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If anyone here has (or knows someone that has) gone to a solo spot right out of residency, I would be interested in hearing your experiences, both good and bad.
Thoughts from those that have gone solo right out of residency?
- Thread starter RadOncLova
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This is a really bad idea IMO. I've been tempted, I know others who have similarly been tempted/done so. The obvious pros are $$$ and that you are the boss. There are numerous cons:
1. Coverage is a problem; if you decide to do something as simple as leave clinic a bit early or take a three-day weekend, coverage will have to be arranged in advance
2. Lack of RO MD oversight, no chart rounds; this is critically important - new grads, no matter how well they are trained, will make a few mistakes when they start out as attendings; lack of peer review is a huge liability risk
3. Lack of real world experience in billing, coding, and administration; let's be honest, residency doesn't train us for these things - you have to develop them in the 'real world.' Therefore you will neither be in a position to lead these efforts and/or the hospital administration will pull wool over your eyes without you knowing.
4. Your life will be consumed - no call sharing, no sharing inpatient responsibilities, no cross coverage when you are doing special procedures in the OR. It's all you buddy.
These types of positions can be exceptionally rewarding for folks who are more seasoned (e.g. > 3 years post-residency) but are dangerous for new grads. Solo positions tend to be located in less desirable rural areas and they have problems recruiting. Therefore, hospital admins will sell gullible new grads a fairy-tale land replete with sunshine, fairies and unicorns.
1. Coverage is a problem; if you decide to do something as simple as leave clinic a bit early or take a three-day weekend, coverage will have to be arranged in advance
2. Lack of RO MD oversight, no chart rounds; this is critically important - new grads, no matter how well they are trained, will make a few mistakes when they start out as attendings; lack of peer review is a huge liability risk
3. Lack of real world experience in billing, coding, and administration; let's be honest, residency doesn't train us for these things - you have to develop them in the 'real world.' Therefore you will neither be in a position to lead these efforts and/or the hospital administration will pull wool over your eyes without you knowing.
4. Your life will be consumed - no call sharing, no sharing inpatient responsibilities, no cross coverage when you are doing special procedures in the OR. It's all you buddy.
These types of positions can be exceptionally rewarding for folks who are more seasoned (e.g. > 3 years post-residency) but are dangerous for new grads. Solo positions tend to be located in less desirable rural areas and they have problems recruiting. Therefore, hospital admins will sell gullible new grads a fairy-tale land replete with sunshine, fairies and unicorns.
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Great post, Gfunk. I have also heard this is a bad idea and adds to an already stressful time. For instance, how will you find time to study for oral boards? I do know 2 that have done it:
1. One did a 6 month solo locums gig before his job started. His patient census was not that high (maybe 15 patients), but he was very stressed. At the end, he was happy to be leaving for his permanent job.
2. Another started a new RT center with a group of medoncs. She was very excited and I think he did quite well with them for a few years. Their facility/group was eventually sold off to a hospital system and she left.
1. One did a 6 month solo locums gig before his job started. His patient census was not that high (maybe 15 patients), but he was very stressed. At the end, he was happy to be leaving for his permanent job.
2. Another started a new RT center with a group of medoncs. She was very excited and I think he did quite well with them for a few years. Their facility/group was eventually sold off to a hospital system and she left.
I did it, and it has been the best decision of my life (financially-speaking). It was manageable since most of my cases were (and continue to be) breast, prostate, and lung which you are exposed to amply in residency. When I had questionable cases, I consulted old attendings, chartrounds.com, SDN, etc. I never took chances with anything. This is not to say I was perfect, but I definitely strictly adhered to the books when I first started, and that kept me out of trouble.
The billing side was a learning process, but I was aggressive about sitting down with my biller from the get-go and learning all I could. For me, the biggest downside has been the lack of coverage. Sans oral boards, I haven't had a vacation in 2 years.
I work very hard, and my job doesn't stop when I leave work. I sometimes carry over 40 patients myself, and I still have to find time to wine and dine my referring docs. But I'm young, and the big money is worth it to me. I'm sure I'll burn out eventually, but for now I'm happy.
The billing side was a learning process, but I was aggressive about sitting down with my biller from the get-go and learning all I could. For me, the biggest downside has been the lack of coverage. Sans oral boards, I haven't had a vacation in 2 years.
I work very hard, and my job doesn't stop when I leave work. I sometimes carry over 40 patients myself, and I still have to find time to wine and dine my referring docs. But I'm young, and the big money is worth it to me. I'm sure I'll burn out eventually, but for now I'm happy.
Holy $hit
I did it and I regret it. I'm a member of a group practice with a series of radonc centers, all but 2 of which have closed, and the other is filled by locums. Consequently, I'm a soloist.
On the plus side, 100% of my plans are absolutely perfect on peer review...which is me, so that's the down side.
No vacation, call is 365 days a year.
Money is good, but not worth it, especially not when starting out, in my opinion.
In retrospect, I wish I had taken the job with the large group for at least the first several years (if not forever) so I could have partners who would critique my work, have my back, and give me someone to talk to other than my patients.
On the plus side, 100% of my plans are absolutely perfect on peer review...which is me, so that's the down side.
No vacation, call is 365 days a year.
Money is good, but not worth it, especially not when starting out, in my opinion.
In retrospect, I wish I had taken the job with the large group for at least the first several years (if not forever) so I could have partners who would critique my work, have my back, and give me someone to talk to other than my patients.
