A Doximity “2024 recap” email reminded me that it was exactly one year ago today that I first wrote about job boards in radiology because of those misleading listings from RP. That’s what first got me thinking about doing something different with Independent Radiology (and the monthly jobs post). I’m glad it’s working so far with our field’s current market and tumultuousness.
This past year was the fifteenth of this site and this is my eleventh reading list. This year, among other things, I also took over as the neuroradiology division chief for our large private practice (in addition to serving as associate program director for our radiology residency) and then started a new hand-crafted high-touch job board exclusively featuring true radiology private practices called Independent Radiology. It’s been busy.
- Steal Like an Artist by Austin Kleon
- Show Your Work by Austin Kleon (referenced in this April post)
- Keep Going by Austin Kleon
- Tehanu by Ursula K. Le Guin (I remember being somewhat disappointed by this book when I read it as a boy. Returning to it as a grown man with children, it feels like a completely different book. Le Guin is one of my favorite writers of all time.)
- The Drawing of the Three by Stephen King (This book and its personalities had a hard time carrying its length, I remember why I dropped the series in high school.)
- Tools of Titans by Tim Ferris (skimmed large sections due to format and the fact that I’m not going to do meaningful dietary content restriction, convoluted workouts, or psychedelics. I have a full-time job and a family I want to eat with.)
- The Boy, the Mole, the Fox, and the Horse by Charlie Mackesy (I read this to my son when it was new and selling oodles of copies, I opened it up again because my daughter is almost to that age again.)
- Make Something Wonderful: Steve Jobs in his own words (a free and sometimes even a little raw collection of Steve Jobs’ emails, quotes, and speeches)
- Bird by Bird by Ann Lamott (this may be the most delightful book about writing I’ve come across)
- The Dark Forest by Cixin Liu (The Three-Body Problem #2)
- The Other Wind by Ursula K. Le Guin (I remember when this came out when I was in high school, and I remember being happy the series ultimately hadn’t ended with Tehanu. But I’d literally forgotten everything about this story [it’s great].)
- Anything You Want by Derek Sivers (very short. Perhaps it’s hard to justify the cover price and sell books when they seem too short, but more nonfiction should be this short and to the point).
- The Eyes and the Impossible by Dave Eggers (this book is middle grade–and I bought it for my son–but I read it first, and I’ll freely admit to being surprised by how it came together).
- Death’s End by Cixin Liu (lots of info dumping and not always the most elegant prose given the translation but incredibly unique and inventive universe-scale science fiction)
- Tales of Earthsea by Ursula K. Le Guin
- The Culture Code by Daniel Coyle
- Ancillary Sword by Ann Leckie (Imperial Radch Book 2–good!)
- Slow Productivity by Cal Newport (1: Do fewer things, 2: Work at a natural pace, and 3: Obsess over quality.)
- The Power Law by Sebastian Mallaby
- A City on Mars by Kelly and Zach Weinersmith (TLDR: All the popular ideas of settling space probably won’t work for a variety of reasons)
- Ancillary Mercy by Ann Leckie (Imperial Radch Book 3)
- Artificial Condition by Martha Wells (Murberbot #2, really great series, concise and enjoyable with strong efficient plotting)
- Rogue Protocol by Martha Wells (Murberbot #3)
- Exit Strategy by Martha Wells (Murberbot #4)
- Network Effect by Martha Wells (Murberbot #5)
- Fugitive Telemetry by Martha Wells (Murberbot #6)
- System Collapse by Martha Wells (Murberbot #7)
- The Coward by Stephen Aryan
- The Warrior by Stephen Aryan
- Loaded by Sarah Newcomb (meh)
- Hyperion by Dan Simmons (this is one of those classic sci-fi Hugo winners from the 1980s. It was pretty out there.)
- Mr. Penumbra’s 24-Hour Bookstore by Robin Sloan
- Yumi and the Nightmare Painter by Brandon Sanderson
- The Algebra of Wealth by Scott Galloway
- Translation State by Ann Leckie (I normally don’t care very much for spin-off stories set off the main story arc, especially prequels. This takes place after the Radch trilogy, covers new ground, and has some fun cameos. I enjoyed it, and the series in general continues to be an illustration–in a good way–of the fact that Science Fiction says more about the period in which it is written than about the future it envisions).
- Spelunky (Boss Fight Books) by Derek Yu (written by the creator of a popular/niche roguelike indy videogame; it’s always neat to open the hood and see how something is made, how someone approaches a novel set of problems.)
- Emperor’s End by Kyle Kirrin (Ripple System #5)
- The Anxious Generation by Jonathan Haidt (I think this is a very important book)
- Children of Memory by Adrian Tchaikovsky (Children of Time #3)
- The Sunlit Man by Brandon Sanderson (I would say overall the most enjoyable of the Year of Sanderson)
- The Knowledge: How to Rebuild Civilization in the Aftermath of a Cataclysm by Lewis Dartnell (answer: it would honestly be very hard.)
- The Happiness Hypothesis by Jonathan Haidt
- The Employees by Olga Ravn (Disorienting epistolary sci-fi. I saw this on a list of 100 best sci-fi books of all time. I definitely wouldn’t go that far, but I’ve always had a soft spot for the form. I wrote a very small portion of an abandoned epistolary novel myself when I was a medical student.)
- The 4 hour Body by Tim Ferriss
- The Infernal Machine by Steven Johnson (Interesting narrative history tying together several bits of history I knew very little about: anarchism, the role of dynamite in the creation of modern terrorism, and the rise of the modern detective).
- He Who Fights with Monsters 11 by Travis Deverell
- The Great CEO Within: The Tactical Guide to Company Building by Matt Mochary
- The Coddling of the American Mind: How Good Intentions and Bad Ideas Are Setting Up a Generation for Failure by Greg Lukianoff and Jonathan Haidt
- Outlive by Peter Attia
- The Signal and the Noise by Nate Silver
- Chrono Trigger (Boss Fight Books) by Michael P. Williams (One of my favorite games of all time, but this didn’t hit anywhere the same notes as Spelunky in terms of diving into the mechanics of the game from the perspective of its designers.)
- The Fragile Threads of Power by VE Schwab (a new series continuing the world of the Shades of Magic)
- A Man for All Markets by Edward O. Thorpe (fascinating memoir, my brief summary and some choice quotes here)
- How to Decide by Annie Duke
- Dungeon Crawler Carl by Matt Dinniman (I’ve read a lot LitRPG, but this series somehow brought the subgenre into the mainstream [relatively speaking]. It looked like–and is–a absolutely ludicrous entry, so I’d been ignoring Amazon’s recommendations about it for a while. But it came up in conversation with a normal human so it seemed like it was time. Seth MacFarlane is even going to make it into a TV show).
- Carl’s Doomsday Scenario by Matt Dinniman (Dungeon Crawler Carl #2)
- The Dungeon Anarchist’s Cookbook by Matt Dinniman (Dungeon Crawler Carl #3)
- The Gate of the Feral Gods by Matt Dinniman (Dungeon Crawler Carl #4)
- The Butcher’s Masquerade by Matt Dinniman (Dungeon Crawler Carl #5)
- The Eye of the Bedlam Bride by Matt Dinniman (Dungeon Crawler Carl #6) (I thought when I started the series that it was complete at 6 books, but book 7 is coming out next year, argh)
- The Black Swan by Nassim Nicholas Taleb (his books are well established in the thought-leader zeitgeist and yet often misconstrued for personal gain. He may be a bit of a boor in his internet and intellectual fights, but I think his arguments themselves hold water.)
- Insight by Tasha Eurich (I bought this book in 2019 apparently. Ultimately, I’m not sure what got me to pick it up at the end of the year, but it’s a great example of the glorified single article premise padded into a book through the overuse of tedious stories format of business publishing)
Here are the prior years:
From “The U.S. Radiologist Workforce: AJR Expert Panel Narrative Review,” just published in AJR:
Between 2014 and 2023, the number of radiology practices decreased by over 17%, while the number of practices with 25-49, 50-99, and 100 or more radiologists grew by 33%, 126%, and 349%, respectively.
Consolidation in action. An arduous regulatory climate, challenging payor relationships, tumor-like health network/hospital/system growth, and the increasing volume and intensity of after-hours work all favor a smaller number of larger groups. Scale to combat scale.
Imaging provider Akumin’s new post-bankruptcy CEO, in an interview with Radiology Business, describes their new owner, Stonepeak, which took control of the company after swapping ~$470 million in debt for equity and dropping an extra $130 million as part of a Chapter 11 bankruptcy:
Stonepeak has a longer-term investment horizon compared to traditional private equity, which typically holds assets for three to five years. For Stonepeak, eight to 12 years has been their typical investment horizon. Our relationship has gone really well with them because, once they own an asset in this space, they stay with it for a long time.
In this industry, a decade is considered a “long time.” I guess that’s true: It took me a decade after college to become a radiologist.
It is because doctors are understood to place patients’ interests above commercial ones that they have long enjoyed professional autonomy and public trust. The history of medicine is too littered with incompetence and immorality to believe that doctors have always been worthy of this status. Still, something profound is lost when we submit to the jaundiced view that medicine is a business like any other. There is value in striving for something higher.
From Dhruv Khullar’s “The Gilded Age of Medicine Is Here” in the New Yorker.
Regarding the future of writing (and thinking) in an AI-enabled world, from “Writes and Write-Nots” by Paul Graham:
The result will be a world divided into writes and write-nots. There will still be some people who can write. Some of us like it. But the middle ground between those who are good at writing and those who can’t write at all will disappear. Instead of good writers, ok writers, and people who can’t write, there will just be good writers and people who can’t write.
A very short essay, well worth the 2 minute read.
With improving AI tools, the progressive ease of information acquisition and low-effort good-enough “work” generation may be good for lots of things, but for actually internalizing the skills of deliberation, argumentation, and communication? Probably not so much.
From “People systematically overlook subtractive changes,” published in Nature back in 2021:
Participants were less likely to identify advantageous subtractive changes when the task did not (versus did) cue them to consider subtraction, when they had only one opportunity (versus several) to recognize the shortcomings of an additive search strategy or when they were under a higher (versus lower) cognitive load. Defaulting to searches for additive changes may be one reason that people struggle to mitigate overburdened schedules, institutional red tape, and damaging effects on the planet.
In so many cases, the easiest, cheapest solution to a problem is to simplify. It’s just so hard to remember/realize/acknowledge that–especially at an organizational or regulatory level–without skin in the game.
I started Independent Radiology–a job board exclusively dedicated to featuring physician-owned private practices–on August 14. This past weekend we hit a major milestone I wouldn’t have predicted: 100 groups advertising their openings. The level of group and user engagement has been great to see.
If you’re a trainee going to RSNA this year, I’ll be giving a talk about careers in radiology during Session M3-RCP20: Navigating the Job Market at 9:30am on Monday. Come say hi!
My internet friends over at Medality are having a big Black Friday sale a holiday gift sale Dec 17-22 for a free self-paced Fellowship with any Premium Membership or Fellowship. Solid use of CME funds before the end of the year, and an easy way to support this site.