Heme/Onc Job Offer Discussion

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Does anyone have good experience or know-how with private practices in the Northeast, specifically New York, New Jersey, Connecticut, or Pennsylvania that are hiring in the next year or two? I have seen NY Cancer and Blood and Astera Care as options but it seems that they are associated with OneOncology. Does anyone know of or work with more private groups that might be hiring? I’m currently a second year fellow
You youngins need to consider other parts of the country if you actually care about finding something that pays decently. Otherwise just accept your fate of being underpaid if you want to stay northeast.

Underrate areas:
MidWest (Iowa, Wisconsin)
PNW
Southeast (like southern VA, North FL)
Southwest

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You youngins need to consider other parts of the country if you actually care about finding something that pays decently. Otherwise just accept your fate of being underpaid if you want to stay northeast.

Underrate areas:
MidWest (Iowa, Wisconsin)
PNW
Southeast (like southern VA, North FL)
Southwest
PNW underrated in 2025?

You serious Clark?
 
You youngins need to consider other parts of the country if you actually care about finding something that pays decently. Otherwise just accept your fate of being underpaid if you want to stay northeast.

Underrate areas:
MidWest (Iowa, Wisconsin)
PNW
Southeast (like southern VA, North FL)
Southwest
Where do you move to make the most money if open to moving anywhere? (I dislike the entirety of the USA equally)
 
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Where do you move to make the most money if open to moving anywhere? (I dislike the entirety of the USA equally)
I mean areas like Iowa, Minnesota, ND paying around $500/hr or 5000-6000$ a day for Oncology shifts, In Illinois area seen around 4500-5000 aday.
 
I mean areas like Iowa, Minnesota, ND paying around $500/hr or 5000-6000$ a day for Oncology shifts, In Illinois area seen around 4500-5000 aday.
Nice why don’t more people move there to grind 300 shifts and make 1.8M/year?
 
Nice why don’t more people move there to grind 300 shifts and make 1.8M/year?
That's a LOT of oncological histories to read through, goals of care, multidisciplinary discussions, and answering "Is it from the cancer doc" or "what can i do about my fatigue". Your patients show up with a notebook to write in, even for the 20-minute follow-ups. This is not an outpatient specialty where you can churn and burn without burning yourself out.
 
I think most of us want something sustainable for years, not just a few months out of the year.
Most of us want a place for our families to settle down and be happy.
Most of us want access to other things outside of work nearby.
Therefore, you should not really be picking between

1) BFE 4 hours from airport, nothing else to do there, live next to cattle only, and make 2+ milly a year
2) Be broke working full time in an oversaturated city or location or where the houses cost 1.5 million for a 2 bed 2 bath


There are lots of jobs out there where people can work 4 days a week with 1 admin day, see 15-18 patients a day or maybe fewer, take 7-9 weeks off a year and still bring home a decent wage. They just happen to be in the second and third tier cities in the USA outside of the Northeast.

Here is a random list of cities from google for tier 3.
You can find really good oncology jobs in or within 1 hour of downtown of all of these below cities.

  • Albany, NY Metro
  • Atlanta, GA Metro
  • Baltimore, MD Metro
  • Baton Rouge, LA Metro
  • Birmingham, AL Metro
  • Charleston, SC Metro
  • Charlotte, NC Metro
  • Cincinnati, OH Metro
  • Cleveland, OH Metro
  • Dallas/Fort Worth, TX Metro
  • Detroit, MI Metro
  • Houston, TX Metro
  • Indianapolis, IN Metro
  • Las Vegas, NV Metro
  • Milwaukee, WI Metro
  • Nashville, TN Metro
  • New Orleans, LA Metro
  • Omaha, NE Metro
  • Orlando, FL Metro
  • Phoenix, AZ Metro
  • Pittsburgh, PA Metro
  • Research Triangle, NC Metro
  • Salt Lake City, UT Metro
  • St. Louis, MO Metro
  • Tampa, FL Metro
  • Twin Cities, MN/WI Metro
 
I think most of us want something sustainable for years, not just a few months out of the year.
Most of us want a place for our families to settle down and be happy.
Most of us want access to other things outside of work nearby.
Therefore, you should not really be picking between

1) BFE 4 hours from airport, nothing else to do there, live next to cattle only, and make 2+ milly a year
2) Be broke working full time in an oversaturated city or location or where the houses cost 1.5 million for a 2 bed 2 bath


There are lots of jobs out there where people can work 4 days a week with 1 admin day, see 15-18 patients a day or maybe fewer, take 7-9 weeks off a year and still bring home a decent wage. They just happen to be in the second and third tier cities in the USA outside of the Northeast.

Here is a random list of cities from google for tier 3.
You can find really good oncology jobs in or within 1 hour of downtown of all of these below cities.

  • Albany, NY Metro
  • Atlanta, GA Metro
  • Baltimore, MD Metro
  • Baton Rouge, LA Metro
  • Birmingham, AL Metro
  • Charleston, SC Metro
  • Charlotte, NC Metro
  • Cincinnati, OH Metro
  • Cleveland, OH Metro
  • Dallas/Fort Worth, TX Metro
  • Detroit, MI Metro
  • Houston, TX Metro
  • Indianapolis, IN Metro
  • Las Vegas, NV Metro
  • Milwaukee, WI Metro
  • Nashville, TN Metro
  • New Orleans, LA Metro
  • Omaha, NE Metro
  • Orlando, FL Metro
  • Phoenix, AZ Metro
  • Pittsburgh, PA Metro
  • Research Triangle, NC Metro
  • Salt Lake City, UT Metro
  • St. Louis, MO Metro
  • Tampa, FL Metro
  • Twin Cities, MN/WI Metro
May I ask what you're seeing in Atlanta? Looking around that area and having a hard time
 
Are the signing bonuses usually paid out when you sign the contract or on your first day of work? I’ve got a couple of kids and an extra 2K per month times 18 months would be big time.
 
Are the signing bonuses usually paid out when you sign the contract or on your first day of work? I’ve got a couple of kids and an extra 2K per month times 18 months would be big time.
Generally paid on day 1. But no reason why you can't ask for it to be distributed. You could also just DIY that by putting it in an HYSA and have it automatically transferred to your checking account on a monthly distribution.
 
Members don't see this ad :)
I think most of us want something sustainable for years, not just a few months out of the year.
Most of us want a place for our families to settle down and be happy.
Most of us want access to other things outside of work nearby.
Therefore, you should not really be picking between

1) BFE 4 hours from airport, nothing else to do there, live next to cattle only, and make 2+ milly a year
2) Be broke working full time in an oversaturated city or location or where the houses cost 1.5 million for a 2 bed 2 bath


There are lots of jobs out there where people can work 4 days a week with 1 admin day, see 15-18 patients a day or maybe fewer, take 7-9 weeks off a year and still bring home a decent wage. They just happen to be in the second and third tier cities in the USA outside of the Northeast.

Here is a random list of cities from google for tier 3.
You can find really good oncology jobs in or within 1 hour of downtown of all of these below cities.

  • Albany, NY Metro
  • Atlanta, GA Metro
  • Baltimore, MD Metro
  • Baton Rouge, LA Metro
  • Birmingham, AL Metro
  • Charleston, SC Metro
  • Charlotte, NC Metro
  • Cincinnati, OH Metro
  • Cleveland, OH Metro
  • Dallas/Fort Worth, TX Metro
  • Detroit, MI Metro
  • Houston, TX Metro
  • Indianapolis, IN Metro
  • Las Vegas, NV Metro
  • Milwaukee, WI Metro
  • Nashville, TN Metro
  • New Orleans, LA Metro
  • Omaha, NE Metro
  • Orlando, FL Metro
  • Phoenix, AZ Metro
  • Pittsburgh, PA Metro
  • Research Triangle, NC Metro
  • Salt Lake City, UT Metro
  • St. Louis, MO Metro
  • Tampa, FL Metro
  • Twin Cities, MN/WI Metro
I'm not sure where "Google" got those, but I'm not sure I'd consider ATL, HTX, DFW, LV, PHX, ORL, PITT, SLC and MSP as 3rd tier cities. And Albany, St Louis and Cleveland deserve to be demoted to tier 5 or 6.
 
Generally paid on day 1. But no reason why you can't ask for it to be distributed. You could also just DIY that by putting it in an HYSA and have it automatically transferred to your checking account on a monthly distribution.
Day 1 as in when you start working or when you sign? Sorry, I’m a bit dense.
 
Day 1 as in when you start working or when you sign? Sorry, I’m a bit dense.
I’ve usually seen it paid on your start date but I imagine you could negotiate it to your signing date at many places. I would caution you about singing (edit: signing, but probably don’t sing in clinic either) halfway through 2nd year, your goals may change unless you really know where you want to live
 
Are the signing bonuses usually paid out when you sign the contract or on your first day of work? I’ve got a couple of kids and an extra 2K per month times 18 months would be big time.
Traditional signing bonuses should usually be paid out within 30 days of your start date.

Some jobs will also offer a separate incentive in the form of a "fellowship stipend", which is what it sounds like you're looking for. Incentives are usually one of the more negotiable aspects of contract discussions, so if you find a place you really like that also really likes you, there could be some hope to improve your cash flow situation as a fellow.

That said, I agree with above that you shouldn't rush the job selection for this purpose.
 
I am planning to switch from hospital employed job to PP position with partnership track. What are some of the important things to look out for in a private practice? I will appreciate any input from someone in PP.
 
With any type of job there’s so many things it’s hard to point out.

Why don’t you tell us about your job and we can tell you where you may be getting screwed.

Edit: if it’s the job you posted about in April then we already covered it
 
Once partner 35 patients a day strictly RVU for 4 days a week approx , that would be 13,500 rvus if 4 weeks vacation. 1.35 mil if $100 / rvu

10% pro and 10% other incentives so around 1.5 mil?

With any type of job there’s so many things it’s hard to point out.

Why don’t you tell us about your job and we can tell you where you may be getting screwed.

Edit: if it’s the job you posted about in April then we already covered it
Yes, same US onc PP job that I posted in April. Base 400k with 2 years to partnership without buy in. Partners median comp is around 1.1-1.2 mil with 25 patients on average with 4 day work week. Is it ok to ask practice financials for last 2-3 years as this is something I haven’t asked yet. Just making sure I don’t get screwed.
 
Yes, same US onc PP job that I posted in April. Base 400k with 2 years to partnership without buy in. Partners median comp is around 1.1-1.2 mil with 25 patients on average with 4 day work week. Is it ok to ask practice financials for last 2-3 years as this is something I haven’t asked yet. Just making sure I don’t get screwed.

They are not going to open the books to you. You are not "buying in" in the typical way. If you were buying with money into the practice directly, yes they would have to show you all the numbers.
 
Yes, same US onc PP job that I posted in April. Base 400k with 2 years to partnership without buy in. Partners median comp is around 1.1-1.2 mil with 25 patients on average with 4 day work week. Is it ok to ask practice financials for last 2-3 years as this is something I haven’t asked yet. Just making sure I don’t get screwed.
Ideally they should, most wont. Only one practice I interviewed at were transparent and showed me the books, its not the norm. Best thing is to ask their most recent partners if they are open to sharing their salary range and amount of patient seen to get an idea. Otherwise if they dont tell you in this day and age, I would be ready to walk away. Some places I asked them to send me a random partners pay sheet with all identifiers hidden, again only one of them shared.
 
Ideally they should, most wont. Only one practice I interviewed at were transparent and showed me the books, its not the norm. Best thing is to ask their most recent partners if they are open to sharing their salary range and amount of patient seen to get an idea. Otherwise if they dont tell you in this day and age, I would be ready to walk away. Some places I asked them to send me a random partners pay sheet with all identifiers hidden, again only one of them shared.
This is pretty disappointing. Especially if you're looking at a fully RVU/ancillary based compensation system. For salaried/employed jobs, it makes a little more sense, but even in my prior hospital employed, community based position we provided the full compensation structure (base, wRVU target, $/wRVU, bonuses) as well as median physician compensation in the group for the prior fiscal year (adjusted for 1.0 FTE since many docs were <1.0 cFTE). That number was 10-15% higher than the base+bonuses that were more or less guaranteed.
 
This is pretty disappointing. Especially if you're looking at a fully RVU/ancillary based compensation system. For salaried/employed jobs, it makes a little more sense, but even in my prior hospital employed, community based position we provided the full compensation structure (base, wRVU target, $/wRVU, bonuses) as well as median physician compensation in the group for the prior fiscal year (adjusted for 1.0 FTE since many docs were <1.0 cFTE). That number was 10-15% higher than the base+bonuses that were more or less guaranteed.
I think that’s different from what people mean by “showing the books” though. My current PP group is (unreasonably IMO) somewhat paranoid regarding our books and considers them on the level of trade secrets that our competition would want to use against us. I doubt we would be willing to show a potential hire the books but once you are on the partner track then our CFO will sit down and go over them with you before you make that commitment.

I doubt your hospital willingly showed your colleagues how much “non”-profit they were making off their Onc group (though IIRC you were in a directorish position so you were more aware of the numbers). The closest I got was when I was interviewing somewhere and one of the people in management let slip that 340b had “saved” their system something insane like $100-200 Million dollars in the past year alone.
 
I think that’s different from what people mean by “showing the books” though. My current PP group is (unreasonably IMO) somewhat paranoid regarding our books and considers them on the level of trade secrets that our competition would want to use against us. I doubt we would be willing to show a potential hire the books but once you are on the partner track then our CFO will sit down and go over them with you before you make that commitment.
I definitely think it's different when you're talking about a PP that has lots of potential ancillary income from partnership. And i wouldn't necessarily expect to see those numbers utnil I was on the cusp of partnership and trying to decide what kind of a buy-in I was willing to make.

But I don't think it's at all unreasonable to provide the information I was talking about, for any kind of a position. For a PP, things like median non-partner and median partner total annual comp is an easy number to get, doesn't compromise any "trade secrets" and the absolute bare minimum I'd expect.
I doubt your hospital willingly showed your colleagues how much “non”-profit they were making off their Onc group (though IIRC you were in a directorish position so you were more aware of the numbers). The closest I got was when I was interviewing somewhere and one of the people in management let slip that 340b had “saved” their system something insane like $100-200 Million dollars in the past year alone.
Yeah, we all know the money to pay for everybody has to come from somewhere. It's just definitely more opaque in most hospital employed situations. There are a lot of people that aren't bothered by that.
 
Do non-academic / PP transplant jobs exist? If so, what would compensation be?
 
Do non-academic / PP transplant jobs exist? If so, what would compensation be?
When interviewing I saw one in Wilkes Barre with Geisinger and another one in Delaware, I think New Ark, it was around 550 and 450 respectively starting - You generate more RVUs in patient specially with daily followups for the patients, hence its busy but ceiling higher.
 
When interviewing I saw one in Wilkes Barre with Geisinger and another one in Delaware, I think New Ark, it was around 550 and 450 respectively starting - You generate more RVUs in patient specially with daily followups for the patients, hence its busy but ceiling higher.
I’m assuming these guys are mostly inpatient and take significantly more 24 hour calls?
 
When interviewing I saw one in Wilkes Barre with Geisinger and another one in Delaware, I think New Ark, it was around 550 and 450 respectively starting - You generate more RVUs in patient specially with daily followups for the patients, hence its busy but ceiling higher.
That’s pretty bad for a full time transplant job in PP.
 
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