Possible to do primarily benign/malignant heme in community practice?

[HPF]

I’m a first year hematology/oncology fellow and I really enjoy benign and malignant hematology. I think I could be happy doing just that for the rest of my life. I’ve also noticed that as interesting as research is, I derive the most satisfaction from taking care of patients. I’m curious to know if working in private practice or academic-affiliated practice doing benign and malignant heme only
is 1) possible, 2) financially feasible (heard rumors benign heme is paid much less but not sure if that is true, 3) would significantly restrict my employability or geographic location, or if it’s essentially required to be much more generalized.

To be clear I am keeping an open mind to all career options this early on in fellowship. But knowing that this might be a possibility would change the way I schedule a few things for the coming year. Particularly some clinic blocks.

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[MD46]

1. Give it some time as its only the first year your preferences might changed, happened with some of my co-fellows

2. In a private group it is possible to do only Ben/Malg Heme in two situations, its a very big group with people specialized in 1-2 fields and you get to only practice Malg/Ben heme. Likely spending more time in patient this way. Other way is finding a group that only does hematology, I did interview at one and they only did Hematology. Their partner take home with a good load of patients was less that half of what their Medical Oncologist Counter parts were making in the same building under a different group. So Heme only compensation with be lower.

3. I think realistically your best bet for doing only heme would likely be either academic in a major metro or near one, or an hybrid practice about 2-3 plus hrs out side a metro.

Good luck

 

[HPF]

Thanks MD46. Option 1 seems more appealing. I wouldn’t mind doing a little more inpatient. Is it rare to find a group divided up in that way? I don’t have geographic restrictions. If you did find a group like that, would a significant paycut be expected as with the heme only groups?

Agree that I am very early on and won’t be deciding anything anytime soon. It helps me to imagine what could be down the line though.

 

[MD46]

Actually a large group in PA I interviewed at wanted me to do inpatient Mal heme and take Ben Heme consults, while most of their established doctors do mostly out patient bread and butter Onc.

My base if I did that was higher (50K higher) but if I did standard route and shared inpatient call equally, it would be same as any other new person joining.

Weekend call would still be shared like usual.

 

[gutonc]

These jobs are out there. They're not super common, but they exist. And you don't need to go 2-3h outside a major metro area either.

My hybrid/academ-ish group (with office and 2 hospitals located smack in the downtown core of a major coastal city) would be happy to hire somebody like this (although not a new grad, for a variety of reasons), to manage an inpatient heme mal and auto BMT service, as well as deal with benign heme stuff in and out-patient. We're sort of passively recruiting for it as I speak. Pay structure would likely be the same as everyone else in the group but we're shifting to a more production focused model soon and will probably need to restructure this kind of position, since inpatient wRVUs suck for the most part, compared to outpatient, at least on a straight E&M basis.

But definitely keep an open mind on this stuff. 2 of my former co-fellows are great examples of how things can change. One came in with a ton of research in Head/Neck and was planning an academic career in that. He then did a research rotation (research pathway) in a leukemia lab and now he's an AML guy with his own lab. Other guy came in BMT or GTFO. After 3 months on the leukemia and BMT services as a first year fellow, he went solid tumor and now does Thyroid and Melanoma.

 

[HPF]

Thanks GutOnc. Good to know. Yes, definitely know I have a lot of exploring to do before I settle on my career path.

 

[whoknows2012]

I was offered a position at a hybrid practice in NJ about 20 mins outside NYC heme only (mostly mal heme) equally split call chance to do some clinical research/trials and pay was 1.75x academic pay in NYC. It was a pretty sweet deal but ultimately decided to stay in academics (leukemia) in NYC