Private Practice

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You are totally mistaken. You absolutely do NOT have to move out of densely populated areas to do private practice. There are plenty of opportunities even in the tightest markets like Chicago, Manhattan, San Diego, etc. The percentage of residents going into some form of private practice varies from 70-80% each year.

From a pateint perspective, you can only go where your insurance lets you. Many insurance companies have contracts with private groups in the area. Unless you are independently wealthy and able to shell out $100K to be treated at a big academic center, you will really have a difficult time convincing your insurance company to let you go "out of network." Besides, many patients would much rather go to a local Rad Onc facility if the are going to be treated for 5+ weeks and not temporarily move somewhere else. Finally, you don't need to go to MDACC to be treated for bread & butter stuff.
 
Might make intuitive sense, but not true at all, really.
Many reasons:
- a lot of people don't like driving into the big city everday (seriously)
- people may want an opinion from MDACC, but are perfectly satisfied with getting their treatment closer to their home or work
- insurance may require you to go somewhere specific, before you are allowed to get a second opinion
- your diagnosing doctor may recommend a certain practictioner that he/she knows to be good and is in the nearby community, so the thought of going to MDACC doesn't cross your mind.
- sometimes the university docs aren't really that great
- going to an academic place might mean having to see a resident at consultation and during every visit on treatment, and some people don't like that

These are just some of the reasons. There are probably many more people can think of.

S
 
This is an interesting question. Any other thoughts out there? I too wondered what the outlook for private practice vs academic jobs was
 
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