I believe in the importance of thriving independent private practices for the field of radiology. True private practice—where doctors control the organization, are responsible to their peers and patients, and earn the full fruits of their labor—is the benchmark that sets the market and provides the anchor against exploitation from unscrupulous employers.

My group, like most groups in this market, is hiring. Here are several more 100%-independent radiologist-owned private practices across the US that are recruiting. If you’re in the market for a new position, consider reaching out with your CV. (Click the triangles for more information.)

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South Texas Radiology Group

(San Antonio, Texas)

STRG is a well-established, expanding, independent subspecialty practice of 70+ radiologists serving 15 hospitals, multiple freestanding ED facilities, and a large outpatient imaging practice (STRIC). Both onsite and remote positions are available.

STRG is a forward-thinking practice with a strong and cohesive culture. Multiple AI projects are in place and in progress to improve efficiency and quality. Internal moonlighting opportunities are available.

Shareholder Track:

• Flexible associate period as short as 18-months.
• Leads to full partnership with board of directors membership.
• Equity ownership within a large expanding outpatient imaging practice (STRIC)
• Competitive salary with up to $800K starting salary for experienced applicants. Up to $600K starting salary for inexperienced applicants.
• Excellent benefits package
• Onsite and work-from-home options for daily work and call
• Hiring across all specialties, with a current emphasis on Body Imaging and Cardiothoracic/Body

Emergency Radiology Track:

• 1 week on/1 week off (7/7) and 1 week on/2 weeks off (7/14) positions available
• Competitive salary with excellent benefits package available.
• Fully remote and onsite options available.

Employee Mammography Position (Onsite):

• Competitive base salary with excellent benefits package
• No call. No nights or weekends.
• Remote opportunities available for general radiology or body imaging work if interested.

Employee Position – All Subspecialties (Onsite, Hybrid, or Remote ):

• Competitive base salary with excellent benefits package
• 5.5 weekends (day shift) per year. No evening or overnight call.

Learn more at https://stric.com/.
Contact: Waynea Finley at wfinley@strg-pa.com

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Kettering Network Radiologists

(Dayton, Ohio)

Kettering Network Radiologists, Inc. (KNRI) is a physician-owned, independent private practice serving Kettering Health’s extensive network. Our team consists of 56 radiologists, 8 physician assistants, and 8 radiology residents, providing high-quality imaging services across  8 hospitals (115-500 beds), 20 outpatient centers, 11 emergency departments, and 2 trauma centers (one Level II, one Level III).

When working ER or night shifts, you are never alone—always part of a team. We are a stable, well-compensated group, enjoying flexible scheduling with very comprehensive benefits.

Contact: Dr. Rachel Shikhman at rachel.shikhman@gmail.com

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RAPA

(Central Arkansas [Little Rock, Conway, Searcy, and Pine Bluff] & Northwest Arkansas)

40+ radiologists covering 20+ sites (hospitals + clinics) with a multi-subspecialty mix of inpatient, outpatient, and ED imaging.

Robust reading room assistants and IT presence to promote peak efficiency. Unified Clario reading list, Inteleviewer PACS, Powerscribe dictation (no switching stations or PACS to read other sites). RadAI automated impressions to improve efficiency.

Greatest needs are IR, mammography, body imaging, MSK, and nuclear medicine, but all subspecialties and general radiologists are welcome.

Learn more at http://rapaxray.com/
Contact: recruitment@rapaxray.com and Dr. Brandon Kelly at bkelly@rapaxray.com

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Eastern Radiologists

(Greenville & Coastal North Carolina)

Eastern Radiologists is a private practice in Eastern North Carolina that is physician-owned and operated and seeking to hire multiple radiologists due to growth and retirement. The well-established private practice serves a large geographic region through 14 area hospitals and several state-of-the-art imaging centers. Support is provided by nearly 70 subspecialty radiologists.

Currently seeking candidates in all subspecialties.

Details:

• Positions are available in Greenville and other coastal communities in Eastern North Carolina.
• Most are partnership track positions which include evening and weekend call responsibilities, but other employment options can be considered. Employment positions can be customized to fit desired schedule/income. Internal moonlighting is available for extra income.
• Most specialties can work nearly 100% in their desired field of interest.
• Great benefits, competitive salary including profit sharing and bonus, generous vacation and paid family leave, and business/educational discretionary account.
• Sign-on bonus

Learn more at https://www.easternrad.com.
Contact: Erica Askew at easkew@easternrad.com

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Radiology and Imaging Specialists

(Central Florida: Lakeland/Winter Haven, SW Orlando, Bradenton)

Independent and long-standing group covering a diverse mix of financially sound hospital partners, outpatient imaging centers, an ASC/OBL, clinics, and a multi-specialty group. 50+ radiologists and 10+ midlevel providers. In-house and experienced IT, Credentialing, HR, and Admin team including dedicated Radiology Liaison support 24/7/365.

Recruiting for Body, Breast, Cardiac, Neuro, IR, and General.

Partnership Track:

• 1-year track for diagnostic radiologists, 2-year track for interventional radiologists
• 10 weeks of vacation
• Sign-on bonus for diagnostic radiologists
• Call compensation for interventional radiologists
• Internal moonlighting available but not required
• Full benefits including CME allocation

Employee or Contractor:

• Flexible scheduling: Hospital (ED/IP) or outpatient coverage options available
• Fully remote, hybrid, or on-site depending on location(s) and coverage schedule desired
• Competitive compensation models (including benefits if employed/full-time)

Learn more at http://risimaging.com.
Contact: Alice Varnadore, Executive Assistant at avarnadore@risimaging.com

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Midwest Radiology

(Minneapolis – St. Paul, Minnesota)

Large 175+ subspecialized practice with 17 weeks of vacation. Two-year shareholder track for new graduates and a one-year track with experience.

Positions (On-site):

Positions (Remote):

Learn more at www.midwestradiology.com.
Contact: Barry.Lindo@MidwestRadiology.com

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Radiology of Huntsville

(Huntsville, Alabama)

ROH is 60+ physician, high-volume, private practice with a 2-year partnership track and nominal buy-in. Hiring for a remote partnership-eligible overnight position as well as onsite/remote openings in most subspecialites. Huntsville is a tremendously livable, high-tech, and growing mid-sized city (a #1 Best Place to Live in the U.S. by U.S. News and World Report).

Learn more at www.radiologyofhuntsville.com.
Contact: Brandy McCown at bmccown@radhunt.com or call 256.713.0621.

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Vantage Radiology & Diagnostic Services

(Near Seattle, Washington)

~35 subspecialized radiologists practicing near Seattle and enjoying a quality lifestyle focused on work-life balance, located minutes from urban amenities, and with easy access to abundant outdoor activities in the natural beauty of the Pacific Northwest. We’ve provided professional services for two hospitals since 1970 and are co-owners of their affiliated imaging centers.

• Competitive salary ($370-570k) with a signing bonus for a 4-day work week and 8 weeks of vacation.
• Benefits include a CME allowance, memberships to professional societies, profit-sharing, malpractice and disability insurance, 401K contributions, and a commitment to associate mentorship.
• All partners and partner-track associates share in general call responsibilities (many from a practice-provided remote home workstation). Overnight call is covered by our internal nighthawk team.

Openings:

Learn more at https://www.vrads.com/
Contact: recruiting@vrads.com

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Reno Radiological Associates

(Reno, Nevada)

Serving Northern Nevada since 1947, RRA is a strong, highly subspecialized, democratic, extremely collegial, high-earning group of 25 radiologists working in perhaps the best city in the country for raising a family and enjoying unparalleled access to natural beauty, endless outdoor activities (perhaps the best ski-city in the US), and incredible weather (jokingly referred to as “the cheapest city in California” for its proximity to Lake Tahoe (<30 min), Napa Valley, national parks, and more without the super high cost of living and no state income tax).

Shareholder Track (onsite):

• 1 year to 75% partner, 2 years to 100%
• Top 90+% comp nationally, maximally generous benefits
• 8/9/10+ weeks of vacation
• Remote shifts + opportunities for extra income, $100 buy-in

Employee Track (remote or onsite):

• High comp, Maximally generous benefits, opportunities for extra income
• Onsite preferred, fully remote night available (8p-3a PST)

Independent Contractor:

• Flexible shift options, high compensation

Learn more at http://www.renorad.com/
Contact: CEO Anthony Dispenziere at adispenziere@renorad.com

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Inland Imaging

(Washington, Oregon, Montana)

Inland Imaging is a 120+ radiologist-owned private practice proudly serving multiple outpatient, clinic, and hospital sites throughout the Inland Northwest region. We own and operate one of the first outpatient interventional labs in the West in addition to 7 outpatient imaging centers.

Our practice:

• Sub-specialty interpretations available across all locations.
• All studies are accessible on a common PACS system, one common voice recognition system, and one common worklist
• Internal Nighthawk System providing final interpretations on all ER, STAT, and Inpatient Exams. 24/7 Neuroradiology Coverage and IR Call Coverage.
• 2-year Partnership Track.
• Full-Time Radiologist Average Time Off = 15 weeks
• Average after-hours obligations = 9 weekends per year and 22 evening/swing Shifts.
• Associate: $503,415–$566,342+ | Shareholder: $629,269+
• Compensation ranges above reflect base; additional earning potential available through extra shifts and increased productivity
• Full Benefit Package including health, vision, dental, disability, and life; 401k match, profit-sharing contribution, and cash balance plan.
• Flexible scheduling arrangements accommodated across all positions, with a rich case mix across multiple outpatient, clinic, and hospital settings
• Hybrid Work Options

Current Openings:

• Remote overnight ER
• Neuroradiology (Spokane, Seattle, Walla Walla, Tri-Cities, Missoula, or remote)
• Body Imaging (Spokane, Seattle, Walla Walla, Tri-Cities, Missoula, or remote)
• Washington
  • Tri-Cities ($75K signing bonus) — Breast, Neuro, MSK, Body
  • Spokane — Pediatrics, Breast, MSK
  • Moses Lake — General/Breast ($90K signing bonus, $20K relocation, annual retention bonus)
  • Colville — General/Breast
• Montana
  • Missoula – IR
• Oregon
  • Pendleton – General/Breast

Learn more at physicians.inlandimaging.com
Contact: Spencer Piper at spiper@inlandimaging.com

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If you’re a group looking to advertise, get in touch. The monthly post here is limited to just a handful of groups at a time, but last year, I launched Independent Radiology as a resource for the broader community, a dedicated private practice radiology job board featuring 160+ groups. If you’re in the market, please also check it out for your job-hunting needs.

Here’s a little compilation of posts from the last few years about getting started as a new radiology resident.

Transitioning

Scan by Scan is an essay about starting in radiology.

Doing

Approaching the Radiology R1 Year and its short companion post: How to be a First-Year Radiology Resident.

Want something a little more controversial? You Should be Correlating Clinically.

Learning

Book Recommendations for First-Year Radiology Residents (and some further recommendations for when there’s extra book fund to burn).

You can round that out with some more general thoughts on studying during residency. Then try my deeper dive: ultralearning radiology.

Iterating

Some important considerations for getting better every day.

More on deliberately improving what I call the “iterative loop of radiology.”

Getting and making the most of feedback. Also, a few more words about your self-worth as an early trainee.

Lastly, radiology call tips (which are also helpful every day).

Efficiency & Ergonomics

The umbrella post that contains the other posts about efficiency, ergonomics, workstation equipment, AutoHotkey, etc is here. People have described the series as (no joke) life-changing.

There’s a lot you can and should do other than just using whatever is plugged into your workstation, but this post for trainees is a start.

Speaking of work units, Dr. Avery J. Knapp Jr. dreams of a different multi-parametric AI work unit for radiology, arguing that wRVUs (and even time-based units) just don’t cut it:

There are at least 30 factors that affect how hard a study is to read. wRVU captures approximately one of them, poorly.

The RUC won’t fix this. It’s the RUC’s job to maintain the current system, not replace it.

PE won’t fix this. PE profits from the information asymmetry between what a study is worth and what a radiologist gets paid.

I wrote about e(ffort)RVUs last year as well. Whether you agree with his first draft of a proposal, it makes useful points for discussion.

He argues that private practices are the best suited to develop an ideal system:

So who builds it?

Radiologists. Independent groups. People who actually sit in front of a PACS and know that an 80-year-old’s postop MRI and a 30-year-old’s screening study are not the same job.

Just turning the dials in a raw time-based fashion for a CPT code creates winners and losers in an ultimately unsatisfying way. Improvement on RVUs or not, it certainly doesn’t capture the whole picture. Those who were/are frustrated to see their favorite exams changed in a system like TBWU might be happier if the hard exams paid better and were counted fairly, and the easy exams were too, and they practiced in a system where those reading complicated cases weren’t punished for doing yeoman’s work.

We all know that there are hard and easy versions of everything (not to mention people can typically still cherry-pick with the tried and true method of previewing a case and then skipping it if it looks bad). So, no, it doesn’t always balance out in an average. And even if the time to interpret a scan across 52 million exams was a neat bell curve, it doesn’t mean every radiologist’s workload will be right in the middle. RP for example says they removed “outliers” from the calculation, which is arguably important to not inadvertently capture the impact of dietary fiber when a case is paused mid-read, but not all outliers are spurious either. None of this is actually easy. The need to add “incremental seconds” in their system tells us that open/sign times in voice recognition software don’t tell a complete story.

If a new system feels unfair to people—not just because of sour grapes, but because it truly doesn’t reflect the effort it takes to read exams—then it would follow that a simple time-based work unit is insufficient to capture effort and that an ideal system would likely be more complicated. Now, RP certainly doesn’t need to attempt an ideal system, and we could surmise that an AI-derived work unit would be even more of a black box, potentially more contentious, and certainly more expensive to create, and that may all be true. But, it might also work.

As a follow-up to the two posts about Radiology Partners’ new time-based work units, the first quarterly TBWU adjustment is taking place quickly: July 1. This will incorporate changes related to any efficiency gains for groups on the Mosaic platform. From the May 15 FAQ:

Based on the TBWU guiding principles, our objective is to improve overall physician compensation per shift, per hour, per year. In order to do that, the efficiency gains from any RP tools (such as Mosaic Drafting or Capture) will be shared with radiologists. In the first TBWU review, 80% of the value from efficiency gains will go directly to our radiologists. After that and through the end of 2027, no less than 50% of the value of the efficiency gains will go to our radiologists.

It’s easy to roll your eyes at that corporate phrasing, but we should be fair about what RP is talking about when it comes to splitting efficiency gains. As previously stated, their intention has always been to reduce TBWUs to “partially” capture efficiency improvements, and their guiding principle is to capture an increasing percentage from the delta itself and not from the total work unit. The work unit of course will decrease, but not by a ton, at least not at first. RP estimates that 20% of the improvement will be 2-7% of the work unit. Yes, this means that they bumped plain films for just a fraction of a year before using Mosaic to start siphoning them back down.

Total aggregate work credit (± compensation itself) would only decrease if productivity didn’t increase to account for the saved time. So, you need to kick faster to tread water, but you arguably won’t care because the kicking will be easier.

To reiterate: Since these are time-based work units, what they’re doing is that when the time-to-read goes down thanks to Mosaic, they won’t move it all the way down the full amount; they’ll leave some of the efficiency gain to rads. For this first iteration of the time difference, it’s 20% to RP and 80% to radiologists. At this early time point, one would venture that the time savings are not going to be huge, so the relative generosity of the split is probably mostly in name. Until the end of 2027, they said they won’t take any more than 50% of the improvement. Reimbursement/credit is going down per case in these adjustments; it’s just that they claim they’re going down less than the time savings, and therefore total work units produced by a human won’t be decreased in aggregate over the course of longitudinal work: you’ll just read more cases because it will be so easy, or something along those lines.

How the proposed improved “overall physician compensation per shift, per hour, per year” will survive over the long term if the market softens and payers catch on remains to be seen. Also, we can acknowledge that the time saved for individual radiologists may be very different than the average time saved. Even if an individual rad doesn’t experience efficiency gains, they still pay the efficiency cost.

As the use of similar tools grows across the field, a relative pay differential could also widen relative to other practices that are able to capture similar productivity gains from other products while reaping the majority of the benefits. That would, of course, depend on how expensive those products are for those practices relative to the efficiency gains and who controls the compensation. Who’s to say how it will shake out? Not me. The laws of supply and demand will keep operating, second-order effects are inevitable, and there are a lot of moving parts. The technology may increase efficiency, but what we do with that depends on the contracts. Employers are incentivized to capture those gains and raise the production floor. Private practices are incentivized to maximize revenues for themselves.

Procedural Time

The FAQ contains an amusing doublespeak regarding IR vs “Non-workstation time”:

IR procedures: Given the unavailability of time studies for IR procedures, TBWUs for IR exams equal the RVU value.

Non-workstation time: Diagnostic mammography and CT coronary angiography (exams with a non-workstation component) include additional time beyond image interpretation. Based on data-driven time studies, incremental seconds were added to these exams to more accurately reflect total time spent, resulting in updated TBWU values.

I am not an IR, but I would venture it is indeed possible to know how long various average IR cases take. It may even be easier than adding “data-driven” “incremental seconds” to fluff numbers. As for non-workstation time…what about fluoroscopy? Something tells me those incremental seconds are largely uncaptured. The difference is that coronary CTA and diagnostic mammo are lucrative, growing service lines that need to be supported.

Perhaps the more salient problem with including IR is that truing up TBWUs to account for the time of procedures would take too many RVUs out of the pool and drive DR values down too much in a zero-sum calculation.

An Incomplete Accounting

The reality is, no one has this data but RP. No one is going to be performing an audit, and no one can ensure honesty or integrity when it comes to anything here (or really at any other practice). This is a privately held company, and we shouldn’t pretend like they have any need to, because if the 12-radiologist TBWU Physician Advisory Committee making “recommendations” to the CMO is enough accountability for the RP rank and file, then it’s enough.

But let’s assume that time-based work units are exactly that: work based on time, fairly calculated and revised on a continual basis. They have argued that TBWUs are better and fairer than RVUs, and that may even be true.

At the same time, TBWUs, like RVUs, are still an incomplete accounting of work.

Averages are averages, and not every case is average. Giving you an average work unit for every case does not necessarily equate to fairness over time. The attempt to adjust based on patient context is insufficient when you consider the broad swath of radiology. The positivity rate, the complexity of an exam, the timing of the exam, the relevance of priors, call findings to clinicians, etc—all these things might impact a true weighting system.

For a company that is touting its AI-native platform, one might ask why just adjust for time when there is so much more? Why not go all the way and do a true effort RVU? Because it’s a hassle they don’t need to attempt.

As I suggested previously, the primary motivation for simple time-based accounting is that time changes can be measured before and after, and those magical promised AI-driven productivity gains can be garnished in increasing amounts over time. How would a multimodal AI-derived work unit account for help from AI? This recursive question is, I would venture, much harder to measure than “time went down.” TBWUs may be better than RVUs, but fairness is not the goal per se. Rather than being an ideal way of internally fixing a broken system, they are the ideal way of “sharing efficiency gains” (repricing the work) and driving the behaviors needed to address the most egregious list behaviors/cherry-picking/backlogs.

For radiologists, the only way to “win” is to use those seconds of “average improvement” to read more cases to make up for the decreases in TBWUs. They frame it as “sharing the upside/gains,” and that’s technically true.

Ultimately, those with the power, leverage, and control have a stronger say in who gets to reap the economic benefits of these new technologies. This is what I expect RP to do. It’s also what I expect basically every hospital, corporate, and academic practice to do eventually.

I can see why some would view this repricing as the beginning of a depressing hamster wheel on turbo mode.