Layoffs

[xrthopeful]

Anyone have to let any of their staff go yet?

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[seper]

Anyone have to let any of their staff go yet?

Not going to see it in RadOnc during the “acute phase” of the epidemic. As therapists get exposed and are sent home, you need someone to run the LINAC


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[thecarbonionangle]

The breadlines are coming you say?

 

[metallica81788]

I've seen hours cut elsewhere to keep as few therapists around as possible to maximize reserve workforce in the case of exposure.

 

[radoncgrad2019]

referring urologist has laid off office staff.

 

[fiji128]

In our clinic dosimetry is working from home. Otherwise the therapist are now one week on and one week off and since they are hourly that is a 50% pay cut for them. None of the physics staff or physicians have been hit yet. Consults are way down this week with many patient cancelling or postponing.

 

[seper]

Some of layoffs that I know firsthand off: in Plastics office and a private path lab

referring urologist has laid off office staff.

 

[RadOncDoc21]

In our hospital, all the admin have taken 50% pay cuts


April Fools!

 

[KHE88]

In our hospital, all the admin have taken 50% pay cuts


April Fools!

They cut minimum wage workers hours, lay people off. The people who keep the lights on, you know, yet they have meetings simply to justify their administrative jobs that shouldn't exist, bloated 6 figure salaries, talk about how COVID is not a big threat, and how we can figure out how to keep the money rolling in.

 

[xrthopeful]

They cut minimum wage workers hours, lay people off. The people who keep the lights on, you know, yet they have meetings simply to justify their administrative jobs that shouldn't exist, bloated 6 figure salaries, talk about how COVID is not a big threat, and how we can figure out how to keep the money rolling in.

I mean I can’t believe there are hospital admins who think covid isn’t a big deal lol. I believe you, just saying this is not my experience, we get nonstop emails all day about it

 

[deleted1002574]

I mean I can’t believe there are hospital admins who think covid isn’t a big deal lol. I believe you, just saying this is not my experience, we get nonstop emails all day about it

It's almost a part time job reading all the emails, going to the virtual meetings, and trying to keep up with what the hell we should be doing ... my admin taking this very seriously.

 

[seper]

At my hospital (a large operation with satellites), yes, admins are pretty stressed out today about whether they can keep their jobs or not.

 

[Gfunk6]

If the House signs off on the relief package by Friday, there will probably be an additional wave of layoffs and furloughs as people will start receiving checks and furlough-dependent salary supplementations.

 

[RadOncDoc21]

At my hospital (a large operation with satellites), yes, admins are pretty stressed out today about whether they can keep their jobs or not.

At the end those who make the decisions will start looking around for budget cuts and the last place they will go is in their wallets.

We started making some adjustments, still trying to keep the staff on without cutting much but with very limited consults and patients coming off with a few hypofractions coming on, the future is looking very bleak. I might need to start looking into becoming a pizza delivery driver before those jobs are gone!

 

[RadOncDoc21]

If the House signs off on the relief package by Friday, there will probably be an additional wave of layoffs and furloughs as people will start receiving checks and furlough-dependent salary supplementations.

Or for those to put back into the stock market.

 

[RadOncDoc21]

One could make the argument that with the economy, the way it is, it makes more sense to fractionated more. I’m starting to feel the administration pressure regarding numbers despite an active pandemic going on!

 

[radoncgrad2019]

One could make the argument that with the economy, the way it is, it makes more sense to fractionated more. I’m starting to feel the administration pressure regarding numbers despite an active pandemic going on!

your admins are insane lol. how do they not have bigger fish to fry right now

 

[RadOncDoc21]

your admins are insane lol. how do they not have bigger fish to fry right now

I agree but I guess it’s better than them asking me to go intubate some COVID patients in the ICU. Either way, I feel on edge and my staff is very uneasy especially the therapists.

 

[radoncgrad2019]

I agree but I guess it’s better than them asking me to go intubate some COVID patients in the ICU. Either way, I feel on edge and my staff is very uneasy especially the therapists.

i think everyone is feeling this burn. no matter where you are. either you're worrying how to treat your covid positive patients or you're worrying about how to keep your people employed, or both.

 

[OTN]

One could make the argument that with the economy, the way it is, it makes more sense to fractionated more. I’m starting to feel the administration pressure regarding numbers despite an active pandemic going on!

Name and shame they don't deserve to be in healthcare.

 

[Mandelin Rain]

Therapists and RNs are being doubly punished for being hourly. Still have to show up and risk infection AND getting less pay or having to take pto to cover lost hours.

Meanwhile, all the salaries staff are at home, doing nothing, and getting full pay.

Believe me the hourly folks have noticed.

 

[radoncgrad2019]

Therapists and RNs are being doubly punished for being hourly. Still have to show up and risk infection AND getting less pay or having to take pto to cover lost hours.

Meanwhile, all the salaries staff are at home, doing nothing, and getting full pay.

Believe me the hourly folks have noticed.

hourly staff getting hazard pay in some places

 

[RadOncDoc21]

Therapists and RNs are being doubly punished for being hourly. Still have to show up and risk infection AND getting less pay or having to take pto to cover lost hours.

Meanwhile, all the salaries staff are at home, doing nothing, and getting full pay.

Believe me the hourly folks have noticed.

I said it before in another thread... it’s a great time to be a dosimitrist!

 

[metallica81788]

My admin is now trying to compress the radiation treatment schedule to the morning period alone.

I'm not a fan of this for many reasons and obviously the therapists aren't. Wouldn't you think it would be worse from a transmission standpoint moving 12-15 patients from over the course of 7-8 hours into a 4 hour window?

 

[evilbooyaa]

My admin is now trying to compress the radiation treatment schedule to the morning period alone.

I'm not a fan of this for many reasons and obviously the therapists aren't. Wouldn't you think it would be worse from a transmission standpoint moving 12-15 patients from over the course of 7-8 hours into a 4 hour window?

Can't social distance in the waiting room. I agree with maybe shrinking times (like not 9-5) but maybe something gentler like 6 hours.

 

[evilbooyaa]

Name and shame they don't deserve to be in healthcare.

As always, happy to post anonymously on anyone's behalf. In this thread, it'd be of dumb as **** admin doing ****ty dangerous ****. @RadOncDoc21 @KHE88

Can't complain about my admins here. Little slow on the response time but hospital is taking it relatively seriously.

 

[seper]

Had a meeting with some RadInc admins this morning (moderately trustworthy characters). They are not planning layoffs but are projecting staff and MD shortages up to 4 months from now. It is due to the upcoming need to quarantine people.




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[RadOncDoc21]

Had a meeting with some RadInc admins this morning (moderately trustworthy characters). They are not planning layoffs but are projecting staff and MD shortages up to 4 months from now. It is due to the upcoming need to quarantine people.




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Are the hourly staff still keeping their hours?

 

[OTN]

Can't social distance in the waiting room. I agree with maybe shrinking times (like not 9-5) but maybe something gentler like 6 hours.

We've been texting all of our patients when their time is ready. They then come straight into the vault from their car.

 

[metallica81788]

We've been texting all of our patients when their time is ready. They then come straight into the vault from their car.

That must be nice. I'd love to do that but I have about a third of my patients arriving by cab or some sort of other arranged transport so they show up when they show up or they don't at all.

All clinics here now are moving to a 7-12 emergency/urgent in person visit and 12-4 virtual visit schedule. Getting pressure to compress the schedule but I will fight for myself and my therapists. Can compromise on a 8/9-3 type scenario but will not squish all patients into a 4 hour window.

 

[RadOncDoc21]

We’ve discussed having each take a day of PTO per week to keep their hours. I don’t see this as a long-term solution but it’s better than them losing their hours on a massive scale as was previously suggested.

 

[medgator]

We've been texting all of our patients when their time is ready. They then come straight into the vault from their car.

We only let one family member in with pt for new consults and observe social distancing in the waiting room and throughout the clinic when possible.

The texting thing is a good idea.

Have you guys noticed that some patients still want treatment and don't really want to postpone/defer. 0/2 so far this week in trying to defer a skin and prostate pt.

 

[xrthopeful]

Have you guys noticed that some patients still want treatment and don't really want to postpone/defer. 0/2 so far this week in trying to defer a skin and prostate pt.

Haha you must be in Florida because that’s the only place people are that crazy.

 

[medgator]

Haha you must be in Florida because that’s the only place people are that crazy.

It's no Mississippi

 

[seper]

Are the hourly staff still keeping their hours?

Yes. The business I’m working for is large and has some cushion, for now


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[Tigerstang]

We only let one family member in with pt for new consults and observe social distancing in the waiting room and throughout the clinic when possible.

The texting thing is a good idea.

Have you guys noticed that some patients still want treatment and don't really want to postpone/defer. 0/2 so far this week in trying to defer a skin and prostate pt.

Yes none of mine want to postpone. But I start to think it may be valid. Who's to say things are gonna look better 1-2 months from now? I think it's wishful thinking. I tell them both sides of the coin, let them flip and pick.

 

[deleted1002574]

Get em in, get em out quickly. If they want treatment, do the shortest possible and safely.

 

[RadOncDoc21]

Yes none of mine want to postpone. But I start to think it may be valid. Who's to say things are gonna look better 1-2 months from now? I think it's wishful thinking. I tell them both sides of the coin, let them flip and pick.

You’re right, who’s to say things might not get worse, before Easter supposedly. After that we’re all good.

 

[metallica81788]

Yes none of mine want to postpone. But I start to think it may be valid. Who's to say things are gonna look better 1-2 months from now? I think it's wishful thinking. I tell them both sides of the coin, let them flip and pick.

This is what I'm thinking as well. Only for people I wouldn't treat for 3-4 months (and that isn't many) would I really consider holding unless the patient themselves is worried for some reason. Then we discuss pros and cons of treating now vs waiting.

 

[BobbyHeenan]

This is what I'm thinking as well. Only for people I wouldn't treat for 3-4 months (and that isn't many) would I really consider holding unless the patient themselves is worried for some reason. Then we discuss pros and cons of treating now vs waiting.

I've thought about this as well. I'm not in a "hot spot" but anticipate things being really no better here in 6 weeks (and may actually be worse if social distancing is pulled back). So I don't feel like I need to delay stuff the same way someone in say Detroit or NYC may need to.

 

[medgator]

I've thought about this as well. I'm not in a "hot spot" but anticipate things being really no better here in 6 weeks (and may actually be worse if social distancing is pulled back). So I don't feel like I need to delay stuff the same way someone in say Detroit or NYC may need to.

Good point

 

[Reaganite]

Yes none of mine want to postpone. But I start to think it may be valid. Who's to say things are gonna look better 1-2 months from now? I think it's wishful thinking. I tell them both sides of the coin, let them flip and pick.

Same here. Patients get pissed if I even suggest a short delay in their start. All say the same thing: will things really be any different a few months from now?

 

[BobbyHeenan]

Same here. Patients get pissed if I even suggest a short delay in their start. All say the same thing: will things really be any different a few months from now?

I'm starting to agree. I already feel like I treat with shorter courses, but being especially mindful of this now and beaming on most patients. I'm not sure 3 months of ADT is going to help your prostate guy you were going to start in a week. Will it really be different in three months? Hell, some articles are talking about a fall "spike" in COVID.

*caveat - as noted above, I'm not in a hot spot right now .

 

[Palex80]

I'm not sure 3 months of ADT is going to help your prostate guy you were going to start in a week.

Then give him 6 months and start RT afterwards with another 2 months of ADT... Non-inferior, potentially a bit more toxic, but why not?

Duration of androgen suppression before radiotherapy for localized prostate cancer: radiation therapy oncology group randomized clinical trial 9910 - PubMed

Extending AS duration from 8 weeks to 28 weeks before radiotherapy did not improve outcomes. A lower than expected prostate cancer death rate reduced ability to detect a between-group difference in disease-specific survival. The schedule of 8 weeks of AS before radiotherapy plus 8 weeks of AS...

www.ncbi.nlm.nih.gov

 

[BobbyHeenan]

Then give him 6 months and start RT afterwards with another 2 months of ADT... Non-inferior, potentially a bit more toxic, but why not?

Duration of androgen suppression before radiotherapy for localized prostate cancer: radiation therapy oncology group randomized clinical trial 9910 - PubMed

Extending AS duration from 8 weeks to 28 weeks before radiotherapy did not improve outcomes. A lower than expected prostate cancer death rate reduced ability to detect a between-group difference in disease-specific survival. The schedule of 8 weeks of AS before radiotherapy plus 8 weeks of AS...

www.ncbi.nlm.nih.gov

I'm good with that for high risk...I was thinking more of the unfavorable int risk where I'd usually give just 4-6 months total.

 

[Palex80]

I'm good with that for high risk...I was thinking more of the unfavorable int risk where I'd usually give just 4-6 months total.

Well RTOG9910 was mostly intermediate risk. I also like to give 4 months for unfavorable intermediate risk, but at these times it's certainly not wrong to give 8 months in individual, well informed patients.

What we have been doing in 2 favorable intermediate risk patients, is to simply wait. We looked at their PSA kinetics (luckily we had more than just one value) and came up with a low velocity. Knowing that those with slowly increasing PSA-values prior to treatment have a favorable prognosis, we decided not to treat 2 favorable intermediate risk patients now and rather watch PSA for a couple of months. We will treat (hopefully) when things settle down.

 

[radiation]

Cutbacks for some doctors and nurses as they battle on the front line - The Boston Globe

These financial cutbacks, coming in response to sudden shortfalls during the coronavirus outbreak, have triggered an outcry from doctors and nurses who are already working grueling shifts in demanding working conditions.

www.bostonglobe.com

Doing this to ER doctors on the frontlines is unconscionable

 

[RadOncDoc21]

Cutbacks for some doctors and nurses as they battle on the front line - The Boston Globe

These financial cutbacks, coming in response to sudden shortfalls during the coronavirus outbreak, have triggered an outcry from doctors and nurses who are already working grueling shifts in demanding working conditions.

www.bostonglobe.com

Doing this to ER doctors on the frontlines is unconscionable

Sickening and just shows you where doctors/nurses are in the grand scheme of everything. We just passed a 2 trillion dollar stimulus bill and yet the ones who need the help the most are receiving pay cuts.

A lot of people are comparing our role to a war. But unlike in military wars, people aren’t even being given what they need to prepare for the enemy. In the meantime, hospital execs are home in their mansions and a lot of businesses are making a significant profit.

 

[Mandelin Rain]

If the first person at your hospital system receiving a pay cut isn’t the CEO, who assuredly makes millions of dollars per year, you have my full permission to walk out.

 

[RadOncDoc21]

If the first person at your hospital system receiving a pay cut isn’t the CEO, who assuredly makes millions of dollars per year, you have my full permission to walk out.

Not only should the ER docs/nurses and ICU staff get paid, they should be getting paid more. No reason why this should be happening. It hasn’t even been one month yet.