Healthcare economics directly impacts radiologists, ranging from residents in training to seasoned practicing physicians. This topic is so critical that the Accreditation Council for Graduate Medical Education includes “understanding health care finances” as part of its Systems-Based Practice competency within radiology residency programs. Despite this recognized importance and the availability of resources, most residency programs struggle to incorporate fundamental components of healthcare economics — such as the reimbursement cycle and payment systems — into resident education.
This challenge stems from various factors, including the lack of easily adoptable programs, difficulty in distilling a breadth of resources into digestible content for busy residents, limited knowledge among local academic leadership, and the financial burden of investing in available resources. Moreover, many didactic resources on healthcare economics provide limited real-world application, leaving trainees without practical insights. As a result, it can be challenging for early-career physicians to individually navigate the business of medicine while simultaneously contending with the steep learning curve of independent clinical practice.
Similarly, personal physician finance is frequently overlooked in residency training programs, despite financial well-being as a significant contributor to physician success and satisfaction. On average, residents enter training in their late twenties, burdened with over $200,000 in educational debt. Despite the combination of significant debt, delayed earning potential, and low residency salaries that limit financial freedom, residents receive minimal formal education on critical financial topics such as loan repayment or retirement planning. This debt can escalate considerably by the time physicians begin independent practice.
Despite the combination of significant debt, delayed earning potential, and low residency salaries that limit financial freedom, residents receive minimal formal education on critical financial topics such as loan repayment or retirement planning.
Furthermore, residents often face complex personal financial decisions, such as starting families, during their training years. By the end of residency or fellowship, most trainees have received little to no formal education on personal finance and are left to make career decisions based on immediate financial pressures rather than long-term fulfillment. The expectation that residents acquire financial literacy independently often leaves them ill-prepared, as paramount clinical demands limit their capacity to seek out this knowledge. Consequently, early-career physicians frequently rely on anecdotal learning or trial-and-error approaches, leaving them vulnerable to predatory advisors or financial missteps.
Incorporating healthcare economics and personal finance into residency education presents several challenges — some of which, fortunately, have potential solutions. The first major challenge is creating a comprehensive and effective curriculum. Professional society resources can provide a strong foundation. For example, the Radiological Society of North America (RSNA) and the American Roentgen Ray Society (ARRS) offer free, high-yield educational videos for trainees that outline key topics. The ACR’s RLI Resident Milestones Program delivers a structured introduction to healthcare economics through nationally recognized experts in a seminar-based format, which is adaptable to residents’ dynamic clinical schedules. Additionally, the ACR Advocacy and Economics webpage offers succinct summaries of reimbursement-related issues relevant to radiology.
The second challenge lies in identifying educators with the appropriate knowledge and ability to teach these topics effectively. Academic attendings who are removed from reimbursement issues may feel unqualified to teach healthcare economics or personal finance. In our institutional experience, reaching out to alumni in private practice has proven successful. Physicians in community settings, particularly those in physician-led groups, often possess greater familiarity with reimbursement dynamics and nuanced personal finance considerations. Additionally, these private practice alumni have reported increased personal fulfillment from engaging with trainees and sharing their experiences.
The third and final challenge is the long-term sustainability of economics curricula. Developing and delivering thoughtful content on healthcare economics and personal finance is already a substantial effort. However, frequent updates are required due to constantly evolving legislation and political climates — far more so than for traditional clinical topics. Program leadership must recognize the importance of these subjects and commit to investing in their integration and maintenance. In the long term, a national course organized by a major radiology society — akin to the ACR Institute for Radiologic Pathology — could offer a unified, standardized solution. Such an initiative would reduce the burden on individual programs to develop and maintain their own curricula while encouraging broader participation.
Ultimately, residency programs must prioritize educating trainees on healthcare economics and personal finance to the best of their ability. The success of future generations of radiologists will depend on this essential knowledge.