Well, I'm not going into heme onc, I can try to answer some of your questions. I think that your best resources are the heme onc docs you've been shadowing though.
Regarding the death issue, I do think that can be difficult, particularly when dealing with many of the cancers that tend to hit patients in their prime or just when they are beginning their lives (eg HD, ALL, CML, etc) in otherwise healthy individuals. I don't want to say that you ever get used to dealing with such psychosocial issues regarding these patients, but I do think that physicians in every specialty have to find way to cope with these issues, regardless of what specialty you choose to go into. Remember that 100% of our patients will die, not just the ones who get "terminal" diagnoses. I. When dealing with terminal patients, I find it to be useful just to remember that you're not expected to alleviate all of the psychological stress they must deal with in dealing with their illness; even though you should treat their depression and try to be as supportive as possible, you can't change their ultimate feelings of loss associated with dying; and bereavement in the family, and with the patient, is natural. A lot of times, it just helps if you have the time to talk to the patient about what they think about their illness and how they are coping.
Regarding the reimbursement issue, I do know that medicare has made some pretty drastic changes involving the drug issue recently, but I haven't talked with any oncologists since then regarding how it's effecting their practice. They previously were doing very well financially though, that can be seen with the large number of free-standing fancy "cancer" centers that seemed to be going up all over the place. Only specialties that make money can make their own buildings, specialties that lose money must be supported by other specialties. My thoughts on reimbursement in medical specialties can be read about in ckent's FAQ; if you are in medical school, I just think that by the time that you finish training, things will be so different then how they are now that it's not worthwhile to make that your sole deciding factor in choosing a specialty. It's definitely not easy to predict which way things will swing financially in any field of medicine. Your main factor should be how much you enjoy working with the patients and doing your job, as these factors have been shown in studies to be better correlated with physician job satisfaction then income levels.
