It can be exceptionally rewarding, but it takes a lot of luck. You had better be exceptionally personable and willing to relentlessly market yourself. You should give your patients concierge care so they go back to their referring docs raving about you. You need to know the insurance landscape. Will the medical groups in the area even contract with you if they are already contracted with several other groups? Hope the other rad oncs in the community are douches and have pissed everybody off. Hope there isn't a hospital machine buying out all the med onc practices. Hope there isn't a urorads or med-onc group with a linac. That's just for starters.