Building Practice

[HemeOnc2029]

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Hi all. I was hoping to get general feedback on developing my practice. After considering academic positions in my Med Onc area of focus, I ended up taking a position in a growing satellite practice of a relatively large cancer institute and very large medical system, but albeit in an area with a good amount of competition. I am about 1.5 months in and I am continuing to see mainly benign heme. I was obviously told that I would be subspecializing in my area, but that seems to be very slow. Like at most 4-5 new Onc patients a week and half the time those are folks I saw on call in the hospital. Other folks who have been here a few years seem to have a mix of benign heme and Onc mostly in their area of focus. I have met the surgeons in my area of focus, as well the rad Oncs to try to increase referral flow. I was hoping to see how long it took folks in similar positions to build their practice and how long I should really be patient with the ramp up period. While I trained at a large academic center, I was only mildly/moderately active in research, so I did not expect to be seeing just one cancer for the rest of my career or something like that.

The last thing I want is to end up being the girl that everyone dumps their benign heme on. Thank you!

 

[gutonc]

Hi all. I was hoping to get general feedback on developing my practice. After considering academic positions in my Med Onc area of focus, I ended up taking a position in a growing satellite practice of a relatively large cancer institute and very large medical system, but albeit in an area with a good amount of competition. I am about 1.5 months in and I am continuing to see mainly benign heme. I was obviously told that I would be subspecializing in my area, but that seems to be very slow. Like at most 4-5 new Onc patients a week and half the time those are folks I saw on call in the hospital. Other folks who have been here a few years seem to have a mix of benign heme and Onc mostly in their area of focus. I have met the surgeons in my area of focus, as well the rad Oncs to try to increase referral flow. I was hoping to see how long it took folks in similar positions to build their practice and how long I should really be patient with the ramp up period. While I trained at a large academic center, I was only mildly/moderately active in research, so I did not expect to be seeing just one cancer for the rest of my career or something like that.

IME in a similar practice environment, roughly 3-4 years until the majority of my practice was in my clinical area of interest. Required lots of face time in surgery clinics, offering to give talks and being the loudest and most data driven/up-to-date med onc to speak up at tumor boards

The last thing I want is to end up being the girl that everyone dumps their benign heme on. Thank you!

Don't worry, eventually you'll hire somebody else to dump all the BS benign heme onto.

 

[HemeOncHopeful19]

1.5 months in isn’t anything to worry about come back to us if you're 1.5 years and still unhappy. Normally I would say satellite clinic is a bait and switch but it the other docs have developed an area of focus it sounds more promising

 

[gutonc]

1.5 months in isn’t anything to worry about come back to us if you're 1.5 years and still unhappy. Normally I would say satellite clinic is a bait and switch but it the other docs have developed an area of focus it sounds more promising

Not all "satellite clinics" are the same. The one where I worked as part of the local university had 5 docs and we saw 4x the # of breast cancer cases, 2x the number of lung cancer and the same # of GI cases as the mother ship did with a total of 12 docs to do ~1/4 the amount of work. We were able to specialize because of the massive volume of cases that came in the door and the fact that we had 1 doc who liked GI, one who liked thoracic, one who liked heme mal, one who liked GU and one who liked breast. The rest of it got sprinkled in as needed.

The thing about community practice, that nobody in academia knows how to teach you about, is that practice building in the community is all about relationships. It's no longer just "refer to GI Onc" it's "refer to Dr. Gutonc". And getting dozens of referring docs to change their referral patterns takes time, patience and work.

 

[HemeOnc2029]

Thank you both!! Very good advice, I think I am going to work on being more out there with the appropriate referring surgeons and such.