The Challenge of Leaving Private Practice for Remote Radiology: 5 Considerations

Leaving private practice is hard. As vRad’s Medical Director, I interview radiologists every day who are wrestling with that difficult decision. Even in the face of exhaustion and burnout, they run up against loyalty to their colleagues. Others worry about the impact of unwinding their current financial entanglements.

For those considering teleradiology, the thought can seem particularly daunting. Will I feel isolated? How fast do I have to read? Can this really be a stable career change?

So how did those who made the switch do it?

I’ve gathered the experiences of some of our radiologists who’ve made the transition from private practice to remote radiology, to explore the most difficult aspects of the change, and to offer some considerations and practical advice to those considering making the move.

1. Are you putting loyalty over your own well-being?

Even radiologists on the verge of burnout struggle with loyalty. Leaving private practice can feel like you’re abandoning your entire practice ecosystem—your colleagues, your friends, your patients. This is especially difficult with the current radiologist shortage because they may not be able to find someone to fully replace you.

One of our radiologists felt tremendous guilt leaving her small-town practice, but she had reached a point where her mental health and family life were suffering too much to continue. The constant worklist pressure and longer and longer hours were grinding her down and making her less. Less of a doctor, less of a spouse, less of a parent. She had to make a change.

I share her story with radiologists who are struggling with loyalty and ask them to consider who they depend on and who depends on them—and understand that balance is critical to avoiding burnout. Hospital administrators, long commutes, higher workloads for the same amount of pay, and a lack of quality family life; these are the kinds of intangibles that you can’t really quantify. But they’re so crucial. Sometimes, the person you need to be loyal to is you.

2. How much control do you have over your salary?

Compensation is a complex web of a practice’s financial obligations, potential partnership investment, and work-life balance, plus the simple fact that you would be walking away from a guaranteed income. For many, that's enough to stop them from looking into the productivity model of teleradiology all together. 

I think the better question to ask yourself is, how much control do you have over your salary and the amount of work you’re expected to perform to earn it?

I advise anyone who’s considering a move to take a step back and evaluate their full package and salary model. An attendance-based model can leave a productive radiologist feeling undervalued at a private practice. A productivity model, like we have a vRad, means that you get paid for exactly the studies you read. Then, when your shift is over, it’s over. Or, if you do want to work more, you can. It’s up to you. It’s a simple, straightforward concept, and one that puts the radiologist completely in charge of their own earnings. For many radiologists looking to leave private practice, this can be a strong motivation.

3. Are other commitments holding you back?

For radiologists who are tied up in contracts, buy ins, or partnership agreements, it can be sticky or expensive to get out. While your individual situation may need a financial advisor or a lawyer, if you’re questioning if leaving is the right choice, I recommend trying to focus on the long-term. Is escaping a life-derailing amount of call worth a five-figure buy-out? How many years can you bear under your current worklist load before burnout catches up to you?

On the practical side, radiologists working or buying their way out of contracts are often relieved to hear about our flexible onboarding. Easing their way out of their practice over several months often sounds better than breaking bonds instantly. Awkward? Sometimes. Difficult? Of course. But doable? Yes.

4. Are you worried that teleradiology means isolation?

Working remotely from the comfort of your home generally sounds great. Post-pandemic, several previously onsite radiology practices now offer remote options. But many radiologists worry about isolation or missing peer connections, and it’s a fair concern. In private practice, even if you don’t see patients, there are coworkers, techs, and physicians who you consult with every shift.

At home there’s only you. I consider this a problem that you can both predict and mitigate. After about eight years at vRad, my family relocated, and I didn’t prepare myself. So, when we arrived in an area where I knew no one, I didn’t realize I would struggle with that change. Here’s some advice I give to radiologists trying remote work for the first time:

• Have friends outside of work
• Utilize your saved commute time to nurture or take up a hobby
• Use social resources during your shifts

These suggestions might sound simple, but you’d be surprised at how many people don’t consider them. Including me! Some basic groundwork will set you up for a more fulfilling remote experience.

You should also ask any potential teleradiology practice if they facilitate intracompany socialization. As an example, our radiologists are all on Teams, so chatting with another radiologist is one click away. This allows them to be as social as they like. Or the reverse. We also offer opportunities throughout the year for our radiologists to meet each other face to face, such as our annual CME conference.

When the right support, communication tools, and culture are in place, you should never feel alone, even in your home office.

5. What’s most important to you?

Many radiologists who come to us from private practice stuck it out until they couldn’t take it anymore. Why? Because it’s hard to leave and we don’t want to pretend it isn’t. So, a question you need to ask yourself is, is it really worth it?

Here are some of the top reasons radiologists have made the switch to vRad’s teleradiology practice and, more importantly, why they stay.

• Staving off burnout
• No worklist pressure
• Control and autonomy in their career
• Work-life balance
• No call and flexible scheduling
• The focus is on patients, not numbers
• Being their best selves for their family or themselves

If you’re considering leaving private practice, I hope this makes you feel comfortable reaching out and asking questions. Want to hear from radiologists who have made the switch from private practice to vRad and are glad they did? I recommend the articles below.

Dr. McGill: Teleradiology to Private Practice and Back: Why I Returned to vRad

Dr. Bartel: Leaving My Hospital Radiology Practice Helped Me Rediscover the Joy of Medicine

Dr. Sokol: 10 Reasons I’m a vRad Lifer