Interviews for Articles about Medical Careers
7 Reasons Rads Burn Out—And How to Cope
Diagnostic Imaging, January 15, 2019
Let’s face it — the dream job doesn’t really exist. Even if you love your position and your institution, there are going to be times when you’re frustrated and tired or when you feel ineffectual. In essence, at some point, you’re going to feel burned out.
But, when that feeling becomes the norm, that’s when the real problems occur. And, according to the 2016 Medscape Physician Life Report, burnout is the reality for 50 percent of radiologists. As a result, job satisfaction falls, patient care suffers, and workflow management becomes inefficient.
Related article: Stop Burnout in Radiology Before It Starts
Consequently, many industry leaders say it’s vital to identify why burnout occurs and pinpoint some methods, both individually and institutionally, to counteract the effects or side-step it altogether. Ignoring the problem, they say, could have grave consequences.
“Burnout threatens our existence as a specialty,” says Peter Moskowitz, MD, executive director of the Center for Professional and Personal Renewal in Palo Alto, California. “There are increasing numbers of people leaving the field prematurely. And, at the same time, medical students are shrewd. They will see what’s going on in radiology and will look elsewhere for a career.”
What’s causing the fizzle?
Knowing what’s behind the loss of enthusiasm in radiology can be integral to fixing the problem. These are some of the most common factors at play.
1. Increased imaging volume
This problem is two-fold, says Moskowitz, clinical professor of radiology emeritus at Stanford University School of Medicine. Not only has imaging utilization crept up, but the number of images taken per study—particularly with cross-sectional studies—has ballooned, as well.
In fact, according to a recent article published in the Journal of the American College of Radiology, imaging workload has grown by 26% in the last 12 years. Unfortunately, the rise has outpaced practitioners’ abilities to keep up.
“Many MRI sequences and CT reconstructions are not necessary for diagnosis,” Moskowitz says. “We must find a way to reduce unnecessary images.”
2. PACS and electronic medical records
While these technologies carry several benefits, interoperability problems still exist. When systems don’t communicate fluidly, it can cause frustrations and decrease radiologist efficiency.
3. RVU focus
Overall, the industry puts too much emphasis on physician RVUs, Moskowitz says.
“Physician salaries and bonuses, status within groups, partnerships — all of these decisions are now made almost exclusively on physician productivity,” he says. “And, it’s killing people.”
4. Educational debt
Nearly 55% of new trainees report student debt weight contributes heavily to their work-related stress. Most graduates and trainees enter practice with between $150,000-$200,000 of debt, he says.
Related article: Why Radiologists Are Bad With Money
5. Generational differences
Frequently, work values between older and younger radiologists differ, Moskowitz says, causing anxiety.
“It’s not that one group is correct and the other is wrong,” he says. “Their values are simply different and it results in friction in the work environment.”
6 Things to Consider Before Switching Jobs
Few jobs are perfect, but sometimes one can’t help thinking that the grass is greener elsewhere, and that thought process has led many radiologists to look for a different work environment. And being as 2018 offers an outstanding job market for radiologists, there are many jobs to choose from.
The American College of Radiology’s (ACR) latest survey revealed the number of radiologist job openings increased by more than 14 percent year over year and the most recent Merritt Hawkins research showed the field was among the top 10 most searched specialties in 2017.
Here are some things for radiologists to think about when deciding if it’s time to make a change.
1. Is a Change Necessary? Before looking for a new position, radiologists should think carefully about whether they really want a change.
Christopher Tillotson, president of Consulting Radiologists Ltd., a diverse subspecialty radiology practice with 25 onsite locations and a variety of work environments, says taking a new job is a big deal.
“A job change creates a large disruption in your life as you get to know new partners, new clients, new venues and new technologies,” he says. “A job switch is akin to a divorce and one wants to make certain that you have done everything possible to make it a success before ending it and starting again.”
With over 29 years as a radiologist, Tillotson has recruited double-digit radiologists on an almost annual basis for CRL, and has seen first-hand how radiologists sometimes second-guess their decision. “A large portion of your waking hours are consumed at work,” he says. “Before jumping to a new place of employment, do your homework on the venue and people who will be co-workers.”
2. Make a Wish List: A good idea is to create a list of all the things you hope to find in a new job and list all the things about your current position that you don’t like. Think carefully about what you are fixing and what your priorities are, i.e. geographic location, large venue versus small, flexible work hours, subspecialization capabilities, partner personalities and security of work contracts.
Peter S. Moskowitz, MD, a retired Stanford pediatric radiologist and executive director of the Center for Professional & Personal Renewal, a healthcare career transition coach in Palo Alto, Calif., says most radiologists in practice are keenly aware of the clinical practice issues and management challenges they must face today.
“When considering a practice transition, all they need to do is to make a written list of what their practice values are, what is most important to them in the workplace, and what specific
things they are not willing to compromise on or give up,” he says. “Then this personalized information can be used to compare one practice opportunity to another.”
3. Look in the Best Places: There are many online job search websites for radiologists—job boards operated by national radiology organizations including the RSNA and ACR, according to Moskowitz.
Matthew Brewster, senior vice president of MedSource Consultants, a national healthcare recruiting agency based in Stamford, Conn., says it’s important to talk to different practices and different recruiters to understand a fair value for the area and who is looking.
“Don’t just look online to find your next job,” he says.
Moskowitz says that seeking information from radiologist friends who are in practice or in teaching centers is always a wise option, as well. It is not uncommon for friends to be aware of opportunities that have just become available but have not yet been formally announced or advertised.
4. Prepare: Before meeting with anyone—be it a recruiter or an imaging center or practice leader, Brewster recommends putting together a strong resume and three letters of reference.
“More often than not, organizations and practices are not looking for radiologists for their clinical skills—though those are important—but it’s about how well someone will fit in their culture, and a reference will speak to that,” he says. “I’ve seen too many people not have references ready and that can keep you from even getting an interview.”
5. Consider All Options: Brewster says accepting a position is sometimes a gut feeling. “It’s not always about the practice itself, it’s about the culture and how you fit in.
“Make sure to spend time with those who will be your colleagues and support team and see if you feel as if you can work with them,” he says. “Do they have smiles on their faces or is everyone looking frazzled and don’t have time to talk? Understand the environment you could be walking into by accepting a job there.”
Moskowitz says that if you have been thorough and completely honest in your assessment, it becomes relatively easy to compare one practice opportunity or more to your current situation and determine which offers the best combination of features.
6. Negotiate: Given the bull market for applicants, Tillotson notes radiologists should consider asking for extras like a signing bonus or help with relocation expenses. “The job market for applicants is phenomenal right now—at least in the Midwest, there are many more jobs than applicants,” he says. “Most groups are egalitarian so it is hard to ask for a salary higher than the members currently there. That’s why asking for extras is a smart idea.”
Moskowitz says that using the salary, benefits, or work conditions of a new job setting to extract a better package for yourself at your current place of employment, while common, is a slippery slope which has the potential to backfire badly.
“It is my opinion that if a radiologist wants to use a new offer as a bargaining chip, that radiologist should be fully and completely be prepared to quit his/her current position if the current practice leadership is unwilling to play into the game,” he says. “If you are not fully prepared to pack up and leave, you have no credibility in the negotiation process.”
Moskowitz adds that there is a risk that in using this strategy, the employee may antagonize their current leadership and can potentially poison the relationship entirely, which creates a very uncomfortable work setting should they eventually elect to turn down the new offer and remain in their current position.
“Negotiating is fine, but we tend to ask folks not to play one against the other,” Brewster says. “It’s more about making sure it’s a fair and comparable offer. Consider the culture, environment, and your family, and decide if this is the fit you are looking for.”
Radiologists Are Burning Out
Physicians Practice, September 11, 2017
So You Want to be a Part-Time Physician?
Career and financial support Whatever direction physicians take to work part-time hours, an employment change, whether temporary or permanent, can prompt concerns about career impact, finances, and even self-worth. To ease the transition, compiling a solid support team — from career coaches to financial planners to family and friends — can be helpful, experts say.
Career coaches can assist in identifying short- and long-term goals as well as potential employment pathways. Peter S. Moskowitz, a physician career and life coach and executive director of the Center for Professional & Personal Renewal, a consultancy for physician career transition and life coaching in Palo Alto, Calif., uses the four basic pillars of self-knowledge to ensure well-integrated career transitions for his clients. “A physician’s personality profile, unique transferable skills, career values, and personal sense of purpose [can] provide a stable platform from which physicians can scout new and appropriate careers,” he said.
When it comes to financial concerns, advanced planning is critical. With issues running the gamut from potential pay reductions and loss of benefits, to access to public service loan forgiveness programs that are based on full-time employment, forming a relationship with a trusted adviser even while still in medical school can lay the groundwork for future career transitions.
Radiologists Are Burning Out
Diagnostic Imaging, Practice Management, PACS and Informatics June 4, 2015Of all the factors that could be contributing to burnout among radiologists, the increase in work volume may be the overriding factor, according to Peter Moskowitz, MD, a clinical professor of radiology at Stanford University School of Medicine.
“It seems every year that the number of cases and the daily work volume seems to be getting greater at a time when there is pressure to increase individual work productivity,” said Moskowitz.
He says radiologists’ RVUs are being monitored to the point where some hospital administrators are using RVU output to determine salary and bonuses.
“There is tremendous pressure on radiologists to work more and do it faster and that stress is the major problem,” said Moskowitz.
Without interventions, he said it’s hard to see the situation improving.
An Even Keel
Di Journal of the American College of Radiology. NEWS Section. January 28, 2014. As imaging becomes increasingly complex, and the radiology work environment more stressful, it is more important than ever for radiologists to maintain their focus. Read what Physician Career Coach Dr. Peter Moskowitz has to say about keeping your focus, and your cool, at work.
How to Improve Your Attitude in 2014
Diagnostic Imaging Online Magazine. January 2, 2014. By Karen Childress
Being happy is a voluntary way of living, according to pediatric radiologist and physician career coach Peter Moskowitz. “Moment by moment, day by day, we make choices about how we live,” says Moskowitz. Research shows that about half of our happiness is hard-wired. About 40 percent is related to one-time events like getting a raise or buying a new car, but that kind of happiness is short-lived.” It’s the remaining 10 percent, says Moskowitz, that’s under an individual’s control. And that 10 percent makes all the difference. Read Moskowitz’s recommendations for physicians who are looking to improve their outlook on life and work.
Has PACS Ignited an Epidemic of Burnout?
Health Imaging Online Magazine. September 11, 2013. Today, more radiologists are succumbing too the plague of professional burnout with potentially dire effects on patients and practice. Error and malpractice rates are suspected to be higher for burned out physicians. “PACS, as well as the use of RVU’s as a performance evaluation measure for salary and bonuses fans the flames of burnout,” continues Moskowitz. Read what Moskowitz recommends for individual radiologists, as well as radiology groups and academic departments, to fix the problem.
Start Early: Avoiding Physician Burnout Begins in Medical School
Lead Doc. Am. College of Physician Executive’s Online Journal for Physician Leaders. March 21, 2013. By Jenny Laws. Peter Moskowitz has 14 years of experience as a life and career coach for physicians and is well versed on the topic of physician stress and burnout. He has seen a trend toward younger physicians and even medical students and residents looking for coaching to rethink career choices and establish better balance. Read about his advice to physicians in-training.
How Radiologists Can Find Balance and Avoid Burnout
Diagnostic Imaging Online Magazine. February 5, 2013. By Sarah Michael. Peter Moskowitz, MD, executive director for the Center for Professional and Personal Renewal and a practicing diagnostic radiologist, offers his suggestions for bringing balance to a stressful life, and the six domains of life balance.
Battling Burnout: Radiologists Seek Career Renewal
RSNA News. October-November, 2011. pp. 5-6. Although gauging the extent of professional burnout among radiologists is difficult, several prior studies have suggested an incidence as high as 40%. Read Dr. Moskowitz’s prescription for avoiding burnout and maintaining balance.
Ontario Medical Association Newsletter. March, 2011.
By Dorothy Pennachio. An informative discussion of physician burnout with prevention/treatment strategies.
Surviving the Malpractice Storm
PracticeLink. January, 2011. If you’re named in a malpractice suit, chances are you’ll go through every emotion, from denial to anger. But with these tips from physician career and life coach Dr. Peter Moskowitz, you can get through it-with both your sanity and your career still intact.
Balancing Your Life at Work and Home
Journal of Oncology Practice. September, 2009. Neglect of self-care, a compulsive drive to achieve, and the inability
To prioritize are all traits that put physicians at risk for work-life imbalance, burnout, depression, mood disorders and substance abuse. Physician coach Dr. Peter Moskowitz says that the inability to say no and to set limits is a very common problem among his physician clients. “Saying “no” without feeling guilty is understandably difficult for physicians, yet if they continue to say “yes” eventually they will not have time for anything. To be effective in work-life balance, you have to learn to set boundaries and priorities.”
Personal Growth Feeds Professional Development
Doctors Digest. Winter-Spring, 2008. pp. 6-17. By Karen Childress. Most clinicians would agree that it is important for them to keep up with the changes in medicine and science that impact their careers. But what about the other side of the equation? This well-written overview of career renewal includes comments from Dr. Peter Moskowitz about Going With The Flow, Aligning Work with Personal Values, The Art of Work-Life Balance, and Keeping Your Career On Track.
Personal and Professional Growth: Flextime Arrangements
Doctors Digest. November-December, 2007. pp. 73-77. By Karen Childress. So much for the 40-hour work week. Increasing numbers of physicians are electing to create more flexibility in their clinical practice, and working less, to permit more time for family, balance, fun, partial retirement, and even new entrepreneurial ventures. Take the advice of physician career coach Dr. Peter Moskowitz, and others, on how to pull it off.
Lonely Doctor’s Lounge
Medical Economics Magazine. February 3, 2006. Peter Moskowitz offers career and life coaching to physicians as executive director of the Center for Professional and Personal Renewal. This work gives him insights into how the empty doctors’ lounge –and fraying collegiality in general might be impacting medicine. “Isolation and loneliness puts doctors at greater risk of burnout,” says Moskowitz. “They become more irritable, more time-pressured, and less empathic with patients and co-workers. It’s easy to see how such doctors are more likely to be sued for malpractice.”
How Are You Feeling?
An Article on Physician Wellness, Southern California Physician. July, 2005. pp. 14-18. Have you stopped to gauge your personal health—mental and physical? If not, let this article on physician wellness serve as a reminder of the value in taking care of yourself, and how to do it.
Burnout: Are you at risk?
Medical Economics Magazine, May 6, 2005 By Dorothy Pennachio. Did you just yell at that patient? Slam that door? Step back–you may be on a slippery slope toward burnout. We can help.
Unhappy patients will leave their physicians
American Medical News, March 19, 2001 By Leigh Page. A study in the Journal of Family Practice reports that doctors say managed care pressures keep them from relating better with patients.
Lifestyle High prices, low salaries squeeze radiologists out of SF Bay Area
Diagnostic Imaging, February 2001 (requires registration) By Jane Lowers. For some exams, reimbursement rates are 30% to 70% of what their peers are paid elsewhere
Splitsville: Time to switch medical groups?
American Medical News, October 2, 2000 By Julie A. Jacob. Divorce from your practice isn’t easy. And a new partnership may not be much better. Here are some things to consider.
Physician stress: What can you do to avoid burnout?
ACOG Today (American College of Obstetricians and Gynecologists), September 1999. “Balancing your life is the most potent form of stress management there is,” advises Dr. Moskowitz. “It’s also a unique concept for doctors, most of whom wouldn’t have survived medical school if they had attempted to life a balanced life.”
Thinking the (previously) unthinkable: What if you get fired?
Medical Economics, September 7, 1998 By Dorren Mangan. As medicine goes corporate more and more doctors are being handed pink slips. Here’s how to cope if it happens to you.
What now, Coach?
American Medical News, January 5, 1998 By Maureen Glabman. As the rapidly changing health care system increases the stress level for many physicians, some doctors are turning to “career coaches” to help them work through their frustrations and sort out their options.
Finding Balance: If Not Now, When?
Hippocrates, January 1998 by Kathrine Kam. There’s no doubt that it’s hard for all busy professionals to balance their work with the rest of theri lives. But it’s especially challenging for doctors. Whether married practitioners with decades of experience or single residents fresh out of medical school, physicians are hard pressed to resolve the relentless demands of the profession with the desire for a rich personal life. Wherein Peter reveals his own dark days in the early ’90s that led him to make major changes in his work and home life and, eventually, to becoming a coach.
How to avoid the pit of radiology burnout
Diagnostic Imaging, October 1997 (requires registration) By Emily Hayes. Rather than seek help early, physicians tend to wait until problems snowball into a crisis. This condensed “day in the life” of a stressed-out radiologist is a composite picture based on interviews with psychologists and career development specialists who work with radiologists and other physicians.
Physician burnout: stemming the epidemic among us
California Physician, September 1997 By Megan Olden. How close are you to burnout? Learn how to control stress before stress controls you Family Practice Management, April 1997 By Janine Latus Musick