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Traditionally RadOnc had higher salaries than HemOnc/MedOnc. Is the trend reversing these days? Just curious.
Are RadOnc salaries now lower than HemOnc salaries?
- Thread starter AmiSansNom
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Our rad oncs don’t take call. Considering the actual $ per hour worked, I think they make significantly more.
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Depends on practice setting. Private med oncs with pharmacy and radiology ownership etc can do much better than even private rad oncs
I think hospital employed RO and MO similar but RO probably comes out ahead when you consider call, hours worked etc but the big difference is the MOs will have a lot more job availability in a given metro and a much better locums market in terms of daily reimbursement
The opportunity to make 7 figures is available to med oncs right out of training if they want it. Locums rates are 5k per day in some locales. Obviously not metro but ive seen locums >3k per day metro and starting gigs 500k+ in uber desirable areas. I hate med onc and you couldnt pay me any amount to do it...but the market is hot. Radoncs probably do make more per hour but there's a much lower ceiling than med onc for the average physician.
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At the big academic center in my hometown, Radonc starts at $370k, Medonc starts at $250k! I really don’t understand the ridiculously low medonc academic salary when they can easily make $500k+ in private practice in any location they want!
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From what I've seen the trend has reversed. I don't want to say it's "easy" to make a million/yr as med onc, but it's definitely more in the realm of possibilities for them (now) than for us. Also, or perhaps on the other hand, in my opinion there tends to be a higher incidence of ascetic tendencies amongst med oncs versus rad oncs (but also more entrepreneurial tendency incidence in med oncs too!). I remember an academic med onc talking about his salary circa 1998 and it also being $250K/year. He said "That's plenty... how much is enough?"
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IMO, the difference between academic and PP medonc is so radical as to justify a big disparity, conversely, most academic radoncs are kinda doing PP type work with some research and teaching.
Many academic medoncs are on call 1-2 mos/year with a relatively low volume continuity clinic in one or two sites of disease. They are often running labs or spending a huge portion of their time on clinical research initiatives.
PP medoncs see 20+ patients per day every day but admin days. More and more they are having to manage a team of APPs much larger than them in their clinical work.
But yes, in my neck of the woods, medoncs get paid more than radoncs to start, and some have negotiated contracts well above any radonc ceiling.
The long term or indefinite administration of multiple targeted and IO therapies has just overwhelmed the system.
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Some of it might be due to the fear of seeing and keeping up with it all in private practice. I'm a fellow and several of my attendings went from the community to academia so they could focus on one organ.
Most definitely, rad onc has not kept up. Losing indications will do that to a specialty.
Academics I can’t comment on and frankly is irrelevant. Rad onc jobs being 50% academics is a real problem. Heme oncs can always work in community hospitals or private practice and make more than rad oncs in similar environments.
Academics I can’t comment on and frankly is irrelevant. Rad onc jobs being 50% academics is a real problem. Heme oncs can always work in community hospitals or private practice and make more than rad oncs in similar environments.
In academics here... at my hospital, rad oncs make more (about 40-50% higher for total comp for equiv academic ranking). I think this is highly variable and likely will change depending on management/comp plan, hospital to hospital
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Academic MO can increase salaries by "consulting" for industry. The means for MedOnc are consistently greater than RadOn on OpenPayments and many an academic MO supplements salary with payments of >$200K/year from industry
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It used to be that way here but they couldn't find any med oncs to take that salary. Now pretty much all of them have negotiated contracts for much more than the academic clinical educator rate.
When I was a resident, the med onc fellows were being recruited from day one with salaries double those I would be offered. I begged all over the country into two job offers. The med onc fellows could go wherever they wanted.
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I've never heard of med onc pay starting that low anywhere in several years
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Isn’t it great to double residency spots to fulfill the increased notewriting demand of our noble seniors?
At my hospital starting med onc salary is now par with rad onc for starting comparable positions (within 20k), however they receive significantly more support and flexibility in their practice setup (call duties, starting packages, disease site, % research / clinical). It’s a fairly big place so room for different roles. Thus there is tremendous flexibility on the med onc side and I’ve seen numerous folks craft or fit into a role that worked for them, which is absolutely the opposite of the rad onc side. I don’t know their top end salary, but there are a few who opted to be clinic heavy. They are extremely busy, and extremely happy when I talk in clinic.
At my hospital starting med onc salary is now par with rad onc for starting comparable positions (within 20k), however they receive significantly more support and flexibility in their practice setup (call duties, starting packages, disease site, % research / clinical). It’s a fairly big place so room for different roles. Thus there is tremendous flexibility on the med onc side and I’ve seen numerous folks craft or fit into a role that worked for them, which is absolutely the opposite of the rad onc side. I don’t know their top end salary, but there are a few who opted to be clinic heavy. They are extremely busy, and extremely happy when I talk in clinic.
...so can we, but probably not as much. I give educational talks for a few market research firms (but certainly not anywhere near 200k worth haha)
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It's all drug company money that they throw around.
The conflicts of interest I'm seeing are only getting worse and worse. At some institutions it's to the point where if you're not either working on patented/patentable drug development or extracting large amounts of money from pharma, your work isn't worth doing, NIH funded or not.
It's hard to get much out of rad onc companies. The amounts are generally small and you need to drink their coolaid in a hard and firm way that I find distasteful. The exception is if you have some blockbuster new device you can patent, but that's really hard in rad onc because it's a small market.
Surgery device suppliers to some extent can generate big revenues, but doesn't really apply to us.
The conflicts of interest I'm seeing are only getting worse and worse. At some institutions it's to the point where if you're not either working on patented/patentable drug development or extracting large amounts of money from pharma, your work isn't worth doing, NIH funded or not.
It's hard to get much out of rad onc companies. The amounts are generally small and you need to drink their coolaid in a hard and firm way that I find distasteful. The exception is if you have some blockbuster new device you can patent, but that's really hard in rad onc because it's a small market.
Surgery device suppliers to some extent can generate big revenues, but doesn't really apply to us.
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Rare but it can happen. Below is the biggest haul I am aware of.
Moderators I am not doxxing anyone.
This information is in the public domain (Open Payments) and I did not include the name but this person is a radiation oncologist.
If all things are equal in a private practice with respect to billing, collections, etc between specialties, from my experience there's overlap between medonc and radonc. The average radonc can make more than the average medonc, but if you want to be a Big Baller Med Onc, the ceiling is higher than it is for Rad Onc. Easier to build a huge practice, as we're limited by time for contouring, treatment review, supervision, etc, and we're downstream from Med Onc, so there are more patients earlier in the chain. MedOncs can hire NPs to manage a ton of patients, and getting chemo started is nothing more than entering an order.
Having said that, the ceiling in private practice is still very high for Rad Onc, and I love to contour, etc, so no ragerts here.
Having said that, the ceiling in private practice is still very high for Rad Onc, and I love to contour, etc, so no ragerts here.
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250k for a med onc is generally doing maybe 1-2 days a week in clinic and being 40-80% research/administrative. Vs Rad Onc at 370 is probably 4 if not 5 days in clinic.
50% of Rad Onc jobs are Hospital-employed. That includes academics but there is a significant proportion of folks that are NOT academic but are employed by a hospital (not a PSA, not shared revenue, etc.). Truly academic Rad Onc is less than 50%. And what defines 'Academic' Rad Onc? Does some research? Has a residency program? If the latter then it's an extremely small percentage of total rad onc jobs.
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It’s important to understand the answer to this kind of question now maybe very different in a few years. I used to make about 25% more than the medoncs at our academic center. Over the last 8 years, my pay has gone up about 35% from where I started which is pretty good for academics. Even with that, those same med oncs now make 15-20% more than me because of market forces.
In my experience, academic/employed vs private rad onc is a very different calculation than med onc. True private rad onc has a higher ceiling but typically comes with seeing more patients and staying a lot busier than most academic rad oncs. I know of vanishingly few academic/employed rad oncs I would consider truly maxed out clinically. I am happy to trade earning potential for a bit more of a relaxed day. Academic med oncs? I know a lot who are constantly one step away from burnout. The patient volumes can be crazy high. Academic vs private med onc also has a sizable difference in pay ceiling but much smaller difference in clinical volume. As a result, it’s becoming a harder sell for new grads and many centers, including our NCI CCC (and the one I graduated from) are having trouble staying fully staffed for med Onc. It took longer than it should, but these places finally started paying them closer to what they should because they had to.
Notice I didn’t mention a 60% expansion in fellowship positions as a solution to the problem…
In my experience, academic/employed vs private rad onc is a very different calculation than med onc. True private rad onc has a higher ceiling but typically comes with seeing more patients and staying a lot busier than most academic rad oncs. I know of vanishingly few academic/employed rad oncs I would consider truly maxed out clinically. I am happy to trade earning potential for a bit more of a relaxed day. Academic med oncs? I know a lot who are constantly one step away from burnout. The patient volumes can be crazy high. Academic vs private med onc also has a sizable difference in pay ceiling but much smaller difference in clinical volume. As a result, it’s becoming a harder sell for new grads and many centers, including our NCI CCC (and the one I graduated from) are having trouble staying fully staffed for med Onc. It took longer than it should, but these places finally started paying them closer to what they should because they had to.
Notice I didn’t mention a 60% expansion in fellowship positions as a solution to the problem…
