Job posting

[Neuronix]

Sent to me by private message.

Radiation Oncologist (1.0 FTE)
Fargo, ND

PRACTICE SPECIFICS
• Our ideal candidate is seeking a strong growing collegial practice, with state-of-the-art equipment, providing compassionate, multidisciplinary care for a wide variety of patients.
• We are accommodating in helping you tailor the practice of your dreams.
•Anticipated starting salary $500,000
• We currently treat 20-30 patients per day.
• Comprehensive Team: 2 Radiation Oncologists, 2 Full time medical physicists, 4 radiation therapists, 2 nurses, 2 dosimetrists.
• Caring and attentive team of support services including genetic counselor, nutrition support, social work, nurse navigation, behavior therapist and lymphedema specialists.
• Specialty services include Interventional Radiology and Palliative Care.
• 1 linear accelerator, 1 dedicated CT simulator, On-site treatment planning. SRS, SBRT, IGRT, IMRT, Gating, VMAT, radiopharmaceuticals and 4D capable CT.
• EPIC electronic medical record.
CANCER PROGRAM
• Essentia Health is a well-established, multi-specialty clinic with a history of outstanding care and research. Dyad led organization with physician leadership partnered with administrative leadership.
• Excels in the relationship and support of cancer patients in a warm and welcoming setting.
• On-site Medical Oncology Team of 3 MD’s and 1 APC. Expanding multi-site regional outreach.
• Multidisciplinary Tumor Board Conferences.
• Telemedicine/community cancer center included.
• NCI Community Oncology Research Program grant (NCORP) recipient with access to current, relevant clinical trials.
• Program accreditations as a Comprehensive Community Cancer Program and the National Accreditation Program for Breast Centers by the American College of Surgeons.
• Certified as HIMSS EMRAM (Electronic Medical Record Adoption Model) Level 7 for both our Inpatient and Ambulatory facilities.

REQUIREMENTS
• Board Certified / Board Eligible in Radiation Oncology

LOCATION
• Centrally located on the border of North Dakota & Minnesota, 4 hours west of Minneapolis/St. Paul.
• Fargo-Moorhead population: 180,000.
• Regional Service area consists of 25 clinics & 5 hospitals.
• Safe, clean, and active community with an abundance of outdoor and lake activities.
Essentia Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, sexual identity, national origin, disability, or protected Veteran Status.

Search or Apply online at www.essentiahealth.org/careers or contact:

Liz Huesman, Physician Recruiter
218-847-0845 • (fax) 218-722-9952
Email: [email protected]

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[fiji128]

With 20 to 30 on treatment seems like a decent full time job for two rad oncs. With a third I'm not sure it would be very busy? Maybe 4 days a week with 2 months of pto? Always wish these ads would go into more details about the actual position and who is doing the hiring instead generic factoids about the hospital and town. It is nice that they did through out a number for pay though.

 

[BobbyHeenan]

With 20 to 30 on treatment seems like a decent full time job for two rad oncs. With a third I'm not sure it would be very busy? Maybe 4 days a week with 2 months of pto? Always wish these ads would go into more details about the actual position and who is doing the hiring instead generic factoids about the hospital and town. It is nice that they did through out a number for pay though.

I assumed it meant it would be 2 docs (even counting hte new hire). I agree 20-30 under treat is not enough patients for 3 docs.

I swear i'm not the recruiter....

But 20-30 patients, 2 docs, one center....is a fantastic set up. If you're young and hungry maybe you'd like to see 40 patients treated per day, but this kind of set up I'm really envious of (multiple docs, one center, private practice on a hospital campus).

 

[deleted1116990]

I assumed it meant it would be 2 docs (even counting hte new hire). I agree 20-30 under treat is not enough patients for 3 docs.

I swear i'm not the recruiter....

But 20-30 patients, 2 docs, one center....is a fantastic set up. If you're young and hungry maybe you'd like to see 40 patients treated per day, but this kind of set up I'm really envious of (multiple docs, one center, private practice on a hospital campus).

I know somebody in a similar set up. Hospital employed in an undesirable location with about that volume but have partner coverage and get a lot of vacation. The difference is they have 700ish income. With benefits and retirement match they're around 800 total comp, which as I posted on the private forum is where this would need to be (and maybe it could be). Honestly not a bad way to coast to an early retirement if practice building is not your thing and admin is minimally tolerable. Just keep your head down and fly off to some island every other month to recharge. I'm envious too (kinda, it's still a hospital). The solo guys in rural making 500s with no backup carrying 25? No. That's pity.

 

[thecarbonionangle]

Yeah that was my first thought. This job is “only” four hours way from minneapolis (not my cup of tea but some like it) and offers 500k. This is a great example of the kind of job that used to and should be paying 700+ Yet they know they can find a sucker to take it.

 

[Mandelin Rain]

20-30 patients split between 2 docs is a nice setup for the alternating Monday/Friday off (making every other weekend a 4 day weekend) and the ability to take plenty of vacation if you so choose.

Pretty ideal setup for many people. You always want a little more money, but it states 500k as a starting salary, so likely a little more upside. But overall seems cush if you could stand being in Fargo.

 

[RickyScott]

Yeah that was my first thought. This job is “only” four hours way from minneapolis (not my cup of tea but some like it) and offers 500k. This is a great example of the kind of job that used to and should be paying 700+ Yet they know they can find a sucker to take it.

Yes, 10 years ago pre-inflation would still have paid significantly more than 700k, but may be a decent job depending on setup. Does your spouse work; as he/she may have to give up career?

 

[deleted941485]

Yes, 10 years ago pre-inflation would still have paid significantly more than 700k, but may be a decent job depending on setup. Does your spouse work; as he/she may have to give up career?

Even with potentially 10 patients on treat?

 

[deleted1116990]

Yeah that was my first thought. This job is “only” four hours way from minneapolis (not my cup of tea but some like it) and offers 500k. This is a great example of the kind of job that used to and should be paying 700+ Yet they know they can find a sucker to take it.

Are they/will they?

If they already have an employed doctor in Fargo who is not there on a visa, chances are they are paying him or her fairly already and you have a better shot of negotiating something non-exploitative.

It could be exploitative, I don't know. But it doesn't reek of it like so many of the rural hellpit ads that staff with semi-to-perma-locums obviously do.

Even with potentially 10 patients on treat?

I knew someone who got paid 750k in the Dakotas with ~8 on beam about 15 years ago.

 

[RadOncDoc21]

Yea… this should be advertising above 650k starting, ideally more.

 

[elementaryschooleconomics]

Yea… this should be advertising above 650k starting, ideally more.

"I think you have a typo, there's an extra 0 in that number, otherwise I agree, $65k" - Ralph

 

[deleted941485]

Are they/will they?

If they already have an employed doctor in Fargo who is not there on a visa, chances are they are paying him or her fairly already and you have a better shot of negotiating something non-exploitative.

It could be exploitative, I don't know. But it doesn't reek of it like so many of the rural hellpit ads that staff with semi-to-perma-locums obviously do.


I knew someone who got paid 750k in the Dakotas with ~8 on beam about 15 years ago.

Yeah they are bottom fishing. They’ll find somebody. They always do. I really want to believe this is a good job but the numbers just don’t make it so.

 

[medgator]

"I think you have a typo, there's an extra 0 in that number, otherwise I agree, $65k" - Ralph

"In line with the pediatricians!!"

 

[deleted941485]

"In line with the pediatricians!!"

Wait I must have missed that comment. He really said that?

 

[medgator]

Wait I must have missed that comment. He really said that?

One of his tweets last year said something about how we were overpaid compared to pediatricians

 

[deleted941485]

One of his tweets last year said something about how we were overpaid compared to pediatricians

And according to DNPs, pediatricians are overpaid. The worst part about Ralph is that he will never die.

 

[thecarbonionangle]

And according to DNPs, pediatricians are overpaid. The worst part about Ralph is that he will never die.

What is dead may never die

 

[medgator]

Yes, what your scenario suggests is over billing. That will never end well.

You can in reasonably good consciousness treat a patient with SBRT and bill for VMAT/IMRT since in reality SBRT is a form of IMRT. But the opposite is much trickier. There is a pretty clear (billing) definition of what constitutes SBRT and if you don’t do it and then bill for it…no bueno.

What is dead may never die

Just need a meme with ralph and palpatines face superimposed on each other

 

[ramsesthenice]

Just need a meme with ralph and palpatines face superimposed on each other

Doesn’t that already exist? Or was the last one Wallner?

 

[jondunn]

“The ABR is a pathway to many abilities some consider to be...... unnatural.” - Wallner, probably​

 

[seper]

Fargo like in the movie?

 

[metallica81788]

What is dead may never die

But in stranger eons death may die

 

[Palex80]

I am reading your responses and wonder if 10 patients on treatment may not be too few for a radiation oncologist.

Let us assune, that
a) 4 of the patients are prostate/breast
b) 3 are GBM, (N)SCLC, Rectum, Esophageal, Gynecological , H&N
c) 3 are palliative brain and bone mets

a) are regularly treated over 3-8 weeks, perhaps some APBI in it too, let us assume 4 weeks median treatment time
b) are regularly treated over 5-7 weeks, with the exception of 5x5 Gy rectum, let us assume 6 weeks median treatment time
c) are regularly treated over 1 day - 2 weeks, let us assume 1 week median treatment time

So you end up in terms of weekly starts with
a) 1 start
b) 0.5 start
c) 3 starts

So, these are 4.5 starts per week. Not everyone get's irradiated, so this doctor may be seeing 5-6 new patients per week.

I think you can do that in 2 days, not 5 (or 4 as someone has suggested with alternating long weekends).




Oh, and BTW:

PRACTICE SPECIFICS
...
• Excels in the relationship and support of cancer patients in a warm and welcoming setting.
...

 

[Sheldor]

I've heard that Fargo is lovely! (Cold, but a nice town.)

I think that this kind of set up is one of the best types of jobs for quality of life, but I think, honestly that salary sounds about right if you are really potentially treating <30 with two docs. I think that if you have a center with two docs that can spend its time closer to 40-50, then you'd really be cooking. Honestly, that to me sounds ideal, having 20-25 on treat with a few of those being SBRT isn't overly taxing, and yet your salary should be nice and high.

For young people looking for jobs, don't underestimate how awesome it is to have a partner, solo practice is tough. Need to go to the dentist? Too bad, you have patients on treat, etc etc.

 

[elementaryschooleconomics]

For young people looking for jobs, don't underestimate how awesome it is to have a partner, solo practice is tough. Need to go to the dentist? Too bad, you have patients on treat, etc etc.

**unless you're in a hospital setting

 

[RickyScott]

**unless you're in a hospital setting

What are coverage requirements for freestanding? I thought they were still supspended and will that suspension become permanent?

 

[medgator]

What are coverage requirements for freestanding? I thought they were still supspended and will that suspension become permanent?

Tele for all sites of service since the start of the pandemic per CMS. Guess you could tele from a dentist office?

 

[Mandelin Rain]

I am reading your responses and wonder if 10 patients on treatment may not be too few for a radiation oncologist.

Let us assune, that
a) 4 of the patients are prostate/breast
b) 3 are GBM, (N)SCLC, Rectum, Esophageal, Gynecological , H&N
c) 3 are palliative brain and bone mets

a) are regularly treated over 3-8 weeks, perhaps some APBI in it too, let us assume 4 weeks median treatment time
b) are regularly treated over 5-7 weeks, with the exception of 5x5 Gy rectum, let us assume 6 weeks median treatment time
c) are regularly treated over 1 day - 2 weeks, let us assume 1 week median treatment time

So you end up in terms of weekly starts with
a) 1 start
b) 0.5 start
c) 3 starts

So, these are 4.5 starts per week. Not everyone get's irradiated, so this doctor may be seeing 5-6 new patients per week.

I think you can do that in 2 days, not 5 (or 4 as someone has suggested with alternating long weekends).




Oh, and BTW:

PRACTICE SPECIFICS
...
• Excels in the relationship and support of cancer patients in a warm and welcoming setting.
...

View attachment 354024

Yeah, this is very much a job-share type position if the volume doesn't increase. Definitely could have a great work-life balance assuming the system allows the pair of docs to work it out with each other and doesn't mandate presence.

 

[metallica81788]

Yeah, this is very much a job-share type position if the volume doesn't increase. Definitely could have a great work-life balance assuming the system allows the pair of docs to work it out with each other and doesn't mandate presence.

This is key and how you get a good QOL

A lot of hospital admins want too much oversight/control and won't let/trust the doctors to just handle it all. Very annoying.

 

[deleted1116990]

For young people looking for jobs, don't underestimate how awesome it is to have a partner, solo practice is tough. Need to go to the dentist? Too bad, you have patients on treat, etc etc.

At my first job, one day I left around 2 PM to literally go across the street for a dental cleaning without telling anyone. As far as I was concerned it was the same as disappearing to the hospital lounge on the other side of the building for a little while.

When I got back, I was greeted by the department manager, a fat brute of a man with the voice of Mr. Hankey from South park, with his arms spread wide screaming at me, Really? REALLY??? Apparently he found out and I was to suffer the wrath of the vice principal like a 9th grader cutting class to smoke cigarettes in the bathroom.

The parts they don't tell you in med school...

 

[RadOncDoc21]

At my first job, one day I left around 2 PM to literally go across the street for a dental cleaning without telling anyone. As far as I was concerned it was the same as disappearing to the hospital lounge on the other side of the building for a little while.

When I got back, I was greeted by the department manager, a fat brute of a man with the voice of Mr. Hankey from South park, with his arms spread wide screaming at me, Really? REALLY??? Apparently he found out and I was to suffer the wrath of the vice principal like a 9th grader cutting class to smoke cigarettes in the bathroom.

The parts they don't tell you in med school...

That’s their sole purpose in life. It’s a sad reality.

 

[elementaryschooleconomics]

At my first job, one day I left around 2 PM to literally go across the street for a dental cleaning without telling anyone. As far as I was concerned it was the same as disappearing to the hospital lounge on the other side of the building for a little while.

When I got back, I was greeted by the department manager, a fat brute of a man with the voice of Mr. Hankey from South park, with his arms spread wide screaming at me, Really? REALLY??? Apparently he found out and I was to suffer the wrath of the vice principal like a 9th grader cutting class to smoke cigarettes in the bathroom.

The parts they don't tell you in med school...

In RadOnc, you're technically a doctor, and are technically on the hook for all liability, yet have very little control or authority.

You only get patients if other doctors decide to refer them to you.

You can't actually get a patient through a course of radiotherapy by yourself, even if you wanted to. You need therapists for the CTSIM, you need Dosimetry and Physics to generate a treatment plan and make sure it works, and you again need therapists to deliver the treatment.

Up until recently, again due to the fact that all liability rests on you, you were supposed to "directly" supervise the machines, which makes no sense in objective reality - it makes sense only if the system needs to make sure there's a scapegoat to sue into oblivion if something goes wrong.

I suspect that our weird training, board certification, and overall culture is sort of a reaction to how powerless we are. Just like a terminal patient thinking that eating organic is going to help fight their cancer, we're looking for any shred of control in a situation where we otherwise have none. Since we can't even deliver our own treatments without a literal team of people, we turn inward, and give ourselves exams in basic science and force everyone to memorize p-values from obscure trials in a continued arms race to prove how smart we are to the other RadOncs, while the external world forgets we exist.

We can't actually do anything with this knowledge without being fed patients from the other specialties, or if our therapists "can't" schedule a sim after 3PM or our dosimetrists "can't" try to get the rectum V75 down a little lower, but we CAN ask bright-eyed PGY2s about enrollment criteria for the RAPIDO trial and give a disappointed sigh if they don't know, just to feel that little rush of superiority.

Now if you'll excuse me, I need to put on my white coat and stethoscope and go to tumor board to see what scraps MedOnc wants to feed me. I need to make sure my department admins, my overlords, see the numbers they want to see, or they'll be very disappointed in my performance. One time I tried to tell them about the pCR for SCC vs adenos on the CROSS trial, but they didn't seem very impressed. I was assured during residency that knowing those numbers would make people think I'm smart?

 

[OTN]

In RadOnc, you're technically a doctor, and are technically on the hook for all liability, yet have very little control or authority.

You only get patients if other doctors decide to refer them to you.

You can't actually get a patient through a course of radiotherapy by yourself, even if you wanted to. You need therapists for the CTSIM, you need Dosimetry and Physics to generate a treatment plan and make sure it works, and you again need therapists to deliver the treatment.

Up until recently, again due to the fact that all liability rests on you, you were supposed to "directly" supervise the machines, which makes no sense in objective reality - it makes sense only if the system needs to make sure there's a scapegoat to sue into oblivion if something goes wrong.

I suspect that our weird training, board certification, and overall culture is sort of a reaction to how powerless we are. Just like a terminal patient thinking that eating organic is going to help fight their cancer, we're looking for any shred of control in a situation where we otherwise have none. Since we can't even deliver our own treatments without a literal team of people, we turn inward, and give ourselves exams in basic science and force everyone to memorize p-values from obscure trials in a continued arms race to prove how smart we are to the other RadOncs, while the external world forgets we exist.

We can't actually do anything with this knowledge without being fed patients from the other specialties, or if our therapists "can't" schedule a sim after 3PM or our dosimetrists "can't" try to get the rectum V75 down a little lower, but we CAN ask bright-eyed PGY2s about enrollment criteria for the RAPIDO trial and give a disappointed sigh if they don't know, just to feel that little rush of superiority.

Now if you'll excuse me, I need to put on my white coat and stethoscope and go to tumor board to see what scraps MedOnc wants to feed me. I need to make sure my department admins, my overlords, see the numbers they want to see, or they'll be very disappointed in my performance. One time I tried to tell them about the pCR for SCC vs adenos on the CROSS trial, but they didn't seem very impressed. I was assured during residency that knowing those numbers would make people think I'm smart?

I don't think it's as bad as portrayed here. Lots of specialties are closer to the end of the referral chain, and I would rather try to gain the trust of my fellow physician colleagues rather than have to advertise to the general public (looking at you here, plastics, derm, oculopastics, etc). Those colleagues actually do care about the pCR of scca vs adenos.

In addition, nearly all physicians work on a team of some sort. One could say that a surgeon can't do a damn thing on their own either- they need OR techs and anesthesia and floor nurses and a pharmacy with pharmacists etc etc.

"Or if our therapists 'can't' schedule a sim after 3 pm" - our CT techs ask me if I need anything/am expecting any add ons before they leave at 5 pm, as they are always willing to stay if need be. It physically pains me to hear about administrator-led departments, and how the culture/vibe/work ethic is SO MUCH WORSE than a well-run physician-led department. Department administrators are NEVER good captains of the ship. The decline of physician-led practices has been woeful for this specialty.

 

[thecarbonionangle]

if you are interviewing for a job and you are already getting weird vibes from admins, proceed very carefully!

 

[RickyScott]

Yeah, this is very much a job-share type position if the volume doesn't increase. Definitely could have a great work-life balance assuming the system allows the pair of docs to work it out with each other and doesn't mandate presence.

Mixed feelings about work life balance. I think I would have been bored out of my mind seeing 5 or less consults a week out of residency.

 

[elementaryschooleconomics]

I don't think it's as bad as portrayed here. Lots of specialties are closer to the end of the referral chain, and I would rather try to gain the trust of my fellow physician colleagues rather than have to advertise to the general public (looking at you here, plastics, derm, oculopastics, etc). Those colleagues actually do care about the pCR of scca vs adenos.

In addition, nearly all physicians work on a team of some sort. One could say that a surgeon can't do a damn thing on their own either- they need OR techs and anesthesia and floor nurses and a pharmacy with pharmacists etc etc.

"Or if our therapists 'can't' schedule a sim after 3 pm" - our CT techs ask me if I need anything/am expecting any add ons before they leave at 5 pm, as they are always willing to stay if need be. It physically pains me to hear about administrator-led departments, and how the culture/vibe/work ethic is SO MUCH WORSE than a well-run physician-led department. Department administrators are NEVER good captains of the ship. The decline of physician-led practices has been woeful for this specialty.

I agree - hyperbole is my favorite tool for comedic effect.

To be more serious about it: obviously, in modern healthcare, everything is team based, and it's almost impossible to do something in isolation. We are not alone in ceding power to the MBA pencil pushers.

However, the concept of the Dosimetrist is absolutely bizarre and unique to RadOnc. It would be like a surgeon sitting off to the side in the OR, telling someone else where to put the scalpel. It makes no sense.

American RadOncs have evolved to a very isolated point. We don't plan our own treatments. We also don't prescribe systemic regimen, unlike most of the rest of the world. We do one part of one thing. I think it puts us in a somewhat compromised position, as AI continues to evolve.

I see an America where a Truebeam is a self-contained entity, with AI-based adaptive autocontouring and treatment planning, and the only thing a physician needs to do is draw a target.

Do we need a separate specialty for that?

 

[Mandelin Rain]

Mixed feelings about work life balance. I think I would have been bored out of my mind seeing 5 or less consults a week out of residency.

No doubt, but if you're only there 3 days a week doing that 8a-4p, while spending the rest of your week exploring hobbies on a 500+k income, you could be doing worse

Doc1
Doc1
Doc1/Doc2-OTV Day
Doc2
Doc2

Looks sweet to me

 

[deleted1116990]

That’s their sole purpose in life. It’s a sad reality.

What's sadder is that they could never talk to the surgeons like that. The managers would be scolded by upper admin for disrespecting a CV surgeon. It's expected that staff will punch down on the rad onc catfish "doctors". Side effect of the screwed up hierarchy of our department with physics, dosi, and RTT compared to surgery where there is the guy in the OR with the knife and it's clear who is captain of the ship.

 

[Mandelin Rain]

Do we need a separate specialty for that?

This is the big question, imo.

EDIT: Expanding on this. I could definitely see a situation (in the not so distant future) where AI and planning algorithms can take a sim scan, deformably register the diagnostic imaging, contour all OARs and estimate target volumes based on PET uptake, create a plan based on NTCP modeling, and spit out a percent complication and tumor control probability based on historic data that a physician can review with a patient.

Sounds nuts, but really, how far off from that are we from being able to do that today?

 

[RickyScott]

Tele for all sites of service since the start of the pandemic per CMS. Guess you could tele from a dentist office?

Grifter Ron at acro stated that despite cms/tele, doc can’t approve cone beams remotely, which sounds rediculous. Went so far as to say cone beams at satellites have to be billed under the doc who was present, not who approved them. Had some very convaluted interpretation that while doc doesn’t have to be present for radiation, somehow he does for cone beam.

 

[thecarbonionangle]

As long as we have the medicolegal set up, there will always be a need for a sucker to be “liable” if something goes wrong. There might be other specialties that might still go forth with it, say a neurosurgeon gets a zap and completely cuts out RO. However there will always be demand for someone, but clearly not enough demand for number of ROs we have

 

[ramsesthenice]

Mixed feelings about work life balance. I think I would have been bored out of my mind seeing 5 or less consults a week out of residency.

You are not a millennial. Plenty of them would be perfectly happy to see zero consults per week and get paid half rate to sit around all day.

 

[temujim]

I agree - hyperbole is my favorite tool for comedic effect.

To be more serious about it: obviously, in modern healthcare, everything is team based, and it's almost impossible to do something in isolation. We are not alone in ceding power to the MBA pencil pushers.

However, the concept of the Dosimetrist is absolutely bizarre and unique to RadOnc. It would be like a surgeon sitting off to the side in the OR, telling someone else where to put the scalpel. It makes no sense.

American RadOncs have evolved to a very isolated point. We don't plan our own treatments. We also don't prescribe systemic regimen, unlike most of the rest of the world. We do one part of one thing. I think it puts us in a somewhat compromised position, as AI continues to evolve.

I see an America where a Truebeam is a self-contained entity, with AI-based adaptive autocontouring and treatment planning, and the only thing a physician needs to do is draw a target.

Do we need a separate specialty for that?

That's why residents should bother to learn how to run the CT sim, LINAC, and treatment planning. Will say those skills have come in very handy from time to time; particularly in people management.

 

[elementaryschooleconomics]

This is the big question, imo.

EDIT: Expanding on this. I could definitely see a situation (in the not so distant future) where AI and planning algorithms can take a sim scan, deformably register the diagnostic imaging, contour all OARs and estimate target volumes based on PET uptake, create a plan based on NTCP modeling, and spit out a percent complication and tumor control probability based on historic data that a physician can review with a patient.

Sounds nuts, but really, how far off from that are we from being able to do that today?

I have heard the stated goal as 10 years from the tech companies currently engaged in this space.

(going from CTSIM to final treatment planning approval in 2 hours, all AI/automated, was more or less the statement)

 

[deleted1116990]

It physically pains me to hear about administrator-led departments, and how the culture/vibe/work ethic is SO MUCH WORSE than a well-run physician-led department. Department administrators are NEVER good captains of the ship. The decline of physician-led practices has been woeful for this specialty.

Agree with this so much. I do probably triple the work in PP than I did in the hospital for not much more money, certainly far less per RVU or however you want to measure labor. Sometimes I miss the how stupidly easy it was for how much I got paid, but then I remember fatass Mr. Hankey and the lackeys that ran the place. Yes, it's way better when we are in charge, at least at this stage in life. The MBA-lead hospital department might be tolerable for somebody end of career just coasting as you basically need to check out mentally to make it work. Soul crushing for a new grad.

 

[RO28]

You are not a millennial. Plenty of them would be perfectly happy to see zero consults per week and get paid half rate to sit around all day.

I am a millennial, I am bored with less than 6 consults per week... so thanks.

 

[temujim]

I have heard the stated goal as 10 years from the tech companies currently engaged in this space.

(going from CTSIM to final treatment planning approval in 2 hours, all AI/automated, was more or less the statement)

Been hearing about automated Pareto optimal plans for almost 20 years. Dosimetrist driven near optimal planning time has improved has been cut by 1/3 to 1/4.

Really starting to see progress in AI/ML OAR contouring, particularly easier sites.

Companies scared of automated targets to a certain extent; as much as you throw on in big bold red flashing letters "decision support" or whatever caveat, there will be MDs (Dr. Boomer) who don't look and just approve.

 

[Ray D. Ayshun]

Mixed feelings about work life balance. I think I would have been bored out of my mind seeing 5 or less consults a week out of residency.

Looks like I'm in about the 7-8/week range on average, which is plenty in a rural place tbh, when it comes to coordinating with other random medical systems, getting patients properly staged, etc. Back at my training site, I'd be fine with 15-20/week, but I'd imagine Fargo is more similar to where I am than where I trained. Though, if I were averaging 5/week, would get pretty antsy.

 

[thecarbonionangle]

Some of the limbus AI demos are pretty impressive!

 

[elementaryschooleconomics]

Some of the limbus AI demos are pretty impressive!

I've been very impressed with all the AI-based contouring products that have come out recently. Sure, they're not perfect, but they're lightyears better than the atlas-based segmentation and exceeded my expectations. It's crazy. Do we need to look for children named John Connor? Maybe.