elsewhere. But it took stepping away from it to fully appreciate just how challenging it is working without vRad’s cutting-edge technology.

I also came to realize just how the support team at vRad made my life easier. If I needed anything, my dedicated physician liaison was always a click or a call away. Extremely helpful people were always available to streamline administrative tasks, scheduling, IT issues, and credentialing. Plus, I had access to vRad’s extensive in-house career development and continuing education resources.

Between the technology and the support, I was able to be a much more efficient, productive radiologist at vRad. I realized that the best thing for me would be to come back to vRad, so here I am.


Some days I can read 25% more cases

Comparing the vRad radiology platform to others, it’s like the difference between driving a Ferrari and driving a Yugo. vRad is far and away the best system I've ever worked with. There are days I know I’m able to read 25% more cases on the system.

The PACS and RIS were developed in house and optimized for teleradiology workflow. They are seamlessly integrated – think Apple versus Microsoft – providing the reading radiologist with maximum efficiency and stability. Workstation crashes are exceedingly rare on the vRad platform, which I found not to be the case in other systems. The vRad software and hardware include features you won't find anywhere else – features that make reading cases faster and more efficient.

When I open a case at vRad, images are automatically displayed with my preferred hanging protocol, regardless of the hospital of origin. Key information is pre-populated on the report automatically – patient demographic information, exam type, laterality, prior exams, etc. I can get right to interpreting - no delay. Additionally, the integrated artificial intelligence (AI) structured reporting software allows me to keep my eyes on the images (and not on the dictation screen) and my hands off the keyboard while I dictate.

The vRad system is built for radiologist productivity. Image loading and scrolling are lightning fast because all case images are pushed to, and cached on, my vRad workstation. I have worked on web-based systems that instead store images on remote servers. They tend to have slower scrolling action and frequent crashes - both of which are frustrating and hamper my productivity.

Another vRad feature is the capability to have two cases open simultaneously, without slowing – or worse crashing – the workstation. I can set aside a critical case in a separate tab while my vRad operations center team locates the referring physician, and I go on to my next case. When the physician is on the phone, one click and I’m looking at the critical case again, ready to discuss. When communication with the referring doctor is completed, one click and I’m back to the case I was working on.

I didn't fully recognize how unique these vRad platform attributes are until I left. Many other practices use "off-the-shelf" systems, which function adequately, but are not nearly as efficient and as stable as vRad.

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AI: Practicing on the leading edge

Once you work with a system that uses AI, it’s hard to go back to reading without it. For radiologists, AI is an incredible tool that improves accuracy and efficiency.

vRad worklist prioritization employs multiple AI models to scan images for the likelihood of specific pathologies – like intracranial hemorrhage (ICH), pulmonary embolism, pneumoperitoneum, and pneumothorax ─ immediately moving critical cases to the top of the worklist, for me or the next available radiologist to read, speeding diagnoses for critical patients. The system recognizes critical findings when present in my dictation and prompts me to autodial the ordering physician, saving more precious time.

vRad AI also scans reports and alerts me to inadvertent errors, such as left/right or male/female discrepancies. It confirms each report meets federally mandated reporting parameters (MIPS) to ensure maximum reimbursement for the work I do.

Unfortunately, many practices are just not able to integrate AI for a variety of reasons. Those that try to patch in off-the-shelf AI software often find the steep learning curve and inadequate systems hinder productivity instead of enhancing it.

Meanwhile, the team at vRad is actively honing AI models and adding new ones. For me and my fellow radiologists, that means the fantastic tools we are working with today are only going to get better. It’s exciting to be working in a practice on the leading edge.

The straight story on compensation

Basically, at vRad you earn what you want to earn. Your schedule is clearly defined, and there are always extra shifts or shift extensions available if you want to earn more.

vRad directly rewards productivity through RVU-based compensation, and vRad technology and support help to make you more productive, as I mentioned above. The increased efficiency directly translates into increased compensation earned.

The lack of "productivity pressure” at vRad is unique. The practice values accuracy in interpretation above all else. There is never pressure to read faster than you are comfortable with and no mandated “productivity floor” metrics. Regardless of your preferred pace, at vRad you can read more studies with less effort, earning more RVUs, which translates to increased compensation.

The mix of cases one reads can also have a huge impact on compensation. vRad automatically distributes cases equitably throughout the practice, eliminating the “cherry picking” of higher value cases by a few people that can erode your earning potential in practices that use open worklists. Automatic prioritization at vRad also ensures timely attention for each case, resulting in better patient care.

If you’re considering a job that offers a base salary with a productivity floor and bonuses, be sure to consider whether their work environment will help or hinder your productivity. If the practice has dated technology or lacks support, you’ll have a hard time reaching the floor, let alone exceeding it for a bonus.

Incomparable support: People make the difference

The people at vRad are simply the best, and I've worked with a lot of helpful and hardworking support team members throughout my career.

vRad IT team members are incredibly responsive and are invaluable in solving any issues that (rarely) arise, so I can keep reading. The 24/7 operations center team in Minnesota does a great job handing all support tasks and facilitating physician communications. The people there are phenomenal resources that make my life so much easier.

In addition, each radiologist has a physician liaison who acts as the go-to person for any questions or issues that you might have. The licensing and credentialing department at vRad understands and tracks the specific CME requirements for each state and compiles each radiologist's CME data – a task that can become burdensome for those of us who hold multiple state licenses. In addition, vRad develops continuing education modules internally, offering free access to CME material to help meet various CME requirements. The only place you're going to find dedicated education like that is through some university program or at a university job.

Very happy to be a vRad radiologist… again

I've worked in just about every form of practice in Radiology, from Academics, to private partnership, to publicly traded company, and vRad has been the best experience for me. I'm hoping to make this the last stop of my career.

Please feel free to email questions at Steven.Cohen@vrad.com.


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Author Steven Cohen, MD, MBA

Radiologist, vRad. Abdominal imaging fellowship, University of California, Los Angeles.


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