You're making the common mistake of thinking that healthcare is some sort of normal market subject to simple supply-and-demand economics rules. The reality that supply is heavily constrained by CMS funding for residency slots, prices are (mostly) fixed by a few large payers, and patient demand is effectively infinite. There is a serious shortage of radiologists already and it's getting worse as the population grows older and sicker. If AI tools make radiologists more productive then more imaging studies will be ordered.
>> supply is heavily constrained by CMS funding for residency slots
I keep hearing this argument. Then I look at an Insurance Explanation of Benefits statement. A Radiologist might make $1-2k/day in billings. If you are in a balance-billing state, whatever insurance doesnt pay gets forward billed to the patient. On a standard 252 day workyear, that is $250-500k/yr in billings. The average resident salary is 70k, lets assume 100k with benefits.
Of course there is plenty of overhead, but from the math i'm seeing, the average Radiology Resident is a 150-400k net revenue center. Is the overhead really greater than 150-400k/yr/resident?
What am I missing, why would a profit center need "CMS funding"? From what my doctor friends tell me, the real bottleneck is the unwillingness of AMA and ABR to open up more radiology residency spots (artificial supply constraint) with "CMS funding" a boogeyman and red herring.
Contrary to what your doctor friends might have told you, the AMA has no power to restrict the number of residency slots. They are a private membership organization with no regulatory or accreditation authority. At one time they did lobby Congress to restrict graduate medical education funding but have since reversed that position.
A minority of funding does come from sources other than CMS. Teaching hospitals are largely free to add more residency slots if they want to. The fact that most hospitals don't do this indicates that GME programs are largely unprofitable.
>> You cannot bill for a resident's work, without an attending signing off on it.
Isnt that the case for almost every industry? I was a management consultant and our Partner signed off on the work before billing clients. Architects bill clients, but only when the lead architect signs off on the plans. Same for civil engineers. Same for magazines where the editor signs off on most major pieces.
