several forum posts have discussed malignant prgrams but information about employers (especially hospitals and networks is scattered). Do you have a negative experience working at a particular center (as staff not a resident)? Have you heard rumors? Are places notorious for turn over near you? Too many of us are forced to look far and wide into unfamiliar markets for decent jobs. Lets create a space here to share our knowledge. Please rely with your experiences or gossip. Please label each as such, however.
Malignant Employers
- Thread starter GOB
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I personally haven't heard of "malignant" or unscrupulous hospital employers. I think that's more pervasive in private practice where employers cut people lose prior to partnership.
Generally speaking, hospitals will offer better salaries and benefits upfront than a private practice the first few years before partnership.
Generally speaking, hospitals will offer better salaries and benefits upfront than a private practice the first few years before partnership.
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Nobody is going to publicly shame these places. Any info posted would immediately lead to vigorous arguments making people wonder about the truthfulness of the information. Unfortunately, there are also bad attendings who can blame places for their problems, and so it's always hard to tell the difference. Specific examples would likely out the person posting and possibly lead to lawsuits.
This is real simple. Do your homework on your end.
Talk to people who have worked there in the past.
Find out the turnover at the practice.
Ask other people in the area about the reputation of that practice.
Review the contract carefully with someone who specializes in physician contracts in that area.
This is a relatively small community with people who will privately help you and give you their honest opinions. This is where networking comes in.
This is real simple. Do your homework on your end.
Talk to people who have worked there in the past.
Find out the turnover at the practice.
Ask other people in the area about the reputation of that practice.
Review the contract carefully with someone who specializes in physician contracts in that area.
This is a relatively small community with people who will privately help you and give you their honest opinions. This is where networking comes in.
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Yep. Be sure and ask plenty of questions and find out why there's an opening, who was there before you, and where they went. A lot of suckers have rolled through a practice in the same town my friend is at. Now on their 7th radonc in 5 years.
I would agree that hospitals will offer better starting salaries, but my experience and that of other employed physicians is that hospital employers view their staff as completely replaceable (cogs) and have no qualms about terminating employed physicians when their pay is deemed higher than market rate.
Bottom line: if you want stability to raise a family, my experience has been that a private group with partnership is the best way to go.
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Based on what my chief residents experienced on the job hunt, PP isn't going to be a realistic option and PP with true partnership nothing more than a pipe dream. I'm not seeing how private is a stable/suitable way to go for most as this practice style is quickly disappearing. The majority of our residents have gone the hospital employed route simply because that is what was available in the majority of desired locations. And who knows what the senior partners are really contemplating as the junior members toil away for 2-3 years before they make partner. At best, PP is no more volatile for rad oncs than hosp employed. At worst, it's just an exploitative exercise as these junior collegues chase the dream of big money that won't be there.
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There are no more slam-dunk approaches to practice at this point. The sky is not falling, but the field used to be a license to print money, but it's just not that way anymore for many reasons.
There are good and bad practices everywhere and can be configured in a number of different ways (private group not employed by hospital but charges only professional fees with service agreement with hospital, private group that owns machines, private group of doctors that owns their own cancer center, employed rad onc by hospital et al). Speaking generally, the risks of a true PP group include not ever really making partner, while the risk of hospital employed is more the "cog" phenomenon or some administrator deciding you make too much (trust me, MGMA helps, but they can hire their own "consultant" to determine whatever market rate they want it to be) and cutting your pay or finding someone else. The over-supply issue comes into play here, because your value/negotiation power in both of these situations is hampered by a potential glut of cogs/junior partners.
Like Nueronix says - you've got to be your own advocate and look out for what is in your best interest. Call former employees, talk to the referring docs, and talk the competition in town. Talk to former residents or anyone at all about how practices work and what the place is telling you and if that jives with his/her experiences out in practice at all. If it sounds too good to be true it probably is.
There are good and bad practices everywhere and can be configured in a number of different ways (private group not employed by hospital but charges only professional fees with service agreement with hospital, private group that owns machines, private group of doctors that owns their own cancer center, employed rad onc by hospital et al). Speaking generally, the risks of a true PP group include not ever really making partner, while the risk of hospital employed is more the "cog" phenomenon or some administrator deciding you make too much (trust me, MGMA helps, but they can hire their own "consultant" to determine whatever market rate they want it to be) and cutting your pay or finding someone else. The over-supply issue comes into play here, because your value/negotiation power in both of these situations is hampered by a potential glut of cogs/junior partners.
Like Nueronix says - you've got to be your own advocate and look out for what is in your best interest. Call former employees, talk to the referring docs, and talk the competition in town. Talk to former residents or anyone at all about how practices work and what the place is telling you and if that jives with his/her experiences out in practice at all. If it sounds too good to be true it probably is.
Not all PP groups are exploitative. Our (very large) PP group has standard contracts, never has/never will "hire and fire", and all new hires, assumed they get along well once they're hired, are made partner at 18 months. I'd like to think we're far less volatile than any hospital-based position.
Unfortunately your group is in the minority. After speaking with multiple former "employed randoncs" at 3 different practices in desirable areas the private practice groups have become much more exploitative over the years. Be very very careful joining these practice. Do your due diligence in finding the people who have left and ask the people who left of why they left.
A good way of finding former employed radoncs is to do a google search of the practice and find the archived google pages of the practice with the former employed radoncs names. Then use astro directory, linkedin, or facebook to find them and ask them questions of why they left. This saved me from joining two practices that I would have later regretted.
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Correct, also in parts of Wisconsin, inland california
One of those starting with an I is a known resident mill.
