Lost my job and can't move . . . now what?

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Moonbeams said:
The explanation given is they can't given certain doctors more PTO than others because the other doctors would complain about it not being fair.
However, obviously it is fine for compensation to vary widely. I suppose that's because how much PTO you take is transparent, whereas your compensation is explicitly to be kept secret by the terms of the contract you signed. Stupid.
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Uh, isn't this against federal law or something? I don't feel any pressure to keep my compensation secret in regards to my other co-workers.
 
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I also thought it was illegal to tell people they can’t talk about their compensation…..although I will also say that I’ve personally seen the toxic environment that these conversations have caused with dosimetry, therapy, and nursing

Have lost a couple great people because some newbie was hired at or above experience employee and newbie immediately ran their mouth
 
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RadRadRad said:
I also thought it was illegal to tell people they can’t talk about their compensation…..although I will also say that I’ve personally seen the toxic environment that these conversations have caused with dosimetry, therapy, and nursing

Have lost a couple great people because some newbie was hired at or above experience employee and newbie immediately ran their mouth
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not a bad thing. if the hospital was underpaying senior people - they deserve to know.
 
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RadRadRad said:
I also thought it was illegal to tell people they can’t talk about their compensation…..although I will also say that I’ve personally seen the toxic environment that these conversations have caused with dosimetry, therapy, and nursing

Have lost a couple great people because some newbie was hired at or above experience employee and newbie immediately ran their mouth
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I have a hard time blaming the new employee for a problem caused by a clinic paying them more than an experienced one makes.
 
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So, the toxic environment was caused by the conversation, not the pay disparity? Like if pay were equal/fair, still would have “toxicity”?

:)
 
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RadRadRad said:
I also thought it was illegal to tell people they can’t talk about their compensation…..although I will also say that I’ve personally seen the toxic environment that these conversations have caused with dosimetry, therapy, and nursing

Have lost a couple great people because some newbie was hired at or above experience employee and newbie immediately ran their mouth
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It's not illegal. 1A.

As for the rest of your post, Not sure how the second paragraph is a bad thing... It's called the free market
 
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There were a few companies that have tried income transparency, Planet Money had an episode about it. Net I would say it’s better for labor, tougher for management
 
Again, 1st off, sorry Op that you are going through this but it is going through many/most specialists in the House of Medicine. Look around, there are very few docs who are truly independent. GI, Derm, EM, Anesth, Rad, Cards, OB, Primary care, Allergy, Heme Onc, nephro. Essentially all hospital based practice is being employed or being bought by VC groups.

Other than Plastics and a few super specialists, most are being bought out and if not yet, will be. If there are money to be had, VC will/Hospitals will find it. They are willing and have the $$$ to take a short term loss to make large profits with the 1st cut being salary + increasing responsibilities.

Your situation sucks but its something Many in the House of medicine is going through.

As an aside, 25 yrs ago when I finished med school, Rad Onc was on no one's radar. Most didn't even know it existed. We had 1 med student go into Rad Onc and he was a bottom 5% student that matched. We all thought Rad Onc was a terrible field. Met him again 10 yrs later and heard from friends he was doing well.

Geeezzzz, never knew they could make 800-1M and I am sure he did it for a good 20 yrs with these high salaries. Makes it hard to feel sorry for Rad Onc esp when EM and other hospital based fields continue to have headwinds making half as much.
 
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emergentmd said:
Geeezzzz, never knew they could make 800-1M and I am sure he did it for a good 20 yrs with these high salaries. Makes it hard to feel sorry for Rad Onc esp when EM and other hospital based fields continue to have headwinds making half as much.
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Most rad oncs do not make this any more. Recent grads are looking at 1/3 of that. Mid career maybe half. That's not adjusting for inflation. You will move anywhere in the country to find that job too.
 
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emergentmd said:
Makes it hard to feel sorry for Rad Onc esp when EM and other hospital based fields continue to have headwinds making half as much.
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Nobody feels sorry for the rad oncs who started practicing > 10 years ago. They rode the gravy train and if they haven't reached financial independence by now that's on them. And even the new crop of residents it's hard to feel sorry for as they have been warned for years now. It's the early career guys who deserve your pity as they could have gone into any field and were sold something by rad onc that was not delivered upon.
 
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Moonbeams said:
Nobody feels sorry for the rad oncs who started practicing > 10 years ago. They rode the gravy train and if they haven't reached financial independence by now that's on them. And even the new crop of residents it's hard to feel sorry for as they have been warned for years now. It's the early career guys who deserve your pity as they could have gone into any field and were sold something by rad onc that was not delivered upon.
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When I met my classmate again 15 yrs ago, he said Rad Onc was competitive and back then I was not even sure why. seeing the amount made and hours he worked seem like NSG pay for an office based field with no call.

No wonder hospitals and VC are moving in.
 
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emergentmd said:
When I met my classmate again 15 yrs ago, he said Rad Onc was competitive and back then I was not even sure why. seeing the amount made and hours he worked seem like NSG pay for an office based field with no call.

No wonder hospitals and VC are moving in.
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Don’t want to dox anyone, but did your bottom 5% classmate have any leadership role in Astro or the ABR?
 
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Moonbeams said:
Nobody feels sorry for the rad oncs who started practicing > 10 years ago. They rode the gravy train and if they haven't reached financial independence by now that's on them. And even the new crop of residents it's hard to feel sorry for as they have been warned for years now. It's the early career guys who deserve your pity as they could have gone into any field and were sold something by rad onc that was not delivered upon.
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I agree. Its very hard to feel the least bit sorry for myself.
 
RickyScott said:
Don’t want to dox anyone, but did your bottom 5% classmate have any leadership role in Astro or the ABR?
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Nope, not that I know of. I always thought he went into Rad Onc b/c it was an easy to get residency and it was cush. I assume in the late 2000's Rad Onc was not competitive, correct me if I am wrong. B/c if I am wrong, then he must have been more of a stud than I thought or killed his board scores. He was one of the smartest guy I knew in medical school, just didn't seem to put the effort in so skated by. Maybe he killed his board scores, knew more than anyone else about Rad Onc?

Given what I know now, I am sure Rad Onc was one of the most competitive fields for the past 15 or so years.

However he got there, making 700+K/yr essentially doing office hours with almost no call seemed like a a great gig for 4 yrs of residency vs a NSG making not that much more doing one of the longest and worse residency known to man.
 
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emergentmd said:
Nope, not that I know of. I always thought he went into Rad Onc b/c it was an easy to get residency and it was cush. I assume in the late 2000's Rad Onc was not competitive, correct me if I am wrong. B/c if I am wrong, then he must have been more of a stud than I thought or killed his board scores. He was one of the smartest guy I knew in medical school, just didn't seem to put the effort in so skated by. Maybe he killed his board scores, knew more than anyone else about Rad Onc?

Given what I know now, I am sure Rad Onc was one of the most competitive fields for the past 15 or so years.

However he got there, making 700+K/yr essentially doing office hours with almost no call seemed like a a great gig for 4 yrs of residency vs a NSG making not that much more doing one of the longest and worse residency known to man.
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Late 2000s, he would have had to be stellar. Radonc started becoming competitive 2000-onwards. There have been periods where radonc was a safe haven for the absolute dregs of medicine. I was trained by some of them. Late 2000s, however, was a time when you almost had to be a Rhodes scholar to match.
 
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RickyScott said:
Late 2000s, he would have had to be stellar. Radonc started becoming competitive 2000-onwards. There have been periods where radonc was a safe haven for the absolute dregs of medicine. I was trained by some of them. Late 2000s, however, was a time when you almost had to be a Rhodes scholar to match.
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Sorry, I messed up. We graduated 2001.

Maybe he was a Rhodes Scholar. He was a stellar test taker, just never seemed to study, and always seemed like he was skating by. We never talked about grades so who knows.
 
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emergentmd said:
Geeezzzz, never knew they could make 800-1M and I am sure he did it for a good 20 yrs with these high salaries. Makes it hard to feel sorry for Rad Onc esp when EM and other hospital based fields continue to have headwinds making half as much.
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This is how we (meaning doctors) lost control of medicine.

Life isn't actually a meritocracy. Whatever any of us feels someone else should "earn" is irrelevant. Might as well talk about how little teachers get paid compared to Michael Jordan while we're at it.

There's a system of healthcare in America. It pays more for some things than others. It's not fair, and I doubt it ever will be. But it's not about "feeling sorry" if the absolute number started high (and in some cases remains high), rather, it's about why the number hasn't remained high. For everyone.

"It's something many in the House of Medicine are going through" - why is that the case? The "healthcare system" is not synonymous with "practicing medicine", though the way it's talked about, I think people have forgotten. Do we just all shrug together about where we're headed? Is it inevitable? We can't do anything about it?

Has the shame of even thinking about money been drilled so deeply into our souls that we see different groups having issues and think "well, they didn't work hard enough for that" instead of realizing we're all sliding down the same slope of burning, wet, hot garbage together?
 
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elementaryschooleconomics said:
This is how we (meaning doctors) lost control of medicine.

Life isn't actually a meritocracy. Whatever any of us feels someone else should "earn" is irrelevant. Might as well talk about how little teachers get paid compared to Michael Jordan while we're at it.

There's a system of healthcare in America. It pays more for some things than others. It's not fair, and I doubt it ever will be. But it's not about "feeling sorry" if the absolute number started high (and in some cases remains high), rather, it's about why the number hasn't remained high. For everyone.

"It's something many in the House of Medicine are going through" - why is that the case? The "healthcare system" is not synonymous with "practicing medicine", though the way it's talked about, I think people have forgotten. Do we just all shrug together about where we're headed? Is it inevitable? We can't do anything about it?

Has the shame of even thinking about money been drilled so deeply into our souls that we see different groups having issues and think "well, they didn't work hard enough for that" instead of realizing we're all sliding down the same slope of burning, wet, hot garbage together?
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Recently, however, I think we have crossed a line where some docs are going to end up downright impoverished, given the cost of med schools and oversupply in specialties like radonc and er. Sadly, it would come as no surprise that those dumb enough to consider these specialties are also most likely to be saddled with 400k in educational debt.
 
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elementaryschooleconomics said:
This is how we (meaning doctors) lost control of medicine.

Life isn't actually a meritocracy. Whatever any of us feels someone else should "earn" is irrelevant. Might as well talk about how little teachers get paid compared to Michael Jordan while we're at it.

There's a system of healthcare in America. It pays more for some things than others. It's not fair, and I doubt it ever will be. But it's not about "feeling sorry" if the absolute number started high (and in some cases remains high), rather, it's about why the number hasn't remained high. For everyone.

"It's something many in the House of Medicine are going through" - why is that the case? The "healthcare system" is not synonymous with "practicing medicine", though the way it's talked about, I think people have forgotten. Do we just all shrug together about where we're headed? Is it inevitable? We can't do anything about it?

Has the shame of even thinking about money been drilled so deeply into our souls that we see different groups having issues and think "well, they didn't work hard enough for that" instead of realizing we're all sliding down the same slope of burning, wet, hot garbage together?
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Hey, I applaud you guys for being able to find a field making 800K having bankers hours/no call. I never fault anyone for making as much as the market bears. But like everything in a capitalistic society, Unicorn fields/jobs/products gets a profit reduction.

And to blame the doctors for selling out is so short sighted. Its economics and supply/demand, its not personal. If you owned a Rad Onc group, made 5M a year, and someone comes and offers you 100M for it, you would be dumb not to sell. Your practice is no different than your home. You would never sell your home for a lower price, you always try to maximize the profit. If a doc is very protective of their field and refuse to sell, then guess what happens? A group or hospital will move in, hire Rad Oncs to compete, offer them 500K salary, pocket 300K/doc, and then your unicorn group value now is down to 20M. You would be dumb not to sell b.c you will be forced at a lower price. Happens all the time. Don't be the last to hold the bag b/c the $$$ went to those who sold out firs.

Rad Onc was a unicorn field, thus became hyper competitive, market forces comes in to lower income b/c there is a large pipeline of docs willing to do the same job for half the price. Its the reality of everything in a capitalistic society.

Bottom line is its about $$$ and also being a realist that no matter what, your practice is not worth what is being offered. So either sell out or be stuck.
 
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emergentmd said:
.

Rad Onc was a unicorn field, thus became hyper competitive, market forces comes in to lower income b/c there is a large pipeline of docs willing to do the same job for half the price. Its the reality of everything in a capitalistic society.

Bottom line is its about $$$ and also being a realist that no matter what, your practice is not worth what is being offered. So either sell out or be stuck.
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Rad onc was 💩 in the pre IMRT era too. Least desired field to match into, like you said 25 years ago (1970s-1990s was pretty much an fmg specialty).

Looks to be headed back that way with the way overtraining and the reimbursement climate is heading
 
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medgator said:
Rad onc was 💩 in the pre IMRT era too. Least desired field to match into, like you said 25 years ago (1970s-1990s was pretty much an fmg specialty).

Looks to be headed back that way with the way overtraining and the reimbursement climate is heading
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Yip; knew of one chair during residency who was an fmg and supposedly working as a cabbie. Got started in the field when he gave zvi fuchs a ride to the airport. (Had 0 gratitude; couldn’t stop laughing when fuks was taken out of mskcc in handcuffs)
 
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RickyScott said:
Yip; knew of one chair during residency who was an fmg and supposedly working as a cabbie. Got started in the field when he gave zvi fuchs a ride to the airport. (Had 0 gratitude; couldn’t stop laughing when fuks was taken out of mskcc in handcuffs)
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This is remarkable, the level of detail. I’m now very curious
 
RickyScott said:
Yip; knew of one chair during residency who was an fmg and supposedly working as a cabbie. Got started in the field when he gave zvi fuchs a ride to the airport. (Had 0 gratitude; couldn’t stop laughing when fuks was taken out of mskcc in handcuffs)
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Sounds like he had zero gratitude and gave zero…

Fuks

csi miami deal with it GIF
 
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Chartreuse Wombat said:
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Nothing triggers my conspiratorial tendencies more than stories like this. First off, the dollar value of the stock!!! How effing rich was fuks to begin with?

Then, the questionable clinical value of Erbitux long term, as well as the clear discordance with published toxicity and my (and many others) experience.

Probably just a few bad, rich actors and coincidence. But, makes you question objectivity all around.
 
Not sure if we are thinking of the same person but a former chair in the midwest has a brother who is a cabbie. Was that chair really a cabbie too ??
 
communitydoc13 said:
Nothing triggers my conspiratorial tendencies more than stories like this. First off, the dollar value of the stock!!! How effing rich was fuks to begin with?

Then, the questionable clinical value of Erbitux long term, as well as the clear discordance with published toxicity and my (and many others) experience.

Probably just a few bad, rich actors and coincidence. But, makes you question objectivity all around.
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maxxor said:
That same stock event sent Martha Stewart to prison.
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Erbitux has been more effective at incarcerating people than curing them of cancer
 
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Maybe the story is actually Potters was a limo driver ? A good friend of mine that matched in RO drove a limo for a while. He’s now an internist, but not a chairman
 
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doing a week of locums next week in an area that is attractive to me and my family to spend a week - 2500 a day. better offer than ive had in a while.
 
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RickyScott said:
How did you find it?
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Furthermore, you have a contract that allows you to use vacation for locums? Every contract I've ever seen says they own you. I've even seen ones that say you can't have ANY source of outside income even non-medical related. So if you want to do this you are taking a gamble (not that I have ever done or would do such a thing...)
 
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Moonbeams said:
Furthermore, you have a contract that allows you to use vacation for locums? Every contract I've ever seen says they own you. I've even seen ones that say you can't have ANY source of outside income even non-medical related. So if you want to do this you are taking a gamble (not that I have ever done or would do such a thing...)
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I don’t work for a corporation.

The idea that someone would tell me I can’t locum or do whatever I want would not fly.

I consider myself lucky to have the job I do
 
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jondunn said:
I don’t work for a corporation.

The idea that someone would tell me I can’t locum or do whatever I want would not fly.

I consider myself lucky to have the job I do
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I have seen the same thing from most private groups as well. Partners are ok with covering your patients if you are at the beach, but not if you are also making money treating somebody else's patients, even if it's at the beach.
 
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Moonbeams said:
I have seen the same thing from most private groups as well. Partners are ok with covering your patients if you are at the beach, but not if you are also making money treating somebody else's patients, even if it's at the beach.
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Have to consider the source of this info... Relatively new grad out of training professing to pull in 7 figures a year at a PP gig. His whole SDN account/handle just screams something that rhymes with bowl, not to mention the perpetual "probationary status" etc.

At least turaco and khe tried to spice it up with some politics from time to time... Probably why this one has still stuck around
 
I don’t see the locum market turning around. In my area, 2 unemployed guys compete with one another for gigs
 
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I’m definitely getting unsolicited recruiters offering about $2,000/day for rural locums work.
 
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RealSimulD said:
Me too

I tell them no one is going to do it for less than $2500.
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I also almost always take the calls from locums recruiters, see what they are offering, explain what my current daily compensation is, and re-educate them that their offer needs to be >$2500 + expenses to bring someone competent out. It's not unusual that they will literally laugh out loud. But the more of us that do this, the better.

This could all be prevented if rural centers would actually offer new grads 90%-tile pay and/or fractional ownership of the LINAC to recruit them out there and bend over backwards to make them happy to keep them around. Many places have run the numbers and figured out they come out ahead with revolving octolocums who will accept stupidly low daily rates wherever they can get work. And so that's what happens and patients suffer. Sad.
 
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RickyScott said:
you have to factor in travel time
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You also have to factor in the liability you are exposing yourself to by walking into some of these places and attaching your name to a trainwreck clinic. What's that worth? A hell of a lot more than $1500/day and dinners at Applebee's.
 
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Moonbeams said:
I also almost always take the calls from locums recruiters, see what they are offering, explain what my current daily compensation is, and re-educate them that their offer needs to be >$2500 + expenses to bring someone competent out. It's not unusual that they will literally laugh out loud. But the more of us that do this, the better.

This could all be prevented if rural centers would actually offer new grads 90%-tile pay and/or fractional ownership of the LINAC to recruit them out there and bend over backwards to make them happy to keep them around. Many places have run the numbers and figured out they come out ahead with revolving octolocums who will accept stupidly low daily rates wherever they can get work. And so that's what happens and patients suffer. Sad.
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It’s gotta be real rural to pull off having poor quality docs
I’ve found that patients are willing to travel about an hour if the community knows the doctors are no good. And they figure this out fast
I’ve seen practices go from 25-30 on beam to 10-15 within 2 years of losing stable doc
(Without any competing center opening). All just driving to other locations.
 
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