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Hospital administration is a huge pyramid scheme. Director—>VP—> SVP—> COO/CEO. My community hospital has nurses that are Vice Presidents making hefty 6 figure salaries and my SVP of physician services tells me that it is against the law to pay me what I want. These people never bill a $!!! Meanwhile, I just got the hospital bulletin congratulating our newest Vice President of environmental engineering services.
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the level of pork belly LARD that these administrators represent in our bloated system is DISGUSTING. I have also noticed the same thing, a new inflated turd bean counter every month announced in a bulletin with a nicely photoshoped picture, see their crazy nice cars as i walk by them every day in the "admin parking spots'', look at their resumes all MBA or nurse bean counters telling us what to do. Medicine is so rotten.
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deleted969641
Let's talk about this. Let me tell you about the IT department in my hospital.
I am not allowed to place shortcuts on the desktop. I am not allowed to install any program. I can't change the butt-ugly desktop color. Forget about adding a link to the start menu or changing the way you want the clock displayed.
Most of the internet is blocked.
I can't view interactive websites such as headneckbrainspine
I can't copy and paste pictures. Even text is a challenge sometimes.
I can't launch programs using the run box (it's a security issue apparently to be able to type "calc" when I want to launch the calculator).
To access my personal files, I have to navigate using about 20 clicks
My version of Microsoft office is well over a decade old.
If you ask IT to make any exceptions, they roll their eyes and tell you "We can't have one-offs for all OUR doctors. We can't support that. We get too many IT help desk tickets about desktop icons that don't work, so we had to streamline it"
They are so lazy they just make the computers minimally functional so they don't have to deal with any help desk tickets. That's the bottom line of it.
When you ask, they say "Meh, that's the "policy" my hands are tied. Can't go against policy. Oh, you mean the policy you literally made up yourself based on nothing other than your own opinions? Yeah, that policy. Yep, it's set in stone. Nothing that can be done.
They have a chip on their shoulder and think they run the place.
How much money does the IT department bring in?
Oh that's right. Every cent in this place comes from billing for physician services. They are technical staff that are supposed to support US and make our jobs easier. Instead, admin treats it the other way around. We are THEIR doctors and they make the rules.
If you complain, you will be called an elitist doctor who thinks he's better than the rest of the staff in their hospital. We're all an equal team. So of course, my personal computer should have the exact same functionality as a shared workstation on the floor that the secretary and MA uses.
It's maddening. I could go on and on and on, but that's enough ranting for today.
Physician autonomy and respect is dead. College students, find something else to do. I'd tell you what, but I have no idea.
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deleted774703
That’s just maddening!
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Saw this posted yesterday on reddit too -
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deleted774703
Damn that's a good post. Very well articulated. Extremely hard to be motivated to know percentages of trials down to xx.x% when it might not all matter in the end
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200 +/- 25k as the only available job this resident was competitive for within a region, not in the rural boonies (although he thinks he might be getting bait and switched into the boonies) is disappointing for sure. To be fair to that resident, there are no job offers I am considering that have a salary nearly that low.
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Excellent post.
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You could make 200,000 as dosimetrist as well and live in sf. UCSF dosimetry pat scale.
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Yikes, for $200k I should have just stayed 2 more years in Medicine and taken a 7/7 Hospitalist job...
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No, they get more.
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Or spend twice as long in training and be "mentored" Junior faculty in Palo Alto for less
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They get $265-300k starting in my neck of the woods and can take extra shifts for even more
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I think it's been said here ad nauseaum that rad onc as a field is great, but the job market is terrible. Really, this reddit post is pretty much exactly what we see on SDN posts and is definitely not a Twitter post. It really isn't a balanced post between SDN and Twitter, the message is indistinguishable from what's been posted here.
radoncradonc
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I thought my 250K from last year was bad. I guess 225K is the going rate this year.
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$200k from a respectable, well-known residency program? Yikes.
The only magic I'm seeing is misdirection, and a disappearing act for all those collections and professional fees this graduate will be generating.
The only magic I'm seeing is misdirection, and a disappearing act for all those collections and professional fees this graduate will be generating.
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Exactly, this is totally 100% in line with what we have said here not the head in the sand twitterati - look at what Drew and RW said and how easily they were willing to throw their own residents under the bus
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Neat. Only have to add 1-2 posters on reddit to the 4-5 here on SDN. Good. And I'm about as much of a "solo guy" as Jabba was.
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Everyone has to make the decision that is right for them but signing in December for a job not in academics and not in some intensively competitive part of the country for 200k I would hope is not absolutely necessary for most people? Because it's not clear to me that there are fulltime jobs outside academics that would pay worse than that so what is the hurry to sign?
$200k>>$0
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Hey but i thought that according to one of the leading misinformation posters on here, there are NO residents posting stories. clearly BLIND like a mole rat about the real issues. There are PLENTY of resident accounts both negative and positive and the narrative that its all attending malcontents is FALSE!
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LMAO. People saw your salary and lowballed this guy. SAD reality people live in. Next guy who takes the 200k boonies job should maybe keep quiet?
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I'm glad that person posted their story.
But I have to say that this place a few months ago (or at least many people here) trashed the Terry Wall salary data as 'anectdotal' but are almost gleeful to post about specific actual anectdotes.
just seems like some people have become political-like about this and have chosen a 'side' and anything that doesn't jive is fake news and stuff that supports their 'argument' is fact.
But I have to say that this place a few months ago (or at least many people here) trashed the Terry Wall salary data as 'anectdotal' but are almost gleeful to post about specific actual anectdotes.
just seems like some people have become political-like about this and have chosen a 'side' and anything that doesn't jive is fake news and stuff that supports their 'argument' is fact.
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True but I think it's important for current PGY5s to realize that there are still jobs to be had and interviews to go on at this time of the year. I'm wishing that guy the best and it sounds like being in a certain region is very important to him but that is a very low salary for community medicine and it is okay to hold out for more or try to negotiate when faced with such an offer.
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Buff the social media is the new buff the charts.
December is neither early nor late, IMO. Sounds like poster was very restricted in geography. When you are restricted in geography, you have to know it really well. I bet they probably talked to everyone in the area and know who will have a position available now and in the near future. They probably thought they didn't have very many options and signed so they could at least have something. We read about that horror story where that one guy was holding out for something better and got nothing. And now locums is not a back up plan with the CMS changes. Hopefully they could at least negotiate a non-compete out if they plan on staying. Maybe they just need their spouse to finish their training and then GTFO.
I interviewed for my current job in December back when the getting was good, in 2008. Signed in Jan/Feb. Was really nice to have that signing bonus for the last half-year of residency and I loved having the stress off my back.
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I spoke with poster and basically he went to subatomic doc’s talk at ASTRO about taking a rural low paying job and was totally convinced...
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Wasn't even that restricted. Didn't get a job within the state he/she wanted.
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Something he could actually give meaningful insight into and now he's keeping his mouth shut. What a troll.
Well, he could say it an invented condition with a potential to increase RadOnc reimbursement, but I actually agree with not saying it publicly.
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Probably, although probably in some backhanded insulting way
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Moral grandstanding on Twitter. Imagine that. Sanctimonious fraud.
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This is ridiculous. For a field that prides itself on being data-driven, having Nancy Lee stand up there and say that even if randomized controlled trials are negative, that they would still use proton beam. These academics are a joke. They built these machines and facilities and started treating without opening any good trials. Off of the top of my head, there's probably only one study that MD Anderson published (not just presented, like their esophageal experience) looking at photons versus protons, which showed modest (?) benefit.
Nancy Lee states that the proton naysayers have an inherent bias. But doesn't the bias go the other way? She's on the one with this brand new facility at New York Proton Center. They are already invested into it, so that's why she put on her slide, in the face of negative data, they would still treat. Nancy, it is YOUR crisis, not the whole radiation oncology community. Surely, there are hospital systems out there who would not hesitate at the chance of building a proton facility if the data shows a benefit in major disease sites, such as breast and prostate. These proton people argue that it is good for pediatrics, but fortunately, there is not that many pediatric cases as there are breast and prostate, but yet, they fill their machines with breast and prostate patients. The English don't do that. They send their pediatric cases to the United States because it is cheaper than building a facility. So, why, in the United States, have there been a proliferation of proton facilities? Is the pediatric cancer endemic that bad that we need a proton facility on every corner?
Where's the data?!?! Some of these facilities have had protons for two decades and did not run the trials to look at the value of proton therapy. This is not a new problem! If we have a new technology, generate the data. It costs money, but clearly, the NY group had no problem dropping 9 figures for a new facility.
So, Nancy, why are we the naysayers? Isn't the burden on proof with those who have it to show the clinical benefit? You say that that it is not about money, but it really is. Your group spent $300 million dollars to build this facility in East Harlem. That's not trivial money. The only way to get that money back is to treat everything and bilk insurers and patients for everything they can, like a broken ATM. You should be a leader and run the trials to show the value of protons. This is your chance to be a trailblazer as you did for IMRT in nasopharyngeal cancer. Get off of your high horse and do some science. We will follow you to the promised land, if the data is good.
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Let them eat APM
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Oft times they're already having to eat IMRT reimbursement levels for proton treatment.
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This is nonsense. Mayo clinic accepts IMRT rates, but their IMRT rates top 400% of medicare.
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But in all honestly - impossible to tell what the context of that quote and slide are. If Nancy Lee is advocating for use of proton regardless of positive data, then for sure she should be criticized. I somewhat doubt she would say that though; at least out loud. Very doubtful.
The slide seems to indicate ‘problems’ that may arise, either way the data goes. She may be talking about the fact that some people will still Insist on using proton, if data negative.
The slide seems to indicate ‘problems’ that may arise, either way the data goes. She may be talking about the fact that some people will still Insist on using proton, if data negative.
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I take the slide to mean an anticipated problem as well. Opinion is that people will continue to use it. Imrt rates is the future of these therapies.
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An unfiltered RW quote might actually be appropriate in this case. Poor Ralph doesn't even know when to use it now
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Absolutely! This is the real issue. I know firsthand several large centers that have found protons at imrt rates profitable because the insurance rates they negotiated for imrt are so high! (Choosing wisely?) Almost no one has straight Medicare without a supplement.
Centers basically obtained protons as a way to defend imrt base.
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Here's her context. If the trials are negative, she said it doesn't make sense to demolish machines. Yeah...because they spent MILLIONS on this, as did a lot of other groups.
Also, who is this ProtonStorey guy? He believes in protons, but yet, looking at his group's website, which his title is Medical Director Clinical Operations, there is NO mention of clinical trials involving protons. If this technology works, show it. Tell us why it is worth 3 times more. It better be 3 times better or 3 fold less toxicity. Value = quality / cost. There better be good quality.
