“Use, do not abuse ... neither abstinence nor excess ever renders man happy.”

—Voltaire

I have been pretty busy of late; we’ve discussed this previously. Worklists are growing exponentially. We are all busy. I talked to an old friend the other day who told me they were fully staffed and caught up with their reading. After recovering from my momentary lapse of consciousness (simple cardioversion and IV fluids), I asked how that was possible. Did they learn to clone staff? Someone willed a few billion dollars to their department? Nope; the answer was a typical yin-yang. A radiology department across town had collapsed, most of the rads liked being in that city, and the jobs at my friend’s place were easy to grab (reasonable salary, simple cross-town drive, learn a new PACS, get a new parking place and ID badge), so they had suddenly filled every position. It might be fleeting, but for now, life for them is good.

Radiology staffing is at an odd (but somehow desirable) place. We are in demand. We can pretty much pick our job and our destination. Remember when you were approaching the end of your training and wondering what to do with yourself? I’ve spoken to first-year residents lately who already know what they are going to do when they finish. Already committed. Looking at houses. This has altered recruiting dynamics, for sure. The best time to recruit new staff it seems now is right out of kindergarten. I think those youngsters are impressionable and you might be able to convince them that pictures on a computer screen and a cool chair are at least as neat as the fire truck. I may be on to something here; I am not clear about the legal issues with this, but a kid who has interest in images and plays well with others might be a great early grab. I do understand the lag time here is considerable, but hey, guaranteed staffing?

This, too, shall pass. I have no reason to suspect that we are always going to be a hot commodity. AI, turf wars, and “radiology providers” are out there, lurking. It doesn’t seem like constancy is anything we should ever count on. I do distinctly remember a while back when jobs were few and far between; residents were suddenly very interested in fellowships; fellows were interested in second fellowships. Abstinence or excess. Voltaire was a smart dude.

Wait. I just thought of a constant. The amount you make for reading that study? It is ALWAYS going to be less next year. And less again the year after. “Volume, volume, volume,” as David Letterman always said. More monitors, faster PACS, shorter reports, longer worklists.

Keep doing that good work. Talk to those kindergarten kids. Mahalo.