Here is the updated first entry in a series of posts about radiology tools, ergonomics, and efficiency. This includes the go-to stuff I use every day to practice diagnostic radiology, (briefly) how I use them, and a few alternatives. This series is the result of a lot of research, trial and error, and input from others in the radiology community.

Unnecessary caveat: There is no real best anything. Here’s what I have idiosyncratically landed on as a stable happy set-up that balances efficiency and comfort (and an editorial selection of those favored by others).

We get into more workflow details and justifications in the other posts, but we can summarize my personal approach as a hands-free microphone solution, a vertical mouse with some—but not a comical number of programmable buttons—and a left-hand device that adds additional hotkey efficiency as well as—critically!—a way to scroll with my nondominant hand in order to spread the love across multiple joints.

The original version of this post was published in May 2023.
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CEO of Anthropic, Dario Amodei, fighting hard on a podcast (clip here) to set a new record on how quickly you can be wrong about how radiology works and how it’s been affected by AI so far:

There’s this story of, like—I think it was Geoff Hinton—predicting that AI will replace radiologists. And indeed, AI has gotten better than radiologists at, you know, doing scans, right?

But what happens today is there aren’t less radiologists. What the radiologist does is they walk the patient through the scan, and they kind of talk to the patient. So, the most highly technical part of the job has gone away, but somehow there’s still some demand for like the kind of underlying human skill.

The “Indeed” is completely baseless and without a reality correlate. It was indeed Geoffrey Hinton who said the world should stop training radiologists in 2016. In feeling compelled to address this current wrongness, I am reminded of this perfect comic by XKCD.

What I find genuinely surprising here is not the marketing hype or the finessing of reality but the bold, straight-faced use of the past tense for something that simply has not happened. The future is uncertain, but the desire to continue raising money doesn’t change the past.

NVIDIA’s Jensen Huang made similarly wrong comments last November and also received no pushback. I appreciate the motivations for this kind of more-than-hyperbolic talk given the massive investment in AI, but is there an example anywhere on any of these podcast tours or speeches where someone has actually pushed back on a laughable, supposedly factual claim and had a real discussion?

The real world of AI is interesting enough as it is without needing to pretend that radiology has proven Jevons Paradox. Like, stuff is happening. It’s cool! I get it. Every day, someone reports something interesting, like a mathematician sharing last week how Claude solved a complicated math problem he was working on. Even if Dario is directionally right about the future, he’s wrong about where we are and where we’ve been.

(I buried the links in those paragraphs, but I wrote not one but two posts responding to Huang’s comments that I think are worth reading.)

It’s always dangerous to assume malevolence over incompetence/ignorance. That said, Dario Amodei is worth $7 billion on paper, with Anthropic raising money on a valuation of something like $380 billion. Maybe I’m too cynical, but I’m starting to think he, Jensen Huang, and others know it’s not true but feel it’s the storytelling they need. This radiology “example” has become such a common talking point that I’m beginning to doubt that all the AI guys don’t know better. I’m not even entirely sure which explanation (untruth vs ignorance) I prefer.

A common response that waves away these sorts of issues is to say that the prediction is/was right, but the timing is/was wrong. This is the excuse Geoffrey Hinton has been giving ever since that infamous 2016 claim.

But when it comes to anything important, there’s a word that summarizes what it means when you are kinda “right” about something broadly but incorrect in all of the details and timing. That word is wrong.

If I predict a stock market crash within the next year and it doesn’t happen, I’m wrong. If it happens four years later, I was still wrong when I said it. And that wrongness can be very unhelpful.

I wouldn’t necessarily argue that Amodei’s predictions about what will happen to work when we achieve a country full of “geniuses in a data center” are wrong. But nothing about those predictions makes a false statement true. It doesn’t change the past, and it does call into question the seriousness of the thought process and the commitment to honest discourse. It also forces you to cynically place those predictions into a market and fundraising context. Because only that helps explain why smart, talented folks who should know better somehow seemingly don’t.

To address Amodei’s vision of what he already thinks radiology is today:

Could we see a world where radiologists do more patient counseling? Sure—though honestly, I doubt that would happen at scale.

Could we see a world where some radiologists really focus more on patient-care aspects? (I’ll generously assume “walking them through the scan” was figurative and not misattributing what a technologist does.) Perhaps a vision of breast imaging after screening profitability is curtailed? Also sure.

Could we see a move, at least for an intermediate-term, to a world where procedural work becomes a greater part of the job for a greater fraction of people? Sure—although people wouldn’t be happy, and maybe, as Dario Amodei and others have also suggested, we’ll just have robots doing everything for everybody all the time.

I won’t pretend that those visions of the future are impossible, or that those possibilityscapes are wrong. But I can point out that the credibility of the visioner goes down when they are piggybacked on statements that are not reality-based.

People with vested interests in AI company valuations going to the moon telling you that AI is going to the moon are not an unbiased source of information. The nature of being the CEO of an extremely valuable company is that everything you say is the spear tip of a one-man marketing machine.

What’s less said amidst all the excitement, of course, is the quiet frustration of daily failure—like how my beloved magical automatic impression generator still sometimes hallucinates conclusions from a source text that is only a few hundred words. The future tense, the present tense, and the past tense are distinct for a reason.

Yes, of course, the jagged frontier is way more powerful than what is commercially available, and the best of what’s technically achievable has almost no market penetration. I agree that cool things are cool. What’s commercially available, however, is where the real world basically lives.

So, if anyone reading this plans to interview Mr. Amodei, Mr. Huang, or anyone else pontificating about AI:

In 2026, for most radiologists, the “most highly technical part of the job” hasn’t meaningfully changed.

Take-home point: I think wireless lapel/lavalier mics are an outstanding solution for radiology.

Context

Longtime readers—or those who have perused my previous posts on radiology equipment—may recall that my solution for hands-free dictation over the past several years was a shotgun microphone at home (like this or this mounted to my monitor and pointed at my face) and then a cheap desk clamp to hold the PowerMic when at the hospital or outpatient centers (seamlessly enabled by AutoHotkey).

These are still great solutions. My old home desk setup was awesome, and I still mostly use the desk clamp solution on-site instead of dealing with the hassle of unplugging a PowerMic to plug my own microphone in (and then undoing that at the end of the day), given that I work at different locations every day. If I were always in the same place, I would definitely switch things up and bring my own.

I recently wrote an article about foldable treadmills, because I redid my office and now have a standing desk for the first time. As a result of this new setup, I am increasingly speaking at varying distances from my computer, which leads to decreases in accuracy when using a fixed microphone solution.

A lav mic clipped to my collar that is always equidistant from my mouth is a much more flexible dictation solution to accommodate that variable distance while standing, sitting, walking, sitting further away with my keyboard tray extended, versus sitting closer using the top of my desk. I use all these different ways of working, and a lapel mic lets me do all that seamlessly. Many reasonably priced models also include optional noise cancellation, which may help with things like treadmill noise, HVAC, fans, space heaters, and the fact that maybe your laundry room is just a few feet away (I need to test this across models more to be sure).

Over the years, I’ve tried a variety of microphone form factors and price points, including crappy wired USB headsets, wireless bone-conduction headsets, and a whole bunch of dynamic, condenser, shotgun, and lav varieties.

Years ago, when I first began the journey of changing the mechanics of how I practice radiology, basically every wireless solution was terrible. The lag/latency was intolerable, and the accuracy hit was often substantial.

That has changed. Over the past few years, technology has improved so much that small wireless lapel mics are now cheap enough and good enough to function just fine for our purposes. There are literally dozens of options.

I will say that I do think there is still a small latency and accuracy hit with these over a wired solution (and accuracy on the treadmill is unsurprisingly a bit worse than rigid working), but they’re manageable overall and I believe worth it for the convenience.

The Devices

Basically, everything you’ll find comes with a receiver that can plug into the USB-C port of your computer and two transmitters, which are the actual microphones that you can clip to your shirt.

I’ve been happily using the Hollyland Lark M2S for months, which I purchased for about $150 a year ago. Thanks to competition, prices have come down.

Now, for around $80-100, you can buy either the Hollyland Lark M2S or the SMALLRIG Wireless Mic S70, both of which work just fine for radiology and are nearly identical. Both use a well-made springy titanium clip hook system that easily clips to your collar and weighs almost nothing. Both include a USB-C receiver dongle for phones that also works in a computer (but if you use the slightly larger receiver via USB, there are a few more controls available to you, like setting the gain levels). The build quality of these is excellent. The SmallRig just came out. Its battery life is reported at 1 hour shorter, but the charging case has a bigger battery itself and contains more total hours of audio time. The SmallRig phone app has some additional audio settings in the app, including a limiter to prevent clipping and slightly better (less-distorting) noise cancelling. It seems like whatever settings you use in the app stay active when using the device elsewhere.

In a similar price range, you can also try the DJI Mic Mini or RØDE Wireless Micro. DJI Mic Mini may actually have the best sound quality, and it has the longest stated battery range, but I don’t like the clip/transmitter design itself; it’s a small square with a tiny clip, sorta hard to clip on, and it’s heavy enough to pull annoyingly at the edge of lightweight clothing. It feels better clipped to something thicker like a fleece. It’s also a totally usable solution and works well overall, but I really prefer the form factor of the M2S and S70.

For budget options, both the Hollyland Lark A1 and the BOYA Mini 2 are $40 or less. These only come with a USB-C phone receiver, so you may need to adjust the settings in the app on your phone in order for them to work as needed on your computer. With default gain settings, it seems like most of these are too quiet for Powerscribe and will fail audio setup. The Lark A1 uses a magnetic back to attach to your shirt instead of a clip, which some people may prefer (similar to the pricier and beloved Lark M2, which currently retails for just $76). The BOYA’s clip is weak and plasticky. I think the upgrades are worth it for build quality and battery life.

There are a variety of more expensive”pro” options costing $200+ (like the Hollyland Lark Max 2, Rode Wireless Pro, etc) that for our dictation purposes are unnecessary. Most include features like 32-bit float, on-device recording, and others that could be helpful if you’re a content creator but are certainly not needed for transcription. Some like those from RØDE are larger and very uncomfortable clipped to most clothingl they are often used clipped to your waistband with a separate lightweight lav mic plugged into that, which would just be an annoying headache for our amateur needs.

Pairing

All of these are designed well so that they pair automatically with the receiver when in use. Since these transmit to their respective receiver over 2.4GHz, there are no Bluetooth menus to configure on each computer or any other nonsense. They are functionally plug-and-play. While 2.4 GHz is a busy spectrum, I haven’t had any transmission issues.

Battery Life

All current varieties come in charging cases like the phenomenal AirPods Pro that I use every day of my life (seriously, what a great product). Dropping the transmitters back into the case will automatically begin charging them to full.

In general, the battery life of these devices is such that you can get through at least close to a whole shift if not a whole shift on a single charge for a single transmitter. If you charge it during a lunch break, definitely. But they all come with two, and having two is important so that you can swap between them if the battery dies so you’re not left unable to dictate.

Swapping between transmitters is so fast that I don’t think it’s a huge deal since two fully charged transmitters will get through basically anything. The stated battery life for the M2S is 9 hours, the SmallRig S70 is 8 hours, and DJI Mic Mini is 11 hours. The budget Boya is at 6 hours, and I don’t think I got even that long.

The batteries inside are tiny and not user-replaceable. Battery life will inevitably get worse and worse over time the more they are used. If you use them every day, I don’t know how many years the batteries will last, but given that the average shift is somewhere between 8 and 12 hours, it’ll take significant degradation before they can’t handle that.

At home, what I’ve done is just keep the charging case plugged into USB at all times and drop the transmitters back into the case whenever I’m done, so they’re always fully charged for a day of work. And yes, I’m using one set for home and another for work (I also have two Contour Shuttles, it’s so much more convenient to have different home/travel setups!)

In short, I do think there is plenty of room for worsening battery performance before two transmitters are insufficient to cover a full workday even while traveling. If you keep the charging case plugged in and swap the transmitters as needed and try to use them both evenly, I think the durability will be impressive.

Final Take Home

Wireless lav mics have come a long way and are a super convenient dictation solution for hands-free radiology. Of the dozens of varieties, I think the Hollyland Lark M2S or the SMALLRIG Wireless Mic S70 are in the sweet spot, and both cost less than a hundred bucks (of the two, my gut still prefers the Lark M2S).

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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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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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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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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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.

Partnership track – Central Arkansas (Little Rock, Conway, Searcy, and Pine Bluff) and Northwest Arkansas:

• 1 year to partnership
• 10 weeks vacation + 1/2 day off per week on average for partners
• Highly competitive compensation combined with low cost of living
• Internal moonlighting options to boost income
• Robust CME allowance, signing and moving bonuses, full benefits
• Many work-from-home shift options
• Minimal after-hours requirements – overnight shifts are fully staffed with telerads

100% Remote Nighthawk, partnership track:

• 7 on/14 off, 10 pm-7:45 am CST
• 1 year to partnership
• Competitive compensation, robust CME allowance, signing bonus, full benefits

Daytime Teleradiology:

• 100% remote.
• Subspecialty work available with up to 50/50 split with general radiology
• Option for employed or partner track. Partner track includes call weekend shifts, approximately 1 in 5 weekends.

Employee track:

• General radiology, mammography, and other options available
• Fully remote, hybrid, or on-site options available
• Flexible scheduling including daytime teleradiology, 7 on/14 off. General radiology, but any subspecialty is a plus.
• Competitive salaries
• Robust CME allowance, signing and moving bonuses, full benefits

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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Mecklenburg Radiology Associates

(Charlotte, North Carolina)

Established in 1917 and fiercely independent, MRA is a well-respected subspecialized practice of 60 radiologists and growing. They especially take pride in their group culture (seriously, there are some really nice people in that group including one of my old senior residents).

Partnership track:

• 3-year partnership track with 8 weeks of vacation per year
  $400K starting salary and an additional $75K sign-on bonus ($125K with 2+ years of experience)
• On-site daytime hospital and imaging center coverage. Hybrid evening and weekend call coverage, including the option to read from home.
• Available positions: Breast, Body, Cardiovascular, Neuro, Light IR, MSK, Nuclear Medicine, and General

Employee track:

• Fully remote, hybrid, or on-site options
• Competitive salary
• Available positions: MSK, General, Overnight ER, Swing Shift ER, Neuro, Body, and Cardiovascular

Learn more at www.meckrad.com/recruitment.
Contact:Tara Nalley at tnalley@meckrad.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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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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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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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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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 with the ability to decrease or increase total time off.
• Average after-hours obligations = 9 weekends per year and 22 evening/swing Shifts.
• Salary Range – $499,454-$624,318
• Full Benefit Package including health, life, vision, dental, disability, and life.
• 401k match, profit-sharing contribution, and cash balance plan.
• Hybrid Work Options

Current Openings:

• Remote overnight ER
• Neuroradiology (choice of Spokane, Seattle, Walla Walla, Tri-Cities, or Missoula)
• Washington
  • Tri-Cities (with $75k signing bonus)
    • Breast
    • Neuro
    • MSK
  • Spokane – Pediatrics
  • Moses Lake – General/Breast (with $90k signing bonus, $20k relocation benefit, and annual retention bonus)
  • Colville – General/Breast
• Montana
  • Missoula – IR
• Oregon
  • Pendleton – General/Breast

More information about these positions can be found on our Independent Radiology listing.

Learn more at https://inlandimaging.com/careers
Contact: Sarah Russell, CEO at srussell@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 150+ groups. If you’re in the market, please also check it out for your job-hunting needs.

The radiology job of “reading scans” is actually two different jobs in rapid alternation: pattern recognition (pixels, asymmetry, gestalt) and translation (turning that visual certainty—or uncertainty—into clean prose with a defensible impression).

The vast majority of my work is diagnostic these days, but there have been times in my life when I wore lead, did a lot of procedures, and planned for a career as such. Interventions were much more physically demanding and certainly had moments of emotional intensity that I haven’t felt in years at this point in my career. But I always found diagnostic radiology more mentally exhausting, especially earlier in my career, when a greater fraction of cases required a greater amount of Type 1 thinking.

A lot of that end-of-day exhaustion isn’t from volume alone; it’s from the accumulated switching cost (attention residue) of bouncing between visual cognition and written language, case after case. If you want real efficiency (and fewer mistakes), you don’t just read faster—you reduce forced context switches so your brain can stay in one mode longer.

We all need to work on our own personal version of the iterative loop and efficiency/ergonomics.

This is one of the missing joys of working without a better process—whether that’s macros, pick lists, templates, or even better physical integration with your computer. A streamlined, efficient process minimizes interruptions, and that seamlessness allows you to move through the cases instead of fighting to get each one done.