2021 ARRO Graduating Resident Jobs Survey

[OTN]

I’m seeing a lot of implication here that radoncs are the only docs who care about their income/want to make as much money as possible.

This is completely untrue, so far off from reality it’s laughable. I have no idea why we would want to paint ourselves this way.

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[deleted1111261]

I’m seeing a lot of implication here that radoncs are the only docs who care about their income/want to make as much money as possible.

This is completely untrue, so far off from reality it’s laughable. I have no idea why we would want to paint ourselves this way.

Ugh. I hope not. We should not. I think, to me, take home is that PCPs are getting absolutely hosed.

 

[OTN]

Ugh. I hope not. We should not. I think, to me, take home is that PCPs are getting absolutely hosed.

In my neck of the woods the PCPs who want to grow their business and make decent money have done very well for themselves. Lots of opportunities for the entrepreneur-type PCP to expand their business. Some don’t want to and that’s fine. Those who do, though, are indeed able to supplement their income rather well.

I also really don’t like the attitude of “doctors shouldn’t be in it for the money.” That leads to exploitation by either government (in some countries) or administration (in others). Absolutely nothing wrong in my mind with wanting to be reimbursed as much as possible for your work. However, I have a background in economics, and the “dismal science” I’m sure has colored my view of human behavior.

 

[RickyScott]

In my neck of the woods the PCPs who want to grow their business and make decent money have done very well for themselves. Lots of opportunities for the entrepreneur-type PCP to expand their business. Some don’t want to and that’s fine. Those who do, though, are indeed able to supplement their income rather well.

I also really don’t like the attitude of “doctors shouldn’t be in it for the money.” That leads to exploitation by either government (in some countries) or administration (in others). Absolutely nothing wrong in my mind with wanting to be reimbursed as much as possible for your work. However, I have a background in economics, and the “dismal science” I’m sure has colored my view of human behavior.

I grew up in a very safe middle class suburb of a top 3 metro. my neighbors were police officers and teachers, engineers, scientists, and middle management. My dad earned 50k a year and we had an old ford pinto. Today that would not be doable on 200k a year and medical school debt. I feel entitled to live in said suburb on a doctors salary. Ralph w would argue otherwise. Hospitals have become insanely profitable. NYU is headed by a dean w/ 5-10 million compensation yet they start Im at 120. Don’t let some rich f—ck like Ralph who had a full lab before he was 30 and huge nest egg guilt you into fellowships and postdocs until you are 40 and then a 200 k year job. Chairs like Louis p should not make 5 x their attending salaries. They are cash driven, but try to come off as noble , charitable pt driven etc Doctors should not earn less than plumbers, subway workers, dock workers etc

 

[RO28]

Today that would not be doable on 200k a year and medical school debt. I feel entitled to live in said suburb on a doctors salary.

This exactly. I wouldn't even use the word entitled, we earned the ability to live in said suburb on a doctors salary.

 

[communitydoc13]

radoncs are the only docs who care about their income

Didn't mean to imply this myself. Just meant to contextualize the mean and median number conversation we were having. Most specialists are just like us, making good money but also putting extra into training. But there are a significant number of docs (some primary care IM, peds, FM, academic IM) that are fine at around that 200K number.

The lower earners and higher earners are both a diverse group, with lower earners including some academics in good cities (Not radonc chairs!), part timers, docs with low patient loads, independently wealthy docs and humanitarians.

The higher earners include entrepreneurial types (both PCP and specialty), and most procedure oriented specialty physicians, employed or not.

FWIW, in my neck of the woods, demographics have driven a terrible PCP shortage and established PCP docs have moved to a very lucrative concierge model that my money grubbing radonc self judges a little bit because it negatively affects point of entry to healthcare services for a growing and vulnerable population.

I have also seen wealthy PCPs who are predatory with their APP staff and make mad money.

I can only speak for myself. But I want to be paid well for doing a good job, and that depends on the market rate for radoncs being pretty high. Pretty simple.

 

[elementaryschooleconomics]

Didn't mean to imply this myself. Just meant to contextualize the mean and median number conversation we were having. Most specialists are just like us, making good money but also putting extra into training. But there are a significant number of docs (some primary care IM, peds, FM, academic IM) that are fine at around that 200K number.

The lower earners and higher earners are both a diverse group, with lower earners including some academics in good cities (Not radonc chairs!), part timers, docs with low patient loads, independently wealthy docs and humanitarians.

The higher earners include entrepreneurial types (both PCP and specialty), and most procedure oriented specialty physicians, employed or not.

FWIW, in my neck of the woods, demographics have driven a terrible PCP shortage and established PCP docs have moved to a very lucrative concierge model that my money grubbing radonc self judges a little bit because it negatively affects point of entry to healthcare services for a growing and vulnerable population.

I have also seen wealthy PCPs who are predatory with their APP staff and make mad money.

I can only speak for myself. But I want to be paid well for doing a good job, and that depends on the market rate for radoncs being pretty high. Pretty simple.

I massively misunderstood the earning potential of a "concierge PCP" service until I saw some real-life models.

It definitely takes entrepreneurial spirit and is less secure than a hospital employed gig...but the upside is much higher.

 

[evilbooyaa]

Well.. it’s you and other people here that say this. And I believe you. This just gives credence to what I’ve been saying the last few days. Nobody says this publicly and non anonymously. So, basically it doesn’t exist - “angry internet people”. The surveys and the popular people say it’s fine. So, it’s fine. Until there are real faces saying it’s bad out there, it’s just rumors / “SDN” making stuff up. I don’t mean to say you are. Just perception.

For many/most of us with the desire to engage in a public forum (SDN/twitter) and who may potentially looking to pivot jobs in the next few years, what's the advantage of telling somebody like Potters he's a *******? What is the advantage to the individual person behind the twitter account to call out one of the more prominent chairmen in Rad Onc, besides potentially damaging one's career?

If I was 100% out of academics and committed to never going back into it, then yeah, I probably wouldn't care either.

Unfortunately, in Rad Onc, the fear of "they can always hurt you more" continues even after residency given how small the field is. It's not good, and it's not an ideal situation, and I'm the first to admit I'm chicken**** for believing it, but it's not worth the risks (to me) to stick my neck out on Twitter, at least at this stage in my career.

I can’t prove this, but I am quite sure that most the American MDs in the match are not very intelligent/utter tools or both. Qualitatively I have heard this comes through via eloquence of candidates during interviews.

This is a really bad take. There are actually a fair amount of good candidates this year. If Rad Onc only had ~100 spots to offer, it'd be just as competitive as usual. The issue is there are not ENOUGH of those candidates to go around for all the relevant programs. Thus, it will lead to situations just like last year, where folks who MATCHED PGY-2 rad onc in some crap program are struggling to find even a surgical prelim to take them and crowd source it to twitter. Eventually, maybe, some of those will not get a prelim spot? Not sure what I should be rooting for here...

 

[communitydoc13]

some real-life models

It's crazy. 1800-3000 per annum fee to be a patient. Often these patients are healthier to begin with. Then they still charge insurance. Their panels drop in half, their income more than doubles and then they often will still make money off of APPs seeing Medicare patients.

 

[medgator]

It's crazy. 1800-3000 per annum fee to be a patient. Often these patients are healthier to begin with. Then they still charge insurance. Their panels drop in half, their income more than doubles and then they often will still make money off of APPs seeing Medicare patients.

Essentially these docs are collecting a six figure fee before the first pt walks through the door.

 

[deleted1111261]

In my neck of the woods the PCPs who want to grow their business and make decent money have done very well for themselves. Lots of opportunities for the entrepreneur-type PCP to expand their business. Some don’t want to and that’s fine. Those who do, though, are indeed able to supplement their income rather well.

I also really don’t like the attitude of “doctors shouldn’t be in it for the money.” That leads to exploitation by either government (in some countries) or administration (in others). Absolutely nothing wrong in my mind with wanting to be reimbursed as much as possible for your work. However, I have a background in economics, and the “dismal science” I’m sure has colored my view of human behavior.

I’m Econ, too!
And fully agree with you.

 

[deleted1111261]

For many/most of us with the desire to engage in a public forum (SDN/twitter) and who may potentially looking to pivot jobs in the next few years, what's the advantage of telling somebody like Potters he's a *******? What is the advantage to the individual person behind the twitter account to call out one of the more prominent chairmen in Rad Onc, besides potentially damaging one's career?

If I was 100% out of academics and committed to never going back into it, then yeah, I probably wouldn't care either.

Unfortunately, in Rad Onc, the fear of "they can always hurt you more" continues even after residency given how small the field is. It's not good, and it's not an ideal situation, and I'm the first to admit I'm chicken**** for believing it, but it's not worth the risks (to me) to stick my neck out on Twitter, at least at this stage in my career.



This is a really bad take. There are actually a fair amount of good candidates this year. If Rad Onc only had ~100 spots to offer, it'd be just as competitive as usual. The issue is there are not ENOUGH of those candidates to go around for all the relevant programs. Thus, it will lead to situations just like last year, where folks who MATCHED PGY-2 rad onc in some crap program are struggling to find even a surgical prelim to take them and crowd source it to twitter. Eventually, maybe, some of those will not get a prelim spot? Not sure what I should be rooting for here...

This is true - there are good candidates and if we limited our spots, would have remained competitive.

 

[elementaryschooleconomics]

It's crazy. 1800-3000 per annum fee to be a patient. Often these patients are healthier to begin with. Then they still charge insurance.

This is exactly the model I observed. The kicker was this particular doc would immediately punt to ED/Urgent Care if it was anything that required more than an antibiotic or reassurance.

Just...crazy.

 

[deleted941485]

This is exactly the model I observed. The kicker was this particular doc would immediately punt to ED/Urgent Care if it was anything that required more than an antibiotic or reassurance.

Just...crazy.

It is crazy. Meanwhile you have internists dealing with govt ins patients with every chronic disease under the sun on 10-20 meds and running around like maniacs getting burnt out. Stepping off the treadmill is probably the best thing you can do. Yeah you lose the "challenge" of a good case but with a 2-5K patient panel poor payor mix and ins up your ass it just isn't worth it anymore.

I never viewed the whole direct payment or concierge service is the answer to a rotten medical system. It comes with a cost no doubt but some people will pay it gladly to escape.

 

[Ray D. Ayshun]

This is exactly the model I observed. The kicker was this particular doc would immediately punt to ED/Urgent Care if it was anything that required more than an antibiotic or reassurance.

Just...crazy.

I get about 1800-3000 per patient and anything more complicated than an abx script goes to urgent care or the Ed.

 

[Lamount]

This is exactly the model I observed. The kicker was this particular doc would immediately punt to ED/Urgent Care if it was anything that required more than an antibiotic or reassurance.

Just...crazy.

I think I would die of boredom

 

[elementaryschooleconomics]

I get about 1800-3000 per patient and anything more complicated than an abx script goes to urgent care or the Ed.

Yeah, but you probably cure a wee bit of cancer in that sequence of events.