I'm interested in hearing from people who have made the jump from one to the other. How long did you stay in your original position? What did you dislike about it? What do you like/dislike after changing jobs? Is there anything you miss about PP/Academics?
PP vs Academics
- Thread starter Doctorer
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I have not jumped from one to the other so feel free to ignore, but I think the dichotomy your question presumes is no longer the case in many instances. With hospital consolidation and other secular trends in health care this is likely to continue.
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Academic in 2018 = Any other Hospital Employed position +/- a resident.
With the added bonus of kicking some of your salary to the dean and chairperson.
With the added bonus of kicking some of your salary to the dean and chairperson.
D
deleted18755
From what I understand an additional “bonus” is a ridiculous army of secretaries, therapists/nurses, and administrators whose salary you pay but whom you have no control over with regard to performance (I almost don’t believe the number of staff to patient under treatment ratios some of my buddies tell me about or the fact that they sometimes literally have to beg a therapist to do an urgent sim after 3pm and even then the therapist tells them they will do the doctor a favor this one time). It’s all the same now whether your boss is the chair or administrator/CEO.
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In some satellites, the RTT unions are so strong and the glut of MDs is so high that there is virtual salary overlap. In hospitals there is a ton more money to be had from technical fees which (as noted above) goes to everyone and their mother except the one who is generating it.
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I totally agree. In general, a large hospital will not be as overstaffed from a physician standpoint i.e you wont have 10 docs treating 75-100 patients, like you do at some "academic" centers.
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So I am currently looking for a job and have talked to some of my faculty and ex-faculty members about this topic. One of the attendings in my program who left for a PP recently was in academics for 10+ years and told me the following:
-Pros of academics: quality colleagues throughout different specialties, not only clinic based and can find career enrichment in working on projects/teaching residents, prestige, overall stability of practice (as in the university isn't going to close down on you)
-Cons of academics (main center position): low pay relative to PP colleagues, publish or perish with respect to promotion, increased bureaucracy and frustrating to see people who are clinically inept be rewarded for research but honestly are not good clinical doctors
-Pros of PP: ~40% pay increase after 2-3 years in comparison to academics, no pressure to publish, can be involved in overall radonc community (ASTRO committees, enroll on NRG trials, etc) if you are interested but no pressure,
-Cons of PP: referring docs can sometimes not be up to par with today's standard of care which is frustrating, some practices are purely eat what you kill so there is pressure to bring in "business" or court referring docs, some areas in the country have competitive markets (San Fran, LA, NYC, So Florida, etc) which can cause lack of practice stability (i.e. 21st century taking over)
Overall, my previous attending is super happy with his decision to leave academics and go into PP. He realized he wasn't cut out for the research demand. He didn't like it and it overall was what was determining his promotion and his career success. He did tell me a caveat to him being happy was he chose to join a large hospital based PP in a medium size city that wasn't super competitive. So he has a much better salary than when he was in academics but doesn't have the pressure to "practice build" and the practice is very financially stable.
Hope this helped.
-Pros of academics: quality colleagues throughout different specialties, not only clinic based and can find career enrichment in working on projects/teaching residents, prestige, overall stability of practice (as in the university isn't going to close down on you)
-Cons of academics (main center position): low pay relative to PP colleagues, publish or perish with respect to promotion, increased bureaucracy and frustrating to see people who are clinically inept be rewarded for research but honestly are not good clinical doctors
-Pros of PP: ~40% pay increase after 2-3 years in comparison to academics, no pressure to publish, can be involved in overall radonc community (ASTRO committees, enroll on NRG trials, etc) if you are interested but no pressure,
-Cons of PP: referring docs can sometimes not be up to par with today's standard of care which is frustrating, some practices are purely eat what you kill so there is pressure to bring in "business" or court referring docs, some areas in the country have competitive markets (San Fran, LA, NYC, So Florida, etc) which can cause lack of practice stability (i.e. 21st century taking over)
Overall, my previous attending is super happy with his decision to leave academics and go into PP. He realized he wasn't cut out for the research demand. He didn't like it and it overall was what was determining his promotion and his career success. He did tell me a caveat to him being happy was he chose to join a large hospital based PP in a medium size city that wasn't super competitive. So he has a much better salary than when he was in academics but doesn't have the pressure to "practice build" and the practice is very financially stable.
Hope this helped.
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I have a personal experience of voluntarily resigning from being a university employee to become a competing large hospital employee. Job essence has not changed much, but 25% in base salary increase was nice.
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I like the spectrum of practice one can enjoy in a PP freestanding center. I treat a full external practice and the variety of cases keep things interesting. Pay is better, as is the lack of hospital/administration politics
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First job out was one of those private groups that basically eat what they kill and was all about profit and keeping patients on the machine at all cost. Due to fear of being on the news, I went to an employed position. Although I miss the money, I feel much safer now.
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I would think that it would be hard to get a taste of the autonomy and money available in a real private practice and go back to having a boss dictate who/what/how you treat and how much you make.
D
deleted18755
I think this is spot on for the traditional pros and cons of academic vs PP but things have changed so much (and likely will continue to do so) that the two are blending together and in extreme cases there is overlap.
Believe it or not, not too long ago (~15-20 years) the resident a few years ahead of me got a 20/80 gig with a start-up support grant (so he was 20% clinical and 80% protected research and he just got a lump sum of money and lab space to help him start out). To keep his job after a year or two he had to secure his own funding and publish ... that’s a true academic job where you “publish or perish” meant.
Alternatively a resident a few years prior literally got a loan from his parents, bought a linac, hired family to be his administrative staff, and rented office space in an old arcade or something like that (built the vault, paid a physicis to QA it etc). That’s what private practice meant.
This isn’t ancient history but back then the dichotomy was clear, now it’s different shades of grey and even some overlap so in many cases it’s not a “jump” so much as a “small step” to go from PP to academics. I bet you could find two “academic” jobs that are farther on the spectrum than two “academic” or PP jobs and I know for a fact some overlap.
This is a big one for me. The thing I like the most about radonc is how we get to treat all organ sites across the body. I love being able to talk to a pulmonologist about EBUS one minute and a surgical oncologist about his planned Whipple procedure the next. I would really not enjoy a truly academic, single-organ-site job.
