The practice of radiology, like other specialties, falls primarily into two categories: Private practice and academic practice. As there are pros and cons to every decision, which path to choose is a decision every radiologist encounters. This article discusses the pros and cons of private practice and academic medicine.
Private practice is the more popular path that radiologists take and focuses mainly on image interpretation and patient care within the community.
1 A workforce survey in 2017 by the ACR® Commission of Human Resources reported 46% of radiologists in private practice compared to 25% in academia.
2 A more recent survey in Radiology Business also found that private practice is the more common pathway with 49% of survey responders in private practice compared to 15% in academic institutions.
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Private practice is geared toward efficiency and production. The compensation is significantly higher, but this comes at a cost of its own. As neuroradiologist Benjamin White, MD, states, “The grind is generally bigger, and you take more call in return for lots more vacation and more money”.
4 Private practice radiologists focus more on general radiology and compensation depends on the individual private practice payment structure.
From my observations, fellowship-trained radiologists still pick up reads outside of their subspecialty. For instance, a radiologist with expertise in mammography may read images from the ER, lung cancer screenings and much more. A 2020 study highlighting the interventional radiology (IR) job market showed that only 15% of private practice job offerings were 100% IR.
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Academia is a very different world compared to private practice. Academic radiologists often serve as mentors to residents and students, take on leadership positions and work to make positive changes for future radiology practices. Academic medicine is also at the forefront of research and innovation. However, in terms of compensation, academia is on the lower end of the pay scale compared to private practice.
The Journal of the American College of Radiology study in 2022 reported that private practice groups have a significantly higher median compensation compared to academic practices.
6 In short, academic medicine is geared toward research, teaching and direct involvement in creating a new generation of physicians.
The decision to enter private practice or academia in radiology is a significant one, and each path offers its own set of advantages and disadvantages. In private practice, patient care is prioritized on a daily basis but in academia, perhaps patient care is more research and mentorship focused, geared toward improving current and future outcomes.
Ultimately, it comes down to a variety of individual preferences and priorities, such as pursuing financial rewards and a fast-paced working environment in private practice or finding fulfillment in shaping the future of radiology through academia.
References
1. Al-Khalili, R., MD. “Academics vs. Private Practice: Where Do I Belong?” RLI Kickstart Your Career PowerPoint slideshow, Nov. 2021. Available at:
/-/media/ACR/Legacy/96F17E23B_rend-al-khalili__academic-perspective-november-2021.pdf. Accessed June 10, 2024.
2. Bender, C.E., Bansal S., et al. “2018 ACR Commission on Human Resources Workforce Survey,” Journal of the American College of Radiology, 2019; 16:508–512. Available at:
https://www.jacr.org/article/S1546-1440(18)31601-6/abstract. Accessed June 10, 2024.
3. Marty Stempniak. “A Dramatic Shift: New Survey Highlights Salaries and Staffing Concerns in Radiology,” Radiology Business, May 17, 2022. Available at:
https://radiologybusiness.com/topics/healthcare-management/radiologist-salary/dramatic-shift-new-survey-highlights-salaries-and. Accessed June 10, 2024.
4. White, B. “Private Practice vs. Academic Radiology,” Ben White Blog, Sept. 21, 2015. Available at:
https://www.benwhite.com/medicine/private-practice-vs-academic-radiology. Accessed June 10, 2024.
5. Hage, A.N., Wadhwa, V., et al. “Contemporary Interventional Radiology Employment: Analysis of the American College of Radiology and the Society of Interventional Radiology Occupational Portals,” Clinical Imaging, Dec. 2020; 68:236–238. Available at:
https://www.clinicalimaging.org/article/S0899-7071(20)30270-9/fulltext. Accessed June 10, 2024.
6. Oladini, L., Ganesh, A., et al. “Current State of Private Practice and Academic Interventional Radiology: Differences in Practice Structure, Case Mix, and Productivity,” Journal of the American College of Radiology, Feb. 2023; 20(2):183–192. Available at:
https://www.jacr.org/article/S1546-1440(22)00734-7/abstract. Accessed June 10, 2024.
