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Radiologist Salary Reckoning: Who Has Control Over Your Compensation?

Radiologist salaries average $420,000 to $430,000 annually. Last year was an outlier due to COVID, when the collective figure dipped to around $413,000, according to Medscape’s latest physician salary survey.

Whether or not your salary is in line with these figures, now is a great time to take stock and ask yourself the following:

  1. Am I happy with the money I’m making as a radiologist?
  2. Am I content with the hours I’m putting in to get there?
  3. Am I even in control of my earnings and how hard do I have to work?

As we all know, no two comp models are the same, and each can impact your potential earnings. Take a closer look at your compensation model. Are you paid a salary with incentive payments for productivity? Do you work on a tiered framework tying your salary to minimum reading requirements?

If you’re working within one of those models, you may find numerous negative influences are causing you to answer No to one, two or all three of the questions above.

Specific compensation pain points vary by practice as well as radiologist, but I’ve found 10 that seem to come up repeatedly. Do any of these common frustrations resonate with you?


  1. Your contract requires you to meet certain minimum read requirements. From the practice’s perspective, this is understandable—up to a point. Your leadership wants to make sure they’re getting a reliable return on their investment in your time. But how are they measuring said investment? Is your salary chaining you to your meeting a base-level RVU threshold? If so, do you feel pressured to read as many cases as you can squeeze into a day? We could go on and on about the possible sticking points associated with minimum read requirements, couldn’t we?


  1. When volumes dip, you sometimes don’t have enough cases to pay the proverbial rent. The falloff in studies isn’t your fault, of course, but it may be taken out of your hide. For example, if a lull contributes to your missing your minimum read level, your practice may adjust your salary downward next year. The numbers have to work for the practice first and the individual radiologists second.


  1. Your contract includes curiously subjective performance-based qualifiers. Do they seem just subjective enough that the practice could—legally if not ethically—make the formula work in its favor should times get tough? Be wary, read your contract closely and reconsider your contract’s performance clause after conducting an honest self-evaluation of your strengths and weaknesses.


  1. Your practice keeps adding referrers, but it doesn’t add radiologists to meet the increased demand for reads. Or you see volume creep by other means. Regardless, you’re not sure you can keep up if the trend continues indefinitely.


  1. You’re reading more studies than anyone else in your practice and doing so with little to no falloff in accuracy—yet you’re getting paid the same as everyone else.


  1. You feel obligated to come in on your days off. Or you must work late or come in early, whether to meet the volume demands of the practice or your own earnings goals. Either way, the effect on your work/life balance is a net negative for you.


  1. You’re frequently stuck working additional hours to keep up with your nonclinical duties.


  1. Obligations are tied to your salary that didn’t seem so onerous when you signed your contract. Hindsight really is 20/20, isn’t it?


  1. You have contractual obligations that remain frustratingly linked with loan repayments, work bonuses or sign-on incentives. Often overlooked are those bright and shiny signing bonuses.  Look out for payback clauses and understand tax implications the following year. Not to mention the tax hit you’ll take on the bonus up front.


  1. Your salary has something to do with where you live. How silly is that?


All of this adds up to one thing. Your practice has control of your compensation. Not you.

Does it surprise you how little control you have over how much you work and how much you make? That lack of say-so over your own life can have a damaging effect on your psyche as well as your physical health and your personal life.

And your pay? I’ll bet you have days when you just want to throw up your hands and cry to the heavens: It’s just not worth it!


Consider another compensation model: productivity-based

What is a productivity model in radiology? Simple. Get paid for what you read. But here’s the rub. I don’t know of any practice in the U.S. that fully lives by it, with one exception.

If you guessed the one exception is vRad, you’re right on the money.

A whole lot of data and analysis goes into making our pure productivity model work. We’re happy to tell you about it if you’re interested. For now, suffice it to say that the way we pay our radiologists is totally transparent. You know what you make per work unit, you read from a worklist that’s basically bottomless and is always prioritized based on patient need, you sign out when your shift is over, and you get paid. Seriously.

Not surprisingly, the very first question posed by a lot of radiologists kicking our tires is: How much does a vRad radiologist make?

We'll get to that. But first, let’s take a little closer look at our productivity model. After all, it’s got everything to do with radiologist compensation.

I mentioned transparency. Another unique and powerful aspect of a productivity model is it puts you in total control. Which means you can balance the lifestyle you want with the salary you want to earn.

Income control

By design, not only do we have no minimum reading rate but also no maximum. This allows you to read at your preferred pace without any risk to contracted obligation. Plus, at vRad:


  • You’ll always know how much you’re earning per work unit (or RVU). And by the way, at vRad the per-unit rates are higher on weekends, early mornings and holidays.

  • You can choose between a day or night schedule and pick the number of hours you’ll contract per year.

  • You’ll spend 100% of your time interpreting images. Absolutely all nonclinical tasks are done by vRad’s 24/7 support staff at our operations center.

  • You won’t experience worklist pressure. This is a big one for many radiologists. (Read a firsthand account from vRad’s Dr. Joan Tomanek here.)

  • You practice as an independent contractor or employee with benefits.

  • If you’re after higher earnings, you have two ways to increase your compensation: Become more efficient or pick up more shifts. Radiologists at vRad have access to efficiency trainers who work one-on-one with you to increase your productivity. If you like your pace and want to simply read more, we have schedulers who help add extra shifts (paid at a higher incentive rate).


So. How much DOES a vRad radiologist make?

vRad’s top earners average $500,000 annually, with several bringing home more than $800,000. What will you make? That depends on a lot of factors.

How much do you want to read? What shifts would you like to work? No two of our rads are the same because each one practices the way he or she wants to practice.

A prime benefit of working in a model like ours is that you take control of your earnings in step with how you want to live your life.

And so, I ask: Are you good with the level of control you have over how much you can make and how hard you have to work to make it?

If your answer is no, why not reach out to vRad? Let one of our experienced radiologist recruiters help you explore what working at vRad would look like for you.

Author Benjamin W. Strong, MD

Chief Medical Officer, Education Committee Chair. Dr. Strong is at the forefront of efforts to expand access to quality, affordable care through telemedicine. As CMO for the nation’s largest radiology practice, he collaborates with radiologist and hospital partners, uncovering opportunities to enhance the practice environment. Dr. Strong completed residency in internal medicine, then practiced emergency medicine before later being drawn to the fast-paced flow of diagnostic puzzles that is radiology.



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