Quantifying Job Market Difficulties and predicting ahead

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hal9k said:
I just looked at md Anderson rad onc alumni list..it’s amazing they continue to take 3-4 of the graduating residents every year. Their department is enormous
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medgator said:
I think it goes... there's the right way, the wrong way and the MD Anderson way.
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The number of MD Anderson GU attendings is up 50% the last 15 years.

The number of prostate cancer patients is down 10% in that timeframe.

If MD Anderson gave 39 fractions to everyone 15 years ago, and it is (or should be) giving 28 nowadays, then the number of "patient-fractions" is down 63%.

This would mean each MD Anderson GU attending is managing 42% as much, or 58% less, prostate CA patients today as 15 years ago (because of rise in their "labor force," and a decline in patients/fractions). So, that's a silly result right? Unless everyone at MD Anderson is stupid, I just proved they've either 1) stolen a lot of business from others, or 2) came up with ever new ways to keep boosting reimbursement. Or both!
 
scarbrtj said:
The number of MD Anderson GU attendings is up 50% the last 15 years.

The number of prostate cancer patients is down 10% in that timeframe.

If MD Anderson gave 39 fractions to everyone 15 years ago, and it is (or should be) giving 28 nowadays, then the number of "patient-fractions" is down 63%.

This would mean each MD Anderson GU attending is managing 42% as much, or 58% less, prostate CA patients today as 15 years ago (because of rise in their "labor force," and a decline in patients/fractions). So, that's a silly result right? Unless everyone at MD Anderson is stupid, I just proved they've either 1) stolen a lot of business from others, or 2) came up with ever new ways to keep boosting reimbursement. Or both!
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Isn't definitive bladder up 600000%?
 
scarbrtj said:
The number of MD Anderson GU attendings is up 50% the last 15 years.

The number of prostate cancer patients is down 10% in that timeframe.

If MD Anderson gave 39 fractions to everyone 15 years ago, and it is (or should be) giving 28 nowadays, then the number of "patient-fractions" is down 63%.

This would mean each MD Anderson GU attending is managing 42% as much, or 58% less, prostate CA patients today as 15 years ago (because of rise in their "labor force," and a decline in patients/fractions). So, that's a silly result right? Unless everyone at MD Anderson is stupid, I just proved they've either 1) stolen a lot of business from others, or 2) came up with ever new ways to keep boosting reimbursement. Or both
Click to expand...
scarbrtj said:
The number of MD Anderson GU attendings is up 50% the last 15 years.

The number of prostate cancer patients is down 10% in that timeframe.

If MD Anderson gave 39 fractions to everyone 15 years ago, and it is (or should be) giving 28 nowadays, then the number of "patient-fractions" is down 63%.

This would mean each MD Anderson GU attending is managing 42% as much, or 58% less, prostate CA patients today as 15 years ago (because of rise in their "labor force," and a decline in patients/fractions). So, that's a silly result right? Unless everyone at MD Anderson is stupid, I just proved they've either 1) stolen a lot of business from others, or 2) came up with ever new ways to keep boosting reimbursement. Or both!
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+ 1000% cms rates and just hiring more faculty
Is certainly a component. When are we going to see red journal articles on this?
 
RickyScott said:
+ 1000% cms rates and just hiring more faculty
Is certainly a component. When are we going to see red journal articles on this?
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The Office Waiting GIF
 
dieABRdie said:
I talked with some of them at ASTRO. All were happy at the multi-doc group I talked to. I also talked to one doc who is the only doc at his shop in Alaska... they were from a large city in Texas and said "I wish I would have done it sooner."
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I'm sure the pay and autonomy must be great. It's a fair point, don't see a lot of alaska openings
 
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Neuronix said:
Probably a night shift job. They're one week on, one week off around here. Some places pay a premium for it because it's hard to find people who will work just nights.
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Bingo. Houston Methodist was offering 500k starting and 650k as once you make partner for a 7 on 7 off overnight gig.
 
Baws said:

'radiation OR oncology OR physician OR to OR join OR ascension OR STATECODE:"IN"' Jobs | ASTRO Radiation Oncology Career Center

3,322 'radiation OR oncology OR physician OR to OR join OR ascension OR STATECODE:
careers.astro.org careers.astro.org

Evansville, Indiana is back!!

srsly...how bad is this job where it gets posted EVERY DAMN year???
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Heres the other one. Also just reposted

'therapy OR associates OR evansville OR in OR STATECODE:"IN"' Jobs | ASTRO Radiation Oncology Career Center

3,362 'therapy OR associates OR evansville OR in OR STATECODE:
careers.astro.org careers.astro.org
 
Turaco said:
The Marshfield, WI posting is particularly egregious. I just checked my email. This job has been spammed to me for over 3 years. THREE YEARS. What kind of insanely crap offer are they trying to get away with there? Anyone actually talk to them? Very curious as to what absurdity is being thrown out there. I'm going to take a wild guess and say $350k salary, crap production bonus, crap benefits, PTO you can't use, and some crap signing bonus/loan repayment deal that you only get it you somehow make it 5 years without killing yourself. Am I close?
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Perhaps you should actually look at their benefit package and cost of living before making unsupported assertions. 11% of your salary for retirement investment, in addition to 401k, is nothing to sneeze at.
 
The Med-Peds Dude said:
Perhaps you should actually look at their benefit package and cost of living before making unsupported assertions. 11% of your salary for retirement investment, in addition to 401k, is nothing to sneeze at.
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if this job was financially worthwhile despite the location, it would not be still be unfilled after 3+ years. By all means though, enlighten us what their salary offer and benefits package is and we can all make our own decisions on whether it is "nothing to sneeze at"
 
radOresident said:
if this job was financially worthwhile despite the location, it would not be still be unfilled after 3+ years. By all means though, enlighten us what their salary offer and benefits package is and we can all make our own decisions on whether it is "nothing to sneeze at"
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I'll not do your reading for you. Benefit details are readily available....
 
The Med-Peds Dude said:
Perhaps you should actually look at their benefit package and cost of living before making unsupported assertions. 11% of your salary for retirement investment, in addition to 401k, is nothing to sneeze at.
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As I said, it was a guess. If you have more information, we're all ears. From the grapevine, I have heard this job pays decently on average for rad onc, but not what it should for rural Wisconsin. I'm glad med peds does well there, but rad onc can be a different story because the pro fees and technical fees rad onc generates are on a totally different level. Whereas a med peds MD might be getting paid more than he or she brings in, it's very common for rad oncs to get paid far less than what they actually bring in, especially in competitive metros.

If the Marshfield job advertised private practice option where you can do your own professional billing and offered an opportunity to buy into a portion of the technical side, this job would be filled within a month, guaranteed. And they would still make plenty of money.
 
The non rad onc contributor should understand that if a job gets reposted annually year after year that there is something probably wrong with it. Otherwise, they are just trolls.
 
Don't expect the folks of Evansville to extend a lot of Thanksgiving dinner invitations to Madonna.
The city is still smarting over a TV Guide story in which Madonna said that Evansville was boring and that she couldn't even watch MTV when she was there to film the movie "A League of Their Own."
 
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Yes, they used to call them fellowships.

It's probably not for an external candidate. It's for one of their internal candidates.

Folks, you do realize that for the graduating class of this year they hired one of their own as a clinical instructor, two stayed on as research fellows and one got a job in the community.

That's only one out of four that got a job that pays real money. And this is Stanford.

Depressing...
 
BetrayedRO said:
Yes, they used to call them fellowships.

It's probably not for an external candidate. It's for one of their internal candidates.

Folks, you do realize that for the graduating class of this year they hired one of their own as a clinical instructor, two stayed on as research fellows and one got a job in the community.

That's only one out of four that got a job that pays real money. And this is Stanford.

Depressing...
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Yikes for so many reasons.
 
BetrayedRO said:
Yes, they used to call them fellowships.

It's probably not for an external candidate. It's for one of their internal candidates.

Folks, you do realize that for the graduating class of this year they hired one of their own as a clinical instructor, two stayed on as research fellows and one got a job in the community.

That's only one out of four that got a job that pays real money. And this is Stanford.

Depressing...
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Not exactly the easiest job market/region to land a job in, but point taken
 
BetrayedRO said:
Yes, they used to call them fellowships.

It's probably not for an external candidate. It's for one of their internal candidates.

Folks, you do realize that for the graduating class of this year they hired one of their own as a clinical instructor, two stayed on as research fellows and one got a job in the community.

That's only one out of four that got a job that pays real money. And this is Stanford.

Depressing...
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Being known for lymphoma RT isn't exactly going to be the hallmark of a great program these days, I'm afraid. Stanford put its eggs in precisely the wrong basket.
 
OTN said:
Being known for lymphoma RT isn't exactly going to be the hallmark of a great program these days, I'm afraid. Stanford put its eggs in precisely the wrong basket.
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Unless of course you’re doing Stanford V followed by RT. LOL. Why did I care so much about scoring so high on the usmle again?
 
I was at a local cancer convention a few years ago where Dr. Richard Hoppe was one of the panelists for a lymphoma case. A couple of observations:

1. Every single Med Onc on that panel ****ted all over radiation as a modality in lymphoma. Not based on any contemporary data mind you, but mindlessly quoting the known sequelae of old mantle-type radiation including secondary malignancy, hypothyroidism, and acceleration of coronary artery disease. Hoppe didn't say one word in protest.

2. When we finally got the RT portion, one of the Stanford Med Oncs on the panel commented that he would only trust Hoppe's expertise in delivering ISRT after chemo. Ridiculous - we need to send a patient to a center of excellence to deliver 24 Gy in 12 fractions!

I actually tore into the panel during the Q&A session but I'm just "small" Rad Onc so I'm sure there was a lot of eye rolling and patronizing sighs in response.
 
Gfunk6 said:
I was at a local cancer convention a few years ago where Dr. Richard Hoppe was one of the panelists for a lymphoma case. A couple of observations:

1. Every single Med Onc on that panel ****ted all over radiation as a modality in lymphoma. Not based on any contemporary data mind you, but mindlessly quoting the known sequelae of old mantle-type radiation including secondary malignancy, hypothyroidism, and acceleration of coronary artery disease. Hoppe didn't say one word in protest.

2. When we finally got the RT portion, one of the Stanford Med Oncs on the panel commented that he would only trust Hoppe's expertise in delivering ISRT after chemo. Ridiculous - we need to send a patient to a center of excellence to deliver 24 Gy in 12 fractions!

I actually tore into the panel during the Q&A session but I'm just "small" Rad Onc so I'm sure there was a lot of eye rolling and patronizing sighs in response.
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Classic, non-confrontational catfish RadOnc moves. I can picture the exasperated sighs you caused now. How bold you must be, delivering 24 Gy ISRT in the community! What a maverick move.
 
elementaryschooleconomics said:
Classic, non-confrontational catfish RadOnc moves. I can picture the exasperated sighs you caused now. How bold you must be, delivering 24 Gy ISRT in the community! What a maverick move.
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That’s annoying but at the end of the day, Medical oncs are holding all the cards and they know it.
 
RadsWFA1900 said:
Medical oncs are holding all the cards and they know it
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Yep. I can't get XRT into a lymphoma pt in the community and the community medoncs are probably more receptive to my opinion than the academic docs. The regional big name places (including where I trained) dismiss it in every setting even pretty classic ones like Deauville 4 after 2 cycles or older high grade B-cell pts with bulky or extranodal disease.

In my opinion, ISRT is probably the least toxic drug a 70 year old will get. They don't see it that way.

Medonc so much healthier field. If you are in the community, log-on to an NCORP meeting. Many, many trials at any time with the periodic XRT trial that dies due to poor accrual. Essentially infinite combinatorial immunotherapy trial space for medonc at this juncture.

Nature of medonc research is -->drug development-->demonstrate efficacy-->disseminate in community ASAP

Nature of radonc research is (non-inferiority trials or cost analysis or biomarker trials to reduce XRT indications) or-->tech development (e.g. protons)-->don't demonstrate superior efficacy-->market superiority of tech relative to the community.

This has affected me significantly. I have seen 60+ year old community medoncs excited about the new tools that they will have in the next ten years. I'm much younger than this, but even if someone magically developed a technique with infinite conformality, I know that my role in cancer will only diminish for the remainder of my career.
 
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communitydoc13 said:
Yep. I can't get XRT into a lymphoma pt in the community and the community medoncs are probably more receptive to my opinion than the academic docs. The regional big name places (including where I trained) dismiss it in every setting even pretty classic ones like Deauville 4 after 2 cycles or older high grade B-cell pts with bulky or extranodal disease.

In my opinion, ISRT is probably the least toxic drug a 70 year old will get. They don't see it that way.

Medonc so much healthier field. If you are in the community, log-on to an NCORP meeting. Many, many trials at any time with the periodic XRT trial that dies due to poor accrual. Essentially infinite combinatorial immunotherapy trial space for medonc at this juncture.

Nature of medonc research is -->drug development-->demonstrate efficacy-->disseminate in community ASAP

Nature of radonc research is (non-inferiority trials or cost analysis or biomarker trials to reduce XRT indications) or-->tech development (e.g. protons)-->don't demonstrate superior efficacy-->market superiority of tech relative to the community.
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Which is why the so called “innovators” and “influencers” who claim to embrace the future of rad onc should have the foresight to see that it’s a future that doesn’t include you and start to make in roads to fields that are actually going places. Would be a shame to further piss away all the so called talent RO hoarded for itself in the heady days only to pigeon hole them in ****ty go nowhere projects.
 
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RickyScott said:
Depends on practice environment. In my system, medonc would not want primaries referring directly to radonc.
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Absolutely.... Harder in certain employed multispecialty group situations, absolutely necessary out in the wilderness in community practice imo, esp if an adversarial med onc is in the picture
 
medgator said:
Absolutely.... Harder in certain employed multispecialty group situations, absolutely necessary out in the wilderness in community practice imo, esp if an adversarial med onc is in the picture
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Currently my situation but starting to see significant changes with new docs coming into the community. Sometimes, all you can do is sit... especially in today's current environment.
 
Baws said:

Faculty Requisition Details - Jobs@UIOWA: Search and Apply for Jobs at The University of Iowa

Jobs@UIOWA: The official place to search and apply for jobs at The University of Iowa.
jobs.uiowa.edu jobs.uiowa.edu

240K for a fulltime job in the middle of nowhere; hilarious how med students continue to apply to this specialty

(FYI: these job postings are super common as academic centers expand and close down the private practices)
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“This is an excellent opportunity for anyone interested in a general practice affiliated with a large academic medical center with integrated physics support and vacation coverage.” Clinton Iowa is on the Mississippi River maybe about a hour north of the quad cities and 3 1/2 hours from O’hare airport in Chicago. Absolutely bonkers they think they can get someone for $240K. That is probably about 40K more then the local wal mart store manager is making who I guarantee you didn’t do 9 years of further education after undergrad.
 
Baws said:

Faculty Requisition Details - Jobs@UIOWA: Search and Apply for Jobs at The University of Iowa

Jobs@UIOWA: The official place to search and apply for jobs at The University of Iowa.
jobs.uiowa.edu jobs.uiowa.edu

240K for a fulltime job in the middle of nowhere; hilarious how med students continue to apply to this specialty

(FYI: these job postings are super common as academic centers expand and close down the private practices)
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you seem new to the game. welcome.

i assume you're new if you think 240 is a real salary. it is something listed on a government official posting. perhaps it is the university salary and there is also a UIowa Physicians Group salary. we have seen this time and time again

be smarter.
 
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