Collins Career Corner

A Peek into the Private Practice Work Environment—You Might Be Surprised

October 28, 2019

What it’s like to work in a radiology private practice environment? 

Experience may be the greatest teacher, but gaining a better sense of the lay-of-the-land is a good idea, too.  Of course, there are many variables that depend on where you actually work, but the private practice environment in general has some differentiating characteristics. 

The following are some common, yet perhaps unexpected elements you may encounter working in a private practice environment: 

Efficiency 

A private practice environment is stereotypically more efficient, especially compared with an academic environment. For example, in private practice a patient may be consented, on the table, scanned, and marked before the radiologist walks into the room to do a CT-guided biopsy.  In academics, there may be lag times before a nurse or other transport personnel can get the patient to the radiology department. In such cases, a resident, fellow or attending radiologist may go retrieve the patient. 

Takeaway: Expect a better-oiled machine    

Clients 

In private practice, your clients are the referring physicians and the ordering providers, and an important part of the radiologist’s job is to make the providers happy.  Those providers may also include mid-level providers like nurse practitioners and physician assistants. Referrers typically choose the radiologists, whereas in academics the referrers don’t choose the radiologists as much as they are just in the system. Of course, it’s still important for all radiologists in any type of practice to provide excellent service, but there is a more direct relationship between the referrer and radiologist in private practice.  

Takeaway: You must play well with others 

Generalist vs. subspecialist

Subspecialty trained radiologists will often be required to perform as generalists a substantial amount of the time. Larger groups may enable new hires to focus more on their area of expertise, both during normal working hours and when on call. 

Takeaway: Prepare to wear your generalist hat 

Investment in technology and equipment

Private practice groups may own their own imaging equipment. It’s also common for an independent group to provide the professional component of radiology practice for a hospital that provides the imaging equipment.  

Most radiology groups have minimal investment in machinery and equipment to operate their business. Unlike academic radiology where hospitals help departments stay on the cutting edge of technology, private practices who own their own imaging equipment must fund these purchases on their own.  This differentiating feature influences the cost of buy-in if a group offers partnership.  

While private practice radiology groups may not tend to invest heavily in equipment, they do, typically, have a substantial investment in their information technology services including a Radiology Information System (RIS) and Electronic Health Records (EHR) to provide efficiency across their practice.  

Takeaway: Light on cutting-edge imaging equipment, but invested in advanced IT services 

Administrative matters

You may find yourself taking on administrative tasks and performing more of a managerial role than you expected. Being in private practice has traditionally required the radiologist to think like a business owner (e.g., understanding expenses, salaries, reimbursement, hiring, firing, billing, etc.) but this is not something that is emphasized in the majority of training programs.  

Takeaway: Think like a business person 

Work schedule

The work schedule of private practice positions varies regarding the number of work days in a week, weekends on call, post-call time off,  administrative time off, number of facilities to cover, and the ability to work from home during the day or at night. Random days off may be allotted when the number of available group radiologists exceeds the number of work assignments.

Takeaway: Work schedule may have potential for greater flexibility and autonomy 

Salary

Salaries are often higher in private practice, of course, but there are other financial variables to consider. These may include a bonus if offered, parity of salary/bonus (i.e., do all partners make the same salary and bonus), years to partner if track is offered, whether partnership if full or partial, and buy-in arrangements if offered. 

Takeaway: Assess the financial and career advancement options offered