Dallas Private Practice job post on ASTRO

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Gfunk6

Gfunk6

And to think . . . I hesitated
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This job was just posted on the ASTRO board. I think it does an absolutely fantastic job of encapsulating what it takes to succeed in private practice.

SEASONED PRIVATE PRACTICE RADIATION ONCOLOGIST

You are a relationship builder by nature. You love to form new connections and innovate ways to improve patient care. You understand and emulate the three “A’s” of private practice: availability, affability and ability. All three are required to begin to excel in the private practice world of this opportunity in a major metropolitan city market.

When you’re on a tumor board, it’s your tumor board. Whether it’s a hospital dominated by a competing private practice or run by a belligerent surgeon, you are at home. Since you are at home, you’re welcoming, friendly, humble, but don’t back down for what’s right.

You realize that the 8:00 to 5:00 world of radiation oncology is just a good clinical day of "beam-on" time. The rest is time you dedicate to getting yourself ready for the clinical day, attending breakfast tumor boards, building professional relationships before, during, and after clinic. Meeting physicians for dinner, drinks, golf, tennis, or whatever social activity helps you to build relationships is your central focus. This drive comes naturally to you. Strong relationships with the entire team of physicians is essential to the absolute highest level of personalized care for your patients.

If this is who you are as a physician, please send your resume to [email protected]. Upon review of your resume, additional information may be provided during the interview process. Thank you for all that you do everyday.
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So residents don't get the wrong idea; not all private practices expect you to buy your referrals with court side tickets and expensive bottles of wine shared over awkward dinners. In fact, this is the kind of thing I'd be very wary of, less you happen to always fall just short of the expectation for partner while going broke trying to impress people with how awesome you are.

Many private practices have strong existing relationships with systems, other groups, and docs. When you "buy-in" to these groups, you're really buying into the relationships. Your job is to continue these positive relationships and grow them over time through competence. Show up to tumor boards, be knowledgeable, courtesy, and self-assured. Never say no to an opportunity to see a patient, even if you think it's superficially ridiculous. Preferably at the moment you're asked to see them if you're sharing a clinic.* Be nice to patients, smile at them, listen to them, help them understand their diagnosis and treatment (even their chemo/surgery/whatever), make their life easier. This will get back to whomever referred them to you, and it will stick in their memory longer than some transparently desperate dinner you shared.

My 2 cents.

* This is easier than you think. It takes 5 minutes to familiarize yourself with the basics of their diagnosis, walk in to a room, introduce yourself and your role on the care team, state that you believe they may benefit from radiation for reasons x, y, z and you'd like them to be scheduled for a more robust conversation of what that will entail and a planning simulation tomorrow at a time convenient to them. Everyone walks out of the room feeling good about the interaction (patient, med onc, you), and you have not buried yourself in an otherwise busy day.
 
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I agree with MR re: golfing, dinners, etc. In my experience we're all looking to get back to our families and non-medical friends after work, and with so many dinners and meetings, I'd be annoyed with a consulting doc if they kept badgering me for my free time. I have done a bit of that with a few referring docs with whom I've genuinely become friends, but it's not the best for everyone. Have to adapt to your market/referring doc.

However, that doesn't mean no marketing at all- quite the contrary. Going to all tumor boards (I've had as many as 6 in one week, with 4 of those at 7 am), going to clinics to talk with doctors and market yourself, accepting every consult immediately, working to stay on top of new treatments/data to share with referring docs...these are more or less prerequisites as far as I'm concerned. I do like how the ASTRO job post emphasizes practice-building, like MR I just don't want everyone to get the impression this is something all private practices are doing/have to do in their market.
 
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This job sounds awful! I’ll take my hospital employee salary any day. I only have to kiss ass 8 hrs a day.
 
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OTN said:
. Going to all tumor boards (I've had as many as 6 in one week, with 4 of those at 7 am), going to clinics to talk with doctors and market yourself, accepting every consult immediately, working to stay on top of new treatments/data to share with referring docs....
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I'll add... reverse referrals to referring docs. Hugely important in the PP world (assuming one has a practice in an area where independent physicians still exist)

I will sometimes send my PEG (and port) referrals to my favorite general surgeon at the same time I refer to medonc (rotating of course) for chemo for my H&N patients. I always send my pulmonologist definitive lung patients for copd eval and baseline pfts if they weren't seen through pulmonary first etc. I sometimes even send snowbirds to establish primary care with it my preferred pcps etc.
 
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medgator said:
I'll add... reverse referrals to referring docs. Hugely important in the PP world (assuming one has a practice in an area where independent physicians still exist)

I will sometimes send my PEG (and port) referrals to my favorite general surgeon at the same time I refer to medonc (rotating of course) for chemo for my H&N patients. I always send my pulmonologist definitive lung patients for copd eval and baseline pfts if they weren't seen through pulmonary first etc. I sometimes even send snowbirds to establish primary care with it my preferred pcps etc.
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Truth.
 
I saw that posting in my email and thought what a ridiculous job description for a rad onc. Like your whole life is either being in the clinic while required or trying to drum up business by hobnobbing and schmoozing. Some of that is important for sure as well as the 3A's but the posting comes off as being a little over the top.
 
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fiji128 said:
I saw that posting in my email and thought what a ridiculous job description for a rad onc. Like your whole life is either being in the clinic while required or trying to drum up business by hobnobbing and schmoozing. Some of that is important for sure as well as the 3A's but the posting comes off as being a little over the top.
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Don't hate the PP player. Hate the PP game
 
Don't forget...

If places such as this have a heavy emphasis on wining and dining referring docs and reeling in new patients, how do you think they're going to respond when their new hire wants to treat a prostate, 60 Gy in 20 fractions, down from their "tried and true" standard of 81 Gy in 45 fractions?

There can potentially be a lot of regressive baggage that comes along with a place that emphasizes the "business of medicine." In my experience, this can often (but not always) lead to a de-emphasis of the "medicine of medicine."

Make sure your priorities align before venturing forth...
 
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Gfunk6 said:
Wow, not quite the response I anticipated. Maybe ASTRO is correct to push for all Rad Oncs to be salaried and employed in academic satellites.
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I don't know, maybe I'm reading into all wrong but it seems a bit extreme on one end of the spectrum. I understand that there is a PP type and you have to do what you need to do in order to be successful but this post just seems to rub me the wrong way like as the poster said above me, your life is the clinic. I'm sure if you have a "heated discussion" with one of the referring docs, this employer wouldn't mind throwing you under the bus in order to maintain a good business relationship.
 
There is a lot of hyperbole, misinformation and uneducated opinions on this thread. You can run an entrepreneurial and successful private practice without violating Stark and without bribing your referring physicians.

There is an art to private practice where you can grow your practice and *gasp* still hold firmly to high standards of ethical, moral and legal conduct.
 
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RollTideRadOnc said:
Don't forget...

If places such as this have a heavy emphasis on wining and dining referring docs and reeling in new patients, how do you think they're going to respond when their new hire wants to treat a prostate, 60 Gy in 20 fractions, down from their "tried and true" standard of 81 Gy in 45 fractions?

There can potentially be a lot of regressive baggage that comes along with a place that emphasizes the "business of medicine." In my experience, this can often (but not always) lead to a de-emphasis of the "medicine of medicine."

Make sure your priorities align before venturing forth...
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If you can bring home the bacon, so to speak, you will partner in. When you partner in, no one is going to tell you how to treat your patients. Gfunk is absolutely correct regarding the FUD on this thread
 
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there is also an art to drafting a job post that does not come across as confrontational
 
radiaterMike said:
there is also an art to drafting a job post that does not come across as confrontational
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I equate the job post to an academic center's example on what entails an outstanding resident... "Someone who will do all my scut work while publishing papers for four years."
 
I find the post a bit over-the-top, but as someone running a successful PP group, I understand where they are coming from. I've put out ads myself, and I've always wondered how aggressively I should stress the affability part of the 3 A's since it really is so critical to private practice, particularly in concentrated geographies. I've definitely wasted time interviewing candidates who I knew almost immediately would not be a good fit for my group personality-wise. Honestly, I think the post is probably just doing prospective applicants a favor. Assuming a baseline level of capability (i.e. board certified), personality trumps CV any day of the week for me and many people I know in PP.
 
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medgator said:
If you can bring home the bacon, so to speak, you will partner in. When you partner in, no one is going to tell you how to treat your patients. Gfunk is absolutely correct regarding the FUD on this thread
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Does bringing home the bacon equate to (at times) treating more fractions for the sake of it?
 
evilbooyaa said:
Does bringing home the bacon equate to (at times) treating more fractions for the sake of it?
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No. I'm talking new patient referrals. As many on this forum can tell you, it is very possible to be successful in PP and follow EBM/guidelines for treating patients. No one tells me how many Fx to give pt XYZ, and quite frankly I've only heard of scenarios like that when someone isn't partnered in yet. Honestly, I would see such action as a big red flag to staying on at such a practice.

My point was that it's a lot different trying to generate business in an employed model at a hospital or academic center vs PP/freestanding environment. If you are considered good enough to be partnered in, no one is going to tell you how to treat your patients.

The post is a bit to the point, but as Reaganite said, I think they are trying to do prospective applicants a favor.
 
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As an entrepreneurial person who always thought he would go for a partnership track private practice position, I decided to sign with a hospital. Excellent base salary, excellent production bonus, excellent benefits, no worries about paying for your own vacation/losing income when you're away, and none of these other expectations. Only downside is some loss of autonomy. But in the pre-partnership period, what autonomy do you really have? And we all know not all partnerships are the same and partners are often not equal/independent. I will be getting paid more than double year one what I was offered as an associate at private practices. My year one salary will be at least if not more than partner income at these places. Maybe I'm missing something, but I don't many upsides of going freestanding PP. Higher risk without commensurate reward.

Regardless, the language of that job add should raise a few red flags for everybody. I am surprised that people are looking at that and thinking, hmm... that seems fine.
 
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medgator said:
No. I'm talking new patient referrals. As many on this forum can tell you, it is very possible to be successful in PP and follow EBM/guidelines for treating patients. No one tells me how many Fx to give pt XYZ, and quite frankly I've only heard of scenarios like that when someone isn't partnered in yet. Honestly, I would see such action as a big red flag to staying on at such a practice.

My point was that it's a lot different trying to generate business in an employed model at a hospital or academic center vs PP/freestanding environment. If you are considered good enough to be partnered in, no one is going to tell you how to treat your patients.
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But isn't that in and of itself a concern? What happens if I join a PP and one of the partners tell me all bone mets have to get 10 (or god forbid, 15) fractions regardless of clinical situation? Do I have to listen or face scrutiny/punishment because I'm not listening to the partners on how to treat? How many years until I make partner in that group? One year more than the year they sell off to the local tertiary referral center and we all become satellite "assistant professor"?

This is not to hate on PP. However, if PP is routinely telling any of their employees how to treat in terms of fractionation, I think that's a significant problem.
 
evilbooyaa said:
But isn't that in and of itself a concern? What happens if I join a PP and one of the partners tell me all bone mets have to get 10 (or god forbid, 15) fractions regardless of clinical situation? Do I have to listen or face scrutiny/punishment because I'm not listening to the partners on how to treat? How many years until I make partner in that group? One year more than the year they sell off to the local tertiary referral center and we all become satellite "assistant professor"?

This is not to hate on PP. However, if PP is routinely telling any of their employees how to treat in terms of fractionation, I think that's a significant problem.
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Completely agree. I faced such pressure in my first practice (which I left) and did not in my current, where I am a partner.

I do hear of stories where a (former) partner used to give 20 fx for bone met. Hopefully the smarter practices understand the importance of evolution and sticking to guidelines and EBM. If they don't, it's a big red flag to leave
 
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KHE88 said:
As an entrepreneurial person who always thought he would go for a partnership track private practice position, I decided to sign with a hospital. Excellent base salary, excellent production bonus, excellent benefits, no worries about paying for your own vacation/losing income when you're away, and none of these other expectations. Only downside is some loss of autonomy. But in the pre-partnership period, what autonomy do you really have? And we all know not all partnerships are the same and partners are often not equal/independent. I will be getting paid more than double year one what I was offered as an associate at private practices. My year one salary will be at least if not more than partner income at these places. Maybe I'm missing something, but I don't many upsides of going freestanding PP. Higher risk without commensurate reward.

Regardless, the language of that job add should raise a few red flags for everybody. I am surprised that people are looking at that and thinking, hmm... that seems fine.
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On average private practitioners will make more than employed physicians, no doubt, so it's more than fair to say on average most will take an income hit to be employed, as should be expected. With less risk comes less return.
 
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In most private practices, there is neither the explicit expectation to over treat patients nor wine-and-dine referring doctors for patients every night.

I work in a private practice setting and if either of these things is of such importance to a practice that they'd place it in their ad, I'd keep looking. But I guess, that's what they're hoping.

In my mind, the ad could just as easily read, "Must be interested in hustling your ass off for 4 years so that the partners can skim your professional/technical fees without ever showing you how much they've skimmed. If you make them enough money without quitting or dying, you stand a 50% chance of being made a junior partner where you'll be able to skim someone else's collections, but just not to the degree of the founding partners who haven't stepped into a clinic in 3 years."

Maybe that's just me reading into it way too much.
 
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KHE88 said:
Regardless, the language of that job add should raise a few red flags for everybody. I am surprised that people are looking at that and thinking, hmm... that seems fine.
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I don't see a problem with it. What do competitor hospitals do? They have war chests to purchase billboards all over town. They can give medical directorship stipends to important referring docs. They have "nurse navigators" who drive business to oncology groups loyal to the hospital. They buy out all the medical oncology groups and PCPs in the area. They have leverage in contract negotiations with local medical groups (i.e. if you don't give us the radiation business, we're gonna jack up our inpatient prices). I mean, the deck is so insanely stacked against us in PP right now, but we're still concerned about an ad looking for an affable physician to combat all of the above? What's described in that ad is exactly what is needed to take down the hospital machine in some areas.
 
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It seems like the job poster got what they were looking for and able to weed out the ones who are truly interested without wasting anyone’s time.

To whoever takes this job, please let us know how it works out... I wish all the best!
 
Reaganite said:
I don't see a problem with it. What do competitor hospitals do? They have war chests to purchase billboards all over town. They can give medical directorship stipends to important referring docs. They have "nurse navigators" who drive business to oncology groups loyal to the hospital. They buy out all the medical oncology groups and PCPs in the area. They have leverage in contract negotiations with local medical groups (i.e. if you don't give us the radiation business, we're gonna jack up our inpatient prices). I mean, the deck is so insanely stacked against us in PP right now, but we're still concerned about an ad looking for an affable physician to combat all of the above? What's described in that ad is exactly what is needed to take down the hospital machine in some areas.
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I don't think we're concerned about the ad, I just don't want those interested in private practice to think that kind of practice building is perfect for all practices. Different practices and different locations call for different strategies. I can say with confidence that the old-school "wining and dining" kind of marketing is kind of looked down upon in our city, as it was exclusively done by the...how do I say this...less robustly-developed private practice in town. That practice did survive for years on that kind of marketing, but the sophistication of private practices in this town has progressed to the point where that kind of marketing isn't going to get it done. Refurbishing a crappy $400k machine, barely doing IMRT, not offering SRS/SBRT/HDR, but wining and dining their ass off worked for decades, but that practice is no longer around. We (the competing practice) focused on offering what they could not- high-quality modern radiation therapy, hammered the point home, and it worked.

Now, we're in a different locale, and while we do have one hospital-based program in town, neither of the other large hospital systems in town has developed an oncology service line, due to the size and overwhelming strength of the private practices already here. That's probably why we need to use the strategies we do to market, but that's the point: all politics is local.

So, what do we do? Other practices (primary care usually) in town care about their costs, so around here you have to show you provide value-based care, but at the same time offer enrollment in clinical trials, offer ancillary services, host support groups, host your own tumor boards, on and on. You have to be able to provide state-of-the-art care, do SRS/SBRT/HDR, etc. You DO have to be available at all times right away to see any patient at any time, you DO have to go to each and every tumor board, and that does lead to the job being much more than an "8 to 5" kind of deal, as really should be expected.
 
Baws said:
This **** job description is still looking for someone ... go figure

Maybe if they add, "ready to sacrifice their spouse" it'll be more attractive
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“Willing to eat their young.” Literally, eat what you kill!
 
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I read the job posting again just to get a good laugh. Like a bad army recruiting poster.
 
If you change just this part of the post: "Meeting physicians for dinner, drinks, golf, tennis, or whatever social activity helps you to build relationships is your central focus." to "Meeting your chairman for dinner, drinks, golf, tennis, or whatever activity to help build your relationship with him/her, presenting, leading a subcommittee, schmoozing with physicians at ASTRO, RTOG, and other scientific meetings, spending your time publishing scientific journals, dedicating your time to successfully apply for RO1 grants is your central focus", and keep everything else the same, then you got the perfect description of what it takes to succeed in an academic practice.

You will need to look beyond your 8a to 5pm lifestyle schedule if you want to succeed in any professional path you take. All I see here is a more vocal group of people who have different motivations, which is absolutely fine IMO, but please do not throw mud at those who see success in a different way.
 
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cancer_doc said:
If you change just this part of the post: "Meeting physicians for dinner, drinks, golf, tennis, or whatever social activity helps you to build relationships is your central focus." to "Meeting your chairman for dinner, drinks, golf, tennis, or whatever activity to help build your relationship with him/her, presenting, leading a subcommittee, schmoozing with physicians at ASTRO, RTOG, and other scientific meetings, spending your time publishing scientific journals, dedicating your time to successfully apply for RO1 grants is your central focus", and keep everything else the same, then you got the perfect description of what it takes to succeed in an academic practice.

You will need to look beyond your 8a to 5pm lifestyle schedule if you want to succeed in any professional path you take. All I see here is a more vocal group of people who have different motivations, which is absolutely fine IMO, but please do not throw mud at those who see success in a different way.
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Compassionate, thoughtful, efficacious care of patients is my primary focus, always will be, not schmoozing. Sure chumming up with referring docs can be a secondary focus, and I agree it can be important at times, means to an end and all that, but once it surpasses patient care, you are compromised.
 
Gfunk6 said:
I know the academic guys may be flabbergasted, but it is possible to be a compassionate evidence based physician and also be entrepreneurial, social and ambitious.
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I totally agree with you and gator. It it is not only possible but necessary for success in many positions, including my own. The post just rubs me wrong to come out and say that schmoozing is the primary objective, not patient care.

You can do both extremely well, but people are fooling themselves if they claim there's no way its ever going to get in the way of patient care if you aren't careful. You can definitely take it too far and it can almost become a subconscious thing that you are not aware of. I run into situations all the time where a referring doc has an overall plan that isn't terrible, but maybe not the best choice for the patient. I try to get very creative to discuss the case and float my idea without pissing them off, it's almost an art form to its self. However, I know for a fact some people just stick their head in the sand and go along with it. Part of private practice is choosing these battles and massaging egos. However, if your priority was schmoozing first, patients second, then you might choose the cowardly route.

I actually don't think the post is that insane if they just toned it down the slightest amount. It's a dog eat dog world out there, and you can't just sit back and cash checks.
 
I agree that relationship and referral base building are an integral part of private practice.

What strikes me odd about that job ad is the absolute lack of detail about the position. I agree with some of the other posters here. A radiation oncology position can never be 100% about personality, and I'd be really scared if it were.

In my limited job search experience, the positions that were very short on details were also the ones that were the worst opportunities when you looked into them. They may then portray the applicant as not the right "personality" because they're not willing to be a sucker.

I'm not saying that's the case with this ad, but it strikes me that way.
 
@radmonckey

It appears that we basically agree.

When I first started private practice, I naively thought, "I will practice very evidence-based medicine, follow national guidelines, be clinically meticulous and kind to patients and that's all I need to advertise myself."

One of the hardest lessons that I've learned is that virtually nobody outside the field of Radiation Oncology truly recognizes the difference between a "poor," "average," or "exceptional" RO MD. I mean, we can't even decide how to classify ourselves! What is a "great" Radiation Oncologist? Do they have to have national leadership positions (e.g. ASTRO, ACR, ABR)? Local leadership positions (e.g. Medical Director, Chief of Staff)? Is enrolling patients in clinical trials a surrogate for quality? Do only people in accredited facilities (e.g. ACR, APEX) count?

In addition to doing what I first thought when I started, here are other elements which are absolutely required for success:

1. Show up to tumor boards (as many as possible) and speak up. When challenged, don't back down - present your evidence. When other people stay stupid stuff, professionally call them out on it.
2. When a referring MD sends a consult your way, drop everything to get that patient in fast. It doesn't matter if records will take a while to obtain or if your schedule is already full.
3. You have got to socialize with your referring MDs - I realize that this is difficult and may seem unnatural to introverted people (like me); however, it is essential. This can take many forms including participation in social charity events, evening libations, or even idle chatter in physician lounges. I can tell you without shame that the referring MDs that send me the most patients have the best relationship with me.

It seems like in the Dallas Private Practice ad in question, #3 on the above list was emphasized above #1 and #2.. It may be market variability.

The bottom line is that if you have ambition, want to earn more money and become a leader, you can't do it by sitting in your department all day waiting for your patients to walk through the door.
 
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My take is the post is "dog whistling." GFUNK has some legitimate points, but given the overall context of the post, and my experience in this field, my guess is that this guy is likely to be a total Dbag. It is like asking salary within the first 30 seconds of a job interview. You can make a lot of arguments why that is logically appropriate, but social norms dictate that this is unbecoming.
 
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radmonckey said:
Compassionate, thoughtful, efficacious care of patients is my primary focus, always will be, not schmoozing. Sure chumming up with referring docs can be a secondary focus, and I agree it can be important at times, means to an end and all that, but once it surpasses patient care, you are compromised.
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Everything you indicated in your first sentence are inherent requisites and as basic as needing to have an MD and graduating from an accredited residency program to be a good radiation oncologist. Everything I and others like me are stressing is beyond that, on top of of all that you are emphasizing, the qualities to be SUCCESSFUL will require additional skill sets, a relentless pursuit towards that goal, and acceptance that it requires more than an 8-5 mindset to achieve that, regardless of which path you take.
 
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cancer_doc said:
Everything you indicated in your first sentence are inherent requisites and as basic as needing to have an MD and graduating from an accredited residency program to be a good radiation oncologist. Everything I and others like me are stressing is beyond that, on top of of all that you are emphasizing, the qualities to be SUCCESSFUL will require additional skill sets, a relentless pursuit towards that goal, and acceptance that it requires more than an 8-5 mindset to achieve that, regardless of which path you take.
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Please read my follow up post. You are completely missing my point and basically misquoting me that these other attributes don't matter. I completely acknowledge that just clocking in is not nearly enough to SUCCEED in any situation. However, you can achieve success, however you define it, both ethically and unethically. You seem to have an awful lot of faith in the human race and the ability of the medical school and residency process to instill these qualities and weed out the bad eggs. I don't think the process produces a factory line of perfect practitioners of medicine by any stretch, but maybe I'm too much of a skeptic.
 
c
radmonckey said:
You seem to have an awful lot of faith in the human race ...
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First of all, I still do, with realistic vigilance :)

Second, I must admit, It is fascinating how you and others took this job post from point "A", which is describing qualities this individual is looking for in a candidate, and projected it to point "B", which is a critique (dare I say venting) of ethical issues and characterization of this individual's motives based on your own assumptions and biases.
 
cancer_doc said:
c


First of all, I still do, with realistic vigilance :)

Second, I must admit, It is fascinating how you and others took this job post from point "A", which is describing qualities this individual is looking for in a candidate, and projected it to point "B", which is a critique (dare I say venting) of ethical issues and characterization of this individual's motives based on your own assumptions and biases.
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Forgive me for thinking our main objective was to take great care of patients. Silly me! My primary objective should be achieving success no matter the cost.

Also, you seem equally anxious to make assumptions about me and my motives, when in one of my posts I actually said "I actually don't think the post is that insane if they just toned it down the slightest amount. It's a dog eat dog world out there, and you can't just sit back and cash checks." That doesn't exactly sound like a scathing review of the job post does it? Please stop cherry picking my comments to fit your agenda...
 
radmonckey said:
Forgive me for thinking our main objective was to take great care of patients. Silly me! My primary objective should be achieving success no matter the cost.

Also, you seem equally anxious to make assumptions about me and my motives, when in one of my posts I actually said "I actually don't think the post is that insane if they just toned it down the slightest amount. It's a dog eat dog world out there, and you can't just sit back and cash checks." That doesn't exactly sound like a scathing review of the job post does it? Please stop cherry picking my comments to fit your agenda...
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I don't share any mutual urge to hijack this thread. Feel free to feel how you feel my friend. :D
 
Gfunk6 said:
@radmonckey

It appears that we basically agree.

When I first started private practice, I naively thought, "I will practice very evidence-based medicine, follow national guidelines, be clinically meticulous and kind to patients and that's all I need to advertise myself."

One of the hardest lessons that I've learned is that virtually nobody outside the field of Radiation Oncology truly recognizes the difference between a "poor," "average," or "exceptional" RO MD. I mean, we can't even decide how to classify ourselves! What is a "great" Radiation Oncologist?
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In pp, I believe a great RO private practitioner is one who can generate a wide spectrum of referrals/business without consistently being fed by a med onc.

I practice in a large combined community-based MO/RO group and I take pride in all of the outside non-MO business I generate for the practice. We keep a track of referrals from a marketing perspective and the weakest RO in our group sees the least number of consults overall and as a % receives a much greater share from our own internal MO partners.
 
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I'm shocked that emphasizing the expectation that "work never stops" was an unsuccessful approach. I do appreciate the complete 180 to "Love your life outside clinic with our work-life balance."

Best I can say is, "Buyer Beware."
 
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