radoncgrad2019

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Location dependent... Midwest/rural academic gig gonna pay better than USC, UCSF, MGH etc for the same clinical productivity
This is why it’s good to look at percentiles.

25th percentile means by definition you can do better and you choose not to.
 

medgator

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KHE88

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Some people lost 401k match? That’s a major hit.
Wait, you guys get a meaningful 401k match?
Ours is slowly vested over a period of 5 years and doesn't start matching until 1 year.

Eye opening to see how awful benefits are in the healthcare industry. Don't get me started on our cheapskate insurance plans.
 
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Wait, you guys get a meaningful 401k match?
Ours is slowly vested over a period of 5 years and doesn't start matching until 1 year.

Eye opening to see how awful benefits are in the healthcare industry. Don't get me started on our cheapskate insurance plans.
I get 7% match, goes up with service years over time. Employer contributions 100% vested after 3 years. Our COVID cut is no match x 3 months, effectively reducing the match this year from 7–>5%.


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Haybrant

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Wait, you guys get a meaningful 401k match?
Ours is slowly vested over a period of 5 years and doesn't start matching until 1 year.

Eye opening to see how awful benefits are in the healthcare industry. Don't get me started on our cheapskate insurance plans.
The match is a big benefit for high salary earners Bc we get hit so hard on taxes. Yearly max is 19500 now I think, so if employer is matching say 5% of salary up to a certain amount could be an extra 12-15k. That gets exposed to the market so it has the potential to be quite significant over time. Alot of smart people that start working in their 20s were contributing high sums and now have major nest eggs whereas we all started in 30s so pretty behind the curve. To entirely lose the match for who knows how long can be a pretty significant difference. The 18k + 12k match I contributed in 2014 just as an example has probably more than doubled Bc of market exposure
 
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medgator

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Reminder that salary does not equal total comp.
Yup. Just ask any major insurance company CEO
Hemsley's 2014 compensation comprises $1.3 million in salary; $3.95 million in non-equity incentive-plan compensation; $107,479 in "other compensation"; $45.57 million in value realized on exercising option awards; and $15.2 million in value realized on stock awards vesting.
 
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Mar 4, 2019
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Reminder that salary does not equal total comp.
For sure. But I happen to think 2% match cut is reasonable. It’s less than 2% of my total compensation. Sure would have preferred gross pay over tax protected dollars, but amount is still low all things considered. Some friends of mine in other PP fields where I live got $0 salary for 2 months.


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Mandelin Rain

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For sure. But I happen to think 2% match cut is reasonable. It’s less than 2% of my total compensation. Sure would have preferred gross pay over tax protected dollars, but amount is still low all things considered. Some friends of mine in other PP fields where I live got $0 salary for 2 months.


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No doubt. It's just funny how the systems will spin things for PR.

"Our execs took a 10% salary cut (while increasing bonuses and/or stock options to cover) while none of our docs took a salary cut (but eliminated retirement contributions which could be a 6% penalty)."

Public thinks, "That's noble."
 

seper

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For sure. But I happen to think 2% match cut is reasonable. It’s less than 2% of my total compensation. Sure would have preferred gross pay over tax protected dollars, but amount is still low all things considered. Some friends of mine in other PP fields where I live got $0 salary for 2 months.


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I prefered my annual salary not to be cut instead of them ending 401k matching. The reason is, your annual contract pay is what you usually negotiate with when changing jobs


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Haybrant

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For sure. But I happen to think 2% match cut is reasonable. It’s less than 2% of my total compensation. Sure would have preferred gross pay over tax protected dollars, but amount is still low all things considered. Some friends of mine in other PP fields where I live got $0 salary for 2 months.


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I know 2 places that removed it entirely this week. No more match at all, not just a 2% cut
 
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KHE88

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I know 2 places that removed it entirely this week. No more match at all, not just a 2% cut
If you have your benefits cut such as losing 401k match or salary reduced, would that invalidate your contract with regards to such things as non-compete clause, signon bonus repayment, etc.?

That's the point of the contract, right? If the hospital doesn't honor it, they are in breech so none of it is valid?
 

OTN

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If you have your benefits cut such as losing 401k match or salary reduced, would that invalidate your contract with regards to such things as non-compete clause, signon bonus repayment, etc.?

That's the point of the contract, right? If the hospital doesn't honor it, they are in breech so none of it is valid?
I've been wondering this the whole time. What's the point of a contract if they can just break it at will? It's not like they don't have the money: All that incredibly expensive art, atria, hallways, etc, throughout all these large hospitals and academic medical centers would pay for a lot of salaries.
 

medgator

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Usually company match is "discretionary".

To me, COVID has really driven home how great private practice is. Nothing better than being your own boss. YMMV.
At least when i make less money, it's usually because I'm less busy. Which makes sense
 
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KHE88

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Usually company match is "discretionary".

To me, COVID has really driven home how great private practice is. Nothing better than being your own boss. YMMV.
Yup. Signing up to become a hospital "employee" for more money upfront and not accepting the multiple partnership track PP offers I had 2 years ago was one of the biggest mistakes I ever made.

True story: I was reported yesterday to upper level administration by a maintenance worker for not wearing a mask in an empty hallway. This individual took it upon himself to question a physician's discretion regarding PPE and infectious disease control and report me to upper administration, which was taken seriously and resulted in a patronizing reprimand. Would they fire me outright if I refused to comply? Of course not. But that doesn't stop them from belittling and intimidating. Really astonishing.

The mentality at the hospital is that we are all the same. Doctors=nurses=PAs=MAs=janitors. Except of course for the admins. The execs and admins are all former nurses with a hundred [email protected]@[email protected]! initials after their names who have a chip on their shoulder against doctors and think they are not only our peers but our superiors. They love screwing us out of money whenever they can and flexing their muscle whenever they can. We are told that it's offensive to use terms like "mid-level provider" and refer to the providers lounge as the "doctor's lounge." Admin refers to physicians as "our doctors." They love making it clear they own you and control how you practice.

I thought I did pretty good with my contract, but it was all a bait-and-switch. Resident, if you are lucky enough to get a partnership track PP offer, take it regardless of the initial salary. If you can't do that, then try and find a physician-owned private hospital. And this was all in a desparate rural area. I've heard multiple other stories of physicians being poorly treated by rural hospitals. I can't imagine the shenangians employed rad oncs have to put up with hospital admin in desirable areas.
 
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evilbooyaa

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If you have your benefits cut such as losing 401k match or salary reduced, would that invalidate your contract with regards to such things as non-compete clause, signon bonus repayment, etc.?

That's the point of the contract, right? If the hospital doesn't honor it, they are in breech so none of it is valid?
Most if not all employment contract leave the employer match as a vague 'employee will get benefits as detailed in employee handbook', usually with the caveat of 'benefits are subject to change per admin blah blah'

At least that's how it was for mine - a drop in salary would break contract, but removing matched contribution technically would not.

In regards to disrespect of physicians even in a rural setting, the only way you'll get them to change their tune (unfortunately) is probably by threatening to leave. Of course whether that is going to be anything more than an empty threat is to be determined.
 

metallica81788

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The mentality at the hospital is that we are all the same. Doctors=nurses=PAs=MAs=janitors. Except of course for the admins. The execs and admins are all former nurses with a hundred [email protected]@[email protected]! initials after their names who have a chip on their shoulder against doctors and think they are not only our peers but our superiors. They love screwing us out of money whenever they can and flexing their muscle whenever they can. We are told that it's offensive to use terms like "mid-level provider" and refer to the providers lounge as the "doctor's lounge." Admin refers to physicians as "our doctors." They love making it clear they own you and control how you practice.
The socialist situation at the hospitals have become even more clear with COVID. Production based physician employees who have been working and generating revenue during no elective procedure times are expected to support the non-producing departments. Then they turn around and take away your production-based bonus. While other doctors sat on their butts for two months and were still paid.
 

thecarbonionangle

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The socialist situation at the hospitals have become even more clear with COVID. Production based physician employees who have been working and generating revenue during no elective procedure times are expected to support the non-producing departments. Then they turn around and take away your production-based bonus. While other doctors sat on their butts for two months and were still paid.
rad onc will always be the fat catfish. We are at the bottom, but we feed a ton of people!
 

scarbrtj

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rad onc will always be the fat catfish. We are at the bottom, but we feed a ton of people!
EBRT has a profit margin probably unsurpassed in medicine. It’s why there was “peak rad onc,” diminishment of private practice and growth in academic jobs over time, why there’s been residency oversupply, why radiation therapy used to literally be traded on the stock market, and a whole host of other things. That profit margin has had a hammer taken to it by multiple forces though. Ten years ago in a pandemic MDACC wouldn’t have missed a beat and honored every contract. Now the economics are a lot more fragile to perturbations. Our wiggle room is gone.
 
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seper

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Declaring employer in contract violation should only be the last resort. After all, they owe you tail coverage (unless it’s occurence-made policy)


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KHE88

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The socialist situation at the hospitals have become even more clear with COVID. Production based physician employees who have been working and generating revenue during no elective procedure times are expected to support the non-producing departments. Then they turn around and take away your production-based bonus. While other doctors sat on their butts for two months and were still paid.
It really is. The producers are all kept in check with threats and intimidation if they don't tote the party line that everyone is the worth the same, speak the poltically-correct newspeak, and sacrifice a lot of their production meanwhile the high ranking hospitburo officials live high on the hog.

The RVU bonus is a big lie. They fudge the numbers and delay reporting such that high volume periods get shifted to lower production periods so the hospital can avoid paying a quarterly bonus. I caught them red-handed doing this. The response? I was criticized for asking questions and not trusting them. The numbers were fixed and the production report indicated that I was owed a bonus. Was I paid? Of course not. Because it turns out the decision of whether or not to pay that bonus is completely at the discretion of the hospital.

Most if not all employment contract leave the employer match as a vague 'employee will get benefits as detailed in employee handbook', usually with the caveat of 'benefits are subject to change per admin blah blah'

At least that's how it was for mine - a drop in salary would break contract, but removing matched contribution technically would not.

In regards to disrespect of physicians even in a rural setting, the only way you'll get them to change their tune (unfortunately) is probably by threatening to leave. Of course whether that is going to be anything more than an empty threat is to be determined.
This is really the only difference between my employer and presumably yours. I can refuse to wear a mask and most likely a high level decision will be made to not confront Dr. KHE. Whereas you likely would be shown the door (after they have lined up a replacement of course as it's not really about patient safety if it were you would be escorted off the premeses same day and not allowed to return, it's about $$$ and subordination of physicians). I have noticed this already. Confrontation with me is avoided and administration disapproval is communicated through passive aggressive back channels or thinly veiled threats instead of direct comply-or-you-will-be-fired communications. This is because I am a difficult-to-replace major revenue center for them, and they HATE that I know this. Capitalist free market win, socialist authoritarianism fail. At least for now in rural areas.

Regarding benefits, would have been easy to negotiate benefits as fixed in the contract. I guess nobody thought of the possibility of having a 401k match eliminated.
 
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Yup. Signing up to become a hospital "employee" for more money upfront and not accepting the multiple partnership track PP offers I had 2 years ago was one of the biggest mistakes I ever made.
Interesting, thank you for sharing. Do most in private practice agree with this, or does it vary from hospital to hospital, or partnership-track PP to PP?
 
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elementaryschooleconomics

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Found it. Since deleted

View attachment 310990
"The real reasons why there is declining interest in our field". Is he serious? The ABR's shenanigans is just the icing on the cake of the declining interest.

I am almost in disbelief at how the "leaders" in this field keep digging the hole deeper. It's truly a skill for them.
 

KHE88

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What's with all this posting and deleting on Twitter?
In general, everyone is walking on eggshells trying to appropriately virtue signal/brownnose while simultaneously managing to avoid the wrath of the SJW mob. Due to the constantly shifting goal posts, what is perfectly fine to say today may be something that could get you fired tomorrow. It's a sad reflection on the state of society, but nothing us nobodys can really do about it, which goes back to my original point that any rad onc posting on Twitter is an idiot.
 

OTN

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Found it. Since deleted

View attachment 310990
HAHAHAHAHAHAHAHAHA

HA!

The "real reasons" why. You have to be kidding me. Almost no one chooses a specialty based on how difficult the boards are. I didn't even think of that issue when I was thinking about specialty choice.

YOU MADE TOO MANY RADIATION ONCOLOGISTS. SUPPLY AND DEMAND EXISTS.

A large and growing part of me believes they truly do know this is the issue, but have no idea what to do about it, so are willfully deceiving medical students, residents, etc. These are smart doctors. Am I supposed to sit here and believe they really think the job market isn't the #1 factor pushing students away? Am I supposed to believe they don't understand some of the central tenants of economics? Really???
 
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