This post is obviously in response to my comments, so I will respond directly.
Yes, it appears that my standards are too high. The standard should be that we view ourselves as an equal part of the team of providers and a "team player" along with the dosimetrist, nurse, RTT, etc, regardless of how much we have invested in it and what the stakes are for us. I was misled when I chose to go to medical school and learn a profession over working my way up through a corporation for the first 20 years of my working life. Now I have come out starting my career at what otherwise would have been the halfway point in my working life and am again facing the exact scenario I was trying to avoid in the first place: Working for corporation as a standardized, certainly not special in any way at all, employee.
I was again misled when I chose to train in radiation oncology. I did not understand that being able to practice my trade I spent a decade learning would require "Yes, boss, no boss, right away boss" with multiple layers of administrative financial decision-making that I am not allowed to be part of between how my services and charged and collected before and how I am compensated for my work with a large part siphoned off by these administrators.
I should clarify that my comments about desiring to have control over my schedule, and other basic historical tenets of physician autonomy, when negotiating an agreement with a hospital are really focused in a situation where I would be the only radiation oncologist. Of course, if I were walking into an environment where there were multiple physicians I would expect that we would make decisions like this co-operatively, as the physicians, as true peers.
You are right. The hospitals and universities desire to employ us directly as providers, not independent physicians, that they completely control. Expectations otherwise will potentially result in an inability to earn a living as a radiation oncologist as this largely requires "employment" in this field. The degree to which they are willing to grant you autonomy is largely a degree of just how rural and difficult-to-recruit the position is. With the oversupply of radiation oncologists and the bloated locums market, we will still lose opportunities in god-forsaken places when we push for either professional and/or financial autonomy in negotiating with hospitals. This is not news to me as I've personally squirmed through every nuance of it. I pushed for autonomy at my first employer, therefore wasn't a "team player", threatened to quit as I knew they couldn't replace me, and they let me walk out the door with zero effort to retain me. They've had revolving locums for years afterwards and the clinic is a disaster. They don't care. It still makes money and locums are easy to get and even easier to control.
So, while I may have naively had unrealistic expectations of being an independent professional a decade ago, don't worry, I certainly don't now. It's not going to keep me from continuing to try, though.
