Rad Onc NP’s/PA’s in Non-Academic Settings

[imhopeful432]

It’s a saturated market nobody cares about your personal incentives. If you have a problem with the salary or the workload then you can ****ing leave, the owners won’t lose sleep. They’ll find some new grad to take your place. I’ve already seen this happen and I’m in a state that has them. They won’t even consider a separate PC Corp so the RO can collect their own fees why? Because they don’t have to and it’s take money out of the skim.

You have a problem with the pace of the work fine, they can and will replace you.

Could share more details in business forum, but I know multiple people in the past year who have been offered urorads jobs in southeast and west coast. 350k even in a desirable area is laughable and no where near what they offer to be able to draw/keep someone.

I know places that have had difficulty attracting someone with 500+ in non-desirable areas for uro-rads if they are moderate volume.

If someone in your area is underpaying to that extent and able to retain someone to run the place 5 days a week, that's....impressive.

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[sirspamalot]

If anyone wants me to see more than 20 avg on tx in a non-desirable (but not necessarily abomination level) location.. # is the floor.

And if anyone thinks anyone smart/competent will take less than #... then they've either found themselves someone horrible, or someone incompetent. Or perhaps a desperate new grad who will be looking for an exit in 2 years.

Its like they say.. there are no girls in teen chat rooms. There are boys and there are FBI agents.. but no girls. Some things you just have to accept, but sometimes learn the hard way first.

 

[RadOncDoc21]

there are no girls in teen chat rooms. There are boys and there are FBI agents.. but no girls. Some things you just have to accept, but sometimes learn the hard way first.

😂

 

[Ray D. Ayshun]

If anyone wants me to see more than 20 avg on tx in a non-desirable (but not necessarily abomination level) location.. # is the floor.

And if anyone thinks anyone smart/competent will take less than #... then they've either found themselves someone horrible, or someone incompetent. Or perhaps a desperate new grad who will be looking for an exit in 2 years.

Its like they say.. there are no girls in teen chat rooms. There are boys and there are FBI agents.. but no girls. Some things you just have to accept, but sometimes learn the hard way first.

for someone with such a long history in this profession, you don't seem to understand the depth of idiocy, laziness, and denial that exists in the C-suite. They're ugly too, but perhaps not relevant.

 

[RadOncDoc21]

for someone with such a long history in this profession, you don't seem to understand the depth of idiocy, laziness, and denial that exists in the C-suite. They're ugly too, but perhaps not relevant.

Not just the C-suite. Admins are all over the place telling docs what they can and can’t do. Hideous looking monsters.

 

[sirspamalot]

Oh, but I do understand the nature of Admin. And also the unethical conduct of a subset.

Funny.. I just read in the news today about one such scumbag. I've waited 14 years to see Karma strike this mofo down, but it finally arrived. Dumbest CEO I've ever talked with, a whistleblower is now taking him down.. long after I left.

A great day today it was..

 

[NotMattSpraker]

Again, incorrect. You really should try to research this a bit more. The goal is to incentivize you to treat and feed the machine. That isn't achieved with a low flat salary and no production incentives

I know like 40 academic rad onc chairs who are evil laughing at your comment with tented hands.

 

[medgator]

I know like 40 academic rad onc chairs who are evil laughing at your comment with tented hands.

So they're gonna start putting more production incentives in and up the base?? Nice!

 

[deleted1111261]

So they're gonna start putting more production incentives in and up the base?? Nice!

Makes it impossible to do real research

And that leads to the garbage we see in RJ

 

[medgator]

Makes it impossible to do real research

And that leads to the garbage we see in RJ

Worst of both worlds is getting that **** salary, putting out **** research in the RJ which seems to be happening in some institutions

 

[deleted1111261]

Idk. I think the “base plus” model is what started the downfall of research. Why not just do database and disparity work (the counting kind, not the useful / actionable work) instead of real research and cash in on RVUs? They wanted people to be more clinically productive and it worked. At the expense of advancing our field.

 

[Mandelin Rain]

So they're gonna start putting more production incentives in and up the base?? Nice!

Academic chair people always have the "promotion" carrot to dangle to push both clinical and research production out of their underlings.

Very reliant on having a gaggle of goody two shoes who rely on external validation by a superior and a status position on their white coat to determine their worth.

 

[Mandelin Rain]

With regard to the initial question/purpose of the thread, I agree with much of what's been said.

Don't expect to have an NP make their salary back. Look at it as a way to either increase your quality of life by not dealing with various time (and or soul) sucking tasks, or increase your bottom line by expanding capacity without hiring another physician.

Best uses:
1. On treatment issues between OTV visits. Pain, dehydration, nausea, whatever... eval those issues if you're in with a consult or something.
2. Follow up/Survivorship. Helps to meet COC if applicable.
3. Prior auth issues
4. Disability/FMLA form signing other social work type issues
5. Smoking cessation/Lung Screening
6. Follow DEXAs and bone management for ADT patients (if you prescribe)
7. Care coordination for concurrent patients.
8. Supervision, if hospital based.
9. Inpatient work. Depends on location, but can coordinate and pop to the floor.
10. Follow up on results of labs/scans/whatever... call patient with results
11. I'm sure there's a bunch others

 

[theradiator]

With regard to the initial question/purpose of the thread, I agree with much of what's been said.

Don't expect to have an NP make their salary back. Look at it as a way to either increase your quality of life by not dealing with various time (and or soul) sucking tasks, or increase your bottom line by expanding capacity without hiring another physician.

Best uses:
1. On treatment issues between OTV visits. Pain, dehydration, nausea, whatever... eval those issues if you're in with a consult or something.
2. Follow up/Survivorship. Helps to meet COC if applicable.
3. Prior auth issues
4. Disability/FMLA form signing other social work type issues
5. Smoking cessation/Lung Screening
6. Follow DEXAs and bone management for ADT patients (if you prescribe)
7. Care coordination for concurrent patients.
8. Supervision, if hospital based.
9. Inpatient work. Depends on location, but can coordinate and pop to the floor.
10. Follow up on results of labs/scans/whatever... call patient with results
11. I'm sure there's a bunch others

Nice post and comprehensive list. The question from a cost effectiveness perspective is whether a NP is necessary for these functions - other than writing notes and prescribing medications - or instead RN, MA or even trained clerical staff.

 

[Mandelin Rain]

Nice post and comprehensive list. The question from a cost effectiveness perspective is whether a NP is necessary for these functions - other than writing notes and prescribing medications - or instead RN, MA or even trained clerical staff.

Depends. I'd guess an NP can make back about 1/2 their salary with follow ups. That makes them about the same net cost as an RN who will recoup none of their salary via reimbursement. I'd much rather have someone who can see patients independently, prescribe, order tests, supervise in a pinch, etc... if the cost to me was the same.

 

[Neuronix]

Academic chair people always have the "promotion" carrot to dangle to push both clinical and research production out of their underlings.

Very reliant on having a gaggle of goody two shoes who rely on external validation by a superior and a status position on their white coat to determine their worth.

Lol as if there is some great non-academic job out there that I can just switch to at any minute.

 

[Mandelin Rain]

Lol as if there is some great non-academic job out there that I can just switch to at any minute.

There's the problem.

I do think most of the people chasing advancement in an academic center are self selecting, however.

 

[Neuronix]

There's the problem.

I do think most of the people chasing advancement in an academic center are self selecting, however.

Would you want to sit at assistant professor salary your whole life?

 

[Lamount]

Would you want to sit at assistant professor salary your whole life?

My sense is there is a wide range in how salary is structured at academic centers. Where I work, there is definitely a raise associated with promotion, but I also know of other centers where pay is largely dependent on production, regardless of rank.

 

[Mandelin Rain]

My sense is there is a wide range in how salary is structured at academic centers. Where I work, there is definitely a raise associated with promotion, but I also know of other centers where pay is largely dependent on production, regardless of rank.

Granted, it's been a long time since I interviewed academics, but this was my impression as well. In fact, I 've seen satellite docs with minimal appointment/no chance of advancement make as much or more than professors at main hub. All depends on the setup.

To answer the question though, no. I would not spend my career at an assistant professor salary, nor associate professor, nor professor at many/most places.

 

[medgator]

Lol as if there is some great non-academic job out there that I can just switch to at any minute.

Would you want to sit at assistant professor salary your whole life?

There are definitely better hospital employed gigs now to choose from without the academic politics, and much better pay.

Location may not be as ideal but that's always been a trade-off. Boston. LA, Miami or NYC has always been a tough place to make big bucks

 

[Fpg1245]

Academic chair people always have the "promotion" carrot to dangle to push both clinical and research production out of their underlings.

Very reliant on having a gaggle of goody two shoes who rely on external validation by a superior and a status position on their white coat to determine their worth.

The small size of the crumbs these people will fight over. It’s pathetic. Do they not realize how undignified it is?

I had somebody brag about their RVU bonus at academic satellite and I almost vomited.

 

[Ray D. Ayshun]

The small size of the crumbs these people will fight over. It’s pathetic. Do they not realize how undignified it is?

I had somebody brag about their RVU bonus at academic satellite and I almost vomited.

what did they say?

edit: RVU bonus = actually getting paid for the work you did

 

[Doctorer]

what did they say?

edit: RVU bonus = actually getting paid for the work you did

Presumably it was because the size of the bonus was a tiny fraction of the money that was made off of the doctor's work. $20/RVU is hardly a "bonus."