Fair Market Value

[deleted1002574]

With a lot of vague talk about salary/compensation/etc., what do people think is fair market value for a mid career non-academic radiation oncologist?

Presuming an average workload of 15-20 on beam with a mix of EBRT, SRS, palliative, curative cases, this is what I think is hypothetically fair market value (not a real job!!!) in a reasonable metro area. Think Kansas City or Pittsburgh or Albuquerque, not Rhinelander or San Francisco.

Salary + bonus - $450-500k
PTO (vacation + sick + CME) - 6 weeks
Benefits - 401k match, CME - $5000ish, and then obvious - health care, STD, malpractice

What do you think is reasonable?

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[w00tz]

Location?

 

[medgator]

Location?

Like real estate.... Location, location, location...

 

[deleted1002574]

Sorry for confusion. Clarified what I meant. It's not a real job. It's just what people's expectations of what a fair offer is.

 

[Reaganite]

I don't see how that could be FMV at too many places. If you only have 15 on beam you aren't generating the revenue to justify the numbers you're posting. (unless you're practicing in the middle of nowhere with contracts at 200% of Medicare).

 

[medgator]

Sorry for confusion. Clarified what I meant. It's not a real job. It's just what people's expectations of what a fair offer is.

I don't see how that could be FMV at too many places. If you only have 15 on beam you aren't generating the revenue to justify the numbers you're posting. (unless you're practicing in the middle of nowhere with contracts at 200% of Medicare).

Yet another reason location matters.

I cover multiple sites, one of which is in a different Medicare sub-district which actually pays a bit more. Even in the same state, Medicare can reimburse differently depending on where you are located.

In the competitive markets with lots of players, reimbursement can take a hit, as Reaganite has alluded to

 

[Burt Radnolds]

With a lot of vague talk about salary/compensation/etc., what do people think is fair market value for a mid career non-academic radiation oncologist?

Presuming an average workload of 15-20 on beam with a mix of EBRT, SRS, palliative, curative cases, this is what I think is hypothetically fair market value (not a real job!!!) in a reasonable metro area. Think Kansas City or Pittsburgh or Albuquerque, not Rhinelander or San Francisco.

Salary + bonus - $450-500k
PTO (vacation + sick + CME) - 6 weeks
Benefits - 401k match, CME - $5000ish, and then obvious - health care, STD, malpractice

What do you think is reasonable?

I think if you are more towards the 20 than the 15, this is fairly accurate. However the devil is really in the details. Number of consults and sims a year may be more enlightening. I know people who treat more towards 15 but have an srs/sbrt heavy practice who are clearing more.

 

[dogjam]

In my experience, an average of 15-20 on treat with a good mix of SRS, SBRT, IMRT, and palliative is probably close to average/median wRVUs (8-9k). Average wRVUs should mean average salary in an average location, so more like $500-$550 would be fair market value, IMO. PTO of 6 weeks is also FMV, IMO. CME 3k-5k.

 

[Mandelin Rain]

Depends on the setup. Employed? PSA?

Pending payor and treatment mix, you may collect about 700k for 20 on beam. But if you run your own, you have to pay malpractice, health insurance, retirement, practice management, billers, etc...

 

[deleted1002574]

This is helpful! Lot of insights here.

- Fair point about consults -> on beam. If you don’t HF at all, will take a lot less consults to get 15-20 on beam
- Brachy also adds/subtracts value depending on situation, I presume
- hospital based vs freestanding, as well
- There is definitely definitely differences - Reaganite says 15 isn’t enough, while radmonckey says could be clearing more with 15

The main idea of the post is that we need to figure out a way that’s better than MGMA to negotiate our contracts in a data driven way. The information asymmetry is not in our favor.

Perhaps a locked forum with verified non-anonymous sources may be a good idea? Or other options - off forum?

We have very little info to arm ourselves. I found when I did have good information, I was able to have admin grant me more. But it did need verification at times.

 

[Mandelin Rain]

With a decent payor mix I’d estimate 175k per year in collections per 5 patients on beam on average.

 

[Reaganite]

This is helpful! Lot of insights here.

- Fair point about consults -> on beam. If you don’t HF at all, will take a lot less consults to get 15-20 on beam
- Brachy also adds/subtracts value depending on situation, I presume
- hospital based vs freestanding, as well
- There is definitely definitely differences - Reaganite says 15 isn’t enough, while radmonckey says could be clearing more with 15

The main idea of the post is that we need to figure out a way that’s better than MGMA to negotiate our contracts in a data driven way. The information asymmetry is not in our favor.

Perhaps a locked forum with verified non-anonymous sources may be a good idea? Or other options - off forum?

We have very little info to arm ourselves. I found when I did have good information, I was able to have admin grant me more. But it did need verification at times.

Its just so practice and geography specific that its almost impossible to generate an estimate. Payor contracts in prime geographies can be as low as 30% of medicare vs. 200% in the boonies. Prof percentages can be quite variable too. (I've seen 18 to 30%). It also depends on your patient mix. (I.e. 20 breast vs 20 prostate on treat). From firsthand experience, 20 on treat in a super competitive geography with terrible contracts can be as low as 25-30k a month prof vs 60k + with co tracts at 125+ percent of medicare.

 

[Mandelin Rain]

If you’re getting 30% of Medicare.... I’m sorry.

 

[evilbooyaa]

This is helpful! Lot of insights here.

- Fair point about consults -> on beam. If you don’t HF at all, will take a lot less consults to get 15-20 on beam
- Brachy also adds/subtracts value depending on situation, I presume
- hospital based vs freestanding, as well
- There is definitely definitely differences - Reaganite says 15 isn’t enough, while radmonckey says could be clearing more with 15

The main idea of the post is that we need to figure out a way that’s better than MGMA to negotiate our contracts in a data driven way. The information asymmetry is not in our favor.

Perhaps a locked forum with verified non-anonymous sources may be a good idea? Or other options - off forum?

We have very little info to arm ourselves. I found when I did have good information, I was able to have admin grant me more. But it did need verification at times.

I will see what we can do about this along with the rest of the moderation staff. I agree that it may be a useful tool.

 

[bluebubbles]

Forgive my ignorance, but does career stage or seniority affect compensation in a clinical, non-academic practice environment? If a radiation oncologist in their 2nd year of practice generates the same RVU's as someone in their 22nd of practice, would their compensation be the same? Assume that seniority isn't associated with machine/practice ownership or administrative/leadership roles (e.g. medical director).

 

[OTN]

Forgive my ignorance, but does career stage or seniority affect compensation in a clinical, non-academic practice environment? If a radiation oncologist in their 2nd year of practice generates the same RVU's as someone in their 22nd of practice, would their compensation be the same? Assume that seniority isn't associated with machine/practice ownership or administrative/leadership roles (e.g. medical director).

Every practice is different.

In our practice, once you're a partner (usually 18 months to partner), everyone is paid via the exact same mechanism.

 

[Neuronix]

Forgive my ignorance, but does career stage or seniority affect compensation in a clinical, non-academic practice environment? If a radiation oncologist in their 2nd year of practice generates the same RVU's as someone in their 22nd of practice, would their compensation be the same? Assume that seniority isn't associated with machine/practice ownership or administrative/leadership roles (e.g. medical director).

OTN beat me to it. I will point out that 18 months is a really short partnership track. I don't know how to get a job where he works. Almost everything else I've seen has been 3+ years or professional "partner" only.

But the answer depends on your specific job. A lot of places have a set salary for your first few years in practice until you're past your trial period or make partner or whatever it's called. Obviously this has its share of risks, like not making partner and being forced out, the practice changing ownership and you not getting what you were promised, getting dumped on while it's "free" for the practice, etc... But in this job market beggars can't be choosers.

 

[Mandelin Rain]

There are definitely predatory groups, as above. These are usually small and hire every couple years. You can suss them out pretty easily. Most large, stable groups are equitable and people stay because they are treated fairly/as promised.

 

[seper]

In my experience, in hospital-employed situations, senior people do get paid considerably more for a given effort. It is simply the result of usual workplace politics. By you 22nd year in practice, you get to know your administrators and exchange favors.

Forgive my ignorance, but does career stage or seniority affect compensation in a clinical, non-academic practice environment? If a radiation oncologist in their 2nd year of practice generates the same RVU's as someone in their 22nd of practice, would their compensation be the same? Assume that seniority isn't associated with machine/practice ownership or administrative/leadership roles (e.g. medical director).

 

[Mandelin Rain]

In my experience, the shelf life of a hospital administrator is about 2 years. They come and go much more rapidly than docs. By the time I've formed a relationship with someone, they have "retired" or "moved on" or some other euphemism for fired for not skimping enough.

 

[seper]

I'm talking board-level administrators - "President of Cancer Service" or alike. Both places I've worked for had them in those positions for a while.

In my experience, the shelf life of a hospital administrator is about 2 years. They come and go much more rapidly than docs. By the time I've formed a relationship with someone, they have "retired" or "moved on" or some other euphemism for fired for not skimping enough.

 

[deleted573262]

Talk about bad job market. Here's an opportunity to live (outside) Atlanta making 250k a year and covering locums sites as needed. wow.

'associate OR radiation OR oncologist OR STATECODE:"GA"' Jobs | ASTRO Radiation Oncology Career Center

2,336 'associate OR radiation OR oncologist OR STATECODE:

careers.astro.org

 

[OTN]

That's not entirely fair. The job posting says $250-$450k and that income may increase along with production. The devil is in the details when it comes to all jobs, and we don't have many about this one.

 

[medgator]

That's not entirely fair. The job posting says $250-$450k and that income may increase along with production. The devil is in the details when it comes to all jobs, and we don't have many about this one.

Tbh, I've seen that group post jobs multiple times the last few years. Makes me wonder if that's the malignant/sketchy group I've heard about in the Atlanta metro

 

[deleted1002574]

It’s the McCord brothers. Churn and burn. I’d stay away

 

[OTN]

It’s the McCord brothers. Churn and burn. I’d stay away

There you go, there are the details...and it looks like the devil certainly is there.