Reviews of American Oncology Network (AON) and US Oncology Network

[osprey099]

I am wondering if anybody who has experience working for either of these two large PP networks can provide feedback on positives and negatives of each employer. I realize that every individual site can be vastly different but what are some general pros and cons of each of these private practices? Seems like these 2 are the largest private practices in the country.

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[bobow98]

They are not a single practice. Each is a network of practices sharing admin/management centralization to some degree but all are run as independent practices.

You should just interview at some of these and find out. They'll explain better to you.

 

[gutonc]

They are not a single practice. Each is a network of practices sharing admin/management centralization to some degree but all are run as independent practices.

You should just interview at some of these and find out. They'll explain better to you.

^This. Hard to know how long this will be the case, but for the time being, it's how it goes.

I will say that, even within one US Oncology group (let's use Texas Oncology as an example), even though the pay/practice structure will technically be consistent across sites, your practice at Texas Oncology Harlingen is going to be very different than at Baylor Sammons Cancer Center in Dallas.

As someone who didn't do this, I also highly recommend that you investigate as many different practice types (not just locations) as possible before deciding on the one that's best for you.

Finally, it is a buyer's market out there right now. I'm in a mid-sized city on the West Coast and across the groups here (academic, a couple of academ-ish, HMO, VA, hospital employed, physician owned MSG and one of those US Oncology PP groups), I'm aware of 20+ open positions. A recruiter I've worked with recently has >80 active hem/onc recruitments WEST OF THE ROCKIES.

Go out...get yours.

 

[solidonc2020]

^This. Hard to know how long this will be the case, but for the time being, it's how it goes.

I will say that, even within one US Oncology group (let's use Texas Oncology as an example), even though the pay/practice structure will technically be consistent across sites, your practice at Texas Oncology Harlingen is going to be very different than at Baylor Sammons Cancer Center in Dallas.

As someone who didn't do this, I also highly recommend that you investigate as many different practice types (not just locations) as possible before deciding on the one that's best for you.

Finally, it is a buyer's market out there right now. I'm in a mid-sized city on the West Coast and across the groups here (academic, a couple of academ-ish, HMO, VA, hospital employed, physician owned MSG and one of those US Oncology PP groups), I'm aware of 20+ open positions. A recruiter I've worked with recently has >80 active hem/onc recruitments WEST OF THE ROCKIES.

Go out...get yours.

Love hearing this as a second year fellow currently looking at jobs.

What do you think has driven the current demand? It seems like fellowship programs are getting bigger and bigger, but obviously not able to keep pace. Is it as simple as boomers hitting retirement age, or is it other market changes (private groups being bought out by hospital systems, etc)? The main geographic market I'm interested in has very few private groups left as they've all been replaced by large systems, so I'm curious how the leverage of being in demand can be used in negotiating those jobs which seem to be less flexible in terms of contracts.

 

[bobow98]

Boomers + not enough fellows going into clinical practice, most want to stay in academic seeing patients 2 days a week, or go to industry, etc.
So lots of demand, low supply.
Average rates are 500k that I'm seeing and you don't even have to be in BFE as the anesthesia forum guys @BLADEMDA @pgg used to (can we still say BFE?) call it.
Just take a look at the below. You can live in BEND where all the tech hippies want to hang and still do pretty well. Mind you, real estate is like 550/sq foot there.


If you take a job like this, you have to realize they'll work you pretty hard. There may or may not be a ramp up to a full clinic. If you start at 0 patients on day one and take 1.5 years to ramp up, that 550k is a great deal. But if you start at 18 patients a day that you inherit from some retiring doc, you'll wish you had just negotiated 112/RVU instead, because you'll probably be hitting more like 7-850k year one. Even then, with infusion billing and drug margin, the system is probably making 500k-1 million or more a year off your back from you hard work.

You need to make sure you never take a job that works you 5 clinic days a week. 4 full days and 1 admin day/totally off site day.

So all you young'guns, go get yours!

Medical Oncologist​

• Bend, Oregon
• Starting at $550,000 with increased earning potential!
• Summit Health

Summit Health, actively recruiting for a BC/BE Medical Oncologist to join our team in Bend, OR. Starting at $550,000 with increased earnin


Reference:

Medical Oncology $500,000 + jobs

Medical Oncology $500,000 + jobs. 15 jobs to view and apply for now with ASCO Career Center

careercenter.asco.org

 

[Mehena]

@bobow98 is spot on.
There is a demand for physicians (any health care workers for that matter) pretty much across every specialty and accross the various health systems including academia. For example, our patients wait several months to be seen by a clue-less palliative NP/RN. You’d be hard-pressed to find a good pediatrician in reasonable time establish care, if you have little ones. I could not find an ophthalmologist to perform a timely funduscopic evaluation for primary CNS lymphoma.

The only reason we’re seeing aggressive recruiting for a warm medical Hem-Onc is simply to capture the sheer volume of patients (sick at that) and the downstream millions of dollars generated from service of each physician (KNOW YOUR WORTH). The number of patients I've referred to Rad and IR within a couple of months employment probably allowed my hospital system to recoup any initial investment or expenses to bring me on-board.

I started building new panel in the Summer of 2022 and close to being a full panel and had surpassed my base salary and recieved a nice quarterly deposits to pay-off my student loan. It’s a busy life and not clear yet if this’s sustainable long-term. I think for some, it would be very reasonable to choose the cushy route for less compensation wherever that may be.

 

[osprey099]

@bobow98 is spot on.
There is a demand for physicians (any health care workers for that matter) pretty much across every specialty and accross the various health systems including academia. For example, our patients wait several months to be seen by a clue-less palliative NP/RN. You’d be hard-pressed to find a good pediatrician in reasonable time establish care, if you have little ones. I could not find an ophthalmologist to perform a timely funduscopic evaluation for primary CNS lymphoma.

The only reason we’re seeing aggressive recruiting for a warm medical Hem-Onc is simply to capture the sheer volume of patients (sick at that) and the downstream millions of dollars generated from service of each physician (KNOW YOUR WORTH). The number of patients I've referred to Rad and IR within a couple of months employment probably allowed my hospital system to recoup any initial investment or expenses to bring me on-board.

I started building new panel in the Summer of 2022 and close to being a full panel and had surpassed my base salary and recieved a nice quarterly deposits to pay-off my student loan. It’s a busy life and not clear yet if this’s sustainable long-term. I think for some, it would be very reasonable to choose the cushy route for less compensation wherever that may be.

If you don't mind sharing, what kind of practice setting are you in? And how many patients do you see per day and how many clinic days per week?

 

[Mehena]

If you don't mind sharing, what kind of practice setting are you in? And how many patients do you see per day and how many clinic days per week?

Hospital employed. Still in a ramp-up phase but stopped seeing patients on my admin day (4day clinic). Give or take ~16 patients daily (~6 new patients) including few inpatients (for chemo, consults what-not). Honestly, I feel too busy even now but learning to be efficient to counterbalance a non-efficient clinic setup.

 

[osprey099]

Hospital employed. Still in a ramp-up phase but stopped seeing patients on my admin day (4day clinic). Give or take ~16 patients daily (~6 new patients) including few inpatients (for chemo, consults what-not). Honestly, I feel too busy even now but learning to be efficient to counterbalance a non-efficient clinic setup.

How much compensation is that roughly? And what part of the country? In my area, that would only be around 300-350k

 

[Mehena]

East coast. Medium-High cost of living. Location is okay for me but it's not where the young and hip dying to move to and not a huge metropolitan. Hmm...$300-$350K sounds too low for current oncology market anywhere in the union but i could be wrong. Perhaps would make sense for a base PP salary with $millions potential after few yrs.

 

[HemeOncHopeful19]

How much compensation is that roughly? And what part of the country? In my area, that would only be around 300-350k

Anything less than 450k for a full time Heme/Onc doc is a joke

Edit: agreed with the post above that for a base salary PP with a good track record of making partnership <= 2 years it would be more reasonable

 

[gutonc]

East coast. Medium-High cost of living. Location is okay for me but it's not where the young and hip dying to move to and not a huge metropolitan. Hmm...$300-$350K sounds too low for current oncology market anywhere in the union but i could be wrong. Perhaps would make sense for a base PP salary with $millions potential after few yrs.

In my current West Coast moderate to high COL location, hospital employed salary + productivity model, that amount of work would net you $500-600K a year.

We can't hire because we don't pay well enough.

 

[osprey099]

Anything less than 450k for a full time Heme/Onc doc is a joke

Edit: agreed with the post above that for a base salary PP with a good track record of making partnership <= 2 years it would be more reasonable

Unfortunately in major NE cities, salaries start in low 300s.. see below from ASCO career center

 

[HemeOncHopeful19]

Unfortunately in major NE cities, salaries start in low 300s.. see below from ASCO career centerView attachment 366428

Yep and I would probably file that into the joke bin unless they offer a true partnership track with a solid track record. They’re looking for someone who doesn’t know any better or whose spouse won’t let them go anywhere else IMO.

There are other jobs in NY State on the ASCO site.

 

[bigboyonc]

In my current West Coast moderate to high COL location, hospital employed salary + productivity model, that amount of work would net you $500-600K a year.

We can't hire because we don't pay well enough.

Damn. Wish y’all did j1 waivers in the Portland offices.

 

[terribletwos]

When I interviewed for acad jobs in major cities in the NE, the hospital employed model of base in the low 200s to high 200s was standard. Incentive pay may or may not have been part of contracts depending on how "academic" or "private practice" the place was. I eventually settled on an academic job that has a few days / wk clinic, pays in high 2 / low 3s but no real incentive RVU pay, but good benefits, minimal/no call. After being traumatized by waking up at all hours for ITP/TTP in the middle of the night as a fellow, I swore I'd take any paycut to never do it again. Maybe that's poor retirement planning on my part, but I also needed a gig that was sustainable and where I wouldn't burn out in just a couple years. When I interviewed for PP-ish jobs in the NE, none of them wanted me to work any less than 5 days - that was a nonstarter for both sides I guess. One of my friends in the NY area found a really nice PP gig where they as a rule take 1 day a week off. But that's more the exception than the rule around here. I think with the oversaturation of the market, consolidation of large academic cancer centers, PP groups in the NE may feel like they need to push everyone to 100% to stay competitive (my theory).

That said, I see these advertisements for jobs in MN and Hawaii for 650 base, 100k signing bonus. We are stuck in NE but I still try to entice my partner to cut ties and go, lol.

I don't know if I have the constitution to do bone marrows any more, or see breast cancer and AML and gastric cancer back to back. I'd feel like I was drowning. I could only consider sub-specialty only (or mostly) PP gig.

 

[Royster33]

Agreed. I'm a northeasterner as well and the jobs I was seeing out of fellowship a few years ago mostly had starting in the 300s. That being said I was able to find a chill 4 day a week gig now with ~12 patients per day and should make about 450k this year.

 

[texashemonc]

US Oncology is owned by Mckesson. Previously, it was owned by a private equity group. Interestingly, a lot of the founders that sold out since branched to different medical specialties - radiology, anesthesiology, dermatology, GI -initially based on the oncology model!

Texas Onc is an independent physician's group (private practice) that contracts with USO - they manage the physician group including HR and all ancillary facilities (physical facilities such as radiation centers, pharmacy, research) in return for a fixed "management" fee.

TxO is the largest physician owned oncology group in US. Lots of leverage. Small rural practices all the way to the large cities. But still consistenly try to practice per community standards- pathways are aligned with NCCN so that standards of care are enforced. But certainly there is going to be differences in practice styles per each individual doctor as it should be.

Our EMR is easy to use (on chrome and mobile) so convenient to pull up anytime and with patients moving around throughout the state, it's great for continuity of care for both the patient and physician especially as medical records don't have to be faxed (one of the biggest headaches for transfer of care patients).

Definitely since direction of medicine is going the larger route (health insurance contracts and drug pricing), sadly the smaller physician practices will prob continue to shrink due to reimbursement. The younger doctors don't want to deal with all of the business financial headaches as well as administrative hassles so either will have to join a large private practice group or join a hospital employed setting.

In private practice, QOL is essential. For me, having the 4 day workweek (no clinic on Fridays) has preserved my sanity. Although i still get numerous calls and texts even on my "day off" but still nice not to go in. My only other advice is to try not to go to more than one hospital if possible. And be careful with hospital practices for obvious reasons (you are not the boss).

A large community private practice such as TxO or Florida cancer or Rocky Mountain cancer would be the direction to strongly consider. At the end of the day, none of us will starve. Salaries are obviously important, but remember the IRS takes out a bigger cut as our pay rises. So it's crucial to find a practice where you feel as you are treated fairly as possible and don't want to leave after a year. And it's always nice to be closer to extended family.

 

[CatFactorial]

US Oncology is owned by Mckesson. Previously, it was owned by a private equity group. Interestingly, a lot of the founders that sold out since branched to different medical specialties - radiology, anesthesiology, dermatology, GI -initially based on the oncology model!

Texas Onc is an independent physician's group (private practice) that contracts with USO - they manage the physician group including HR and all ancillary facilities (physical facilities such as radiation centers, pharmacy, research) in return for a fixed "management" fee.

TxO is the largest physician owned oncology group in US. Lots of leverage. Small rural practices all the way to the large cities. But still consistenly try to practice per community standards- pathways are aligned with NCCN so that standards of care are enforced. But certainly there is going to be differences in practice styles per each individual doctor as it should be.

Our EMR is easy to use (on chrome and mobile) so convenient to pull up anytime and with patients moving around throughout the state, it's great for continuity of care for both the patient and physician especially as medical records don't have to be faxed (one of the biggest headaches for transfer of care patients).

Definitely since direction of medicine is going the larger route (health insurance contracts and drug pricing), sadly the smaller physician practices will prob continue to shrink due to reimbursement. The younger doctors don't want to deal with all of the business financial headaches as well as administrative hassles so either will have to join a large private practice group or join a hospital employed setting.

In private practice, QOL is essential. For me, having the 4 day workweek (no clinic on Fridays) has preserved my sanity. Although i still get numerous calls and texts even on my "day off" but still nice not to go in. My only other advice is to try not to go to more than one hospital if possible. And be careful with hospital practices for obvious reasons (you are not the boss).

A large community private practice such as TxO or Florida cancer or Rocky Mountain cancer would be the direction to strongly consider. At the end of the day, none of us will starve. Salaries are obviously important, but remember the IRS takes out a bigger cut as our pay rises. So it's crucial to find a practice where you feel as you are treated fairly as possible and don't want to leave after a year. And it's always nice to be closer to extended family.

Hospitals covered I guess is location dependent? The TXOncs I know all cover at least three hospitals on their weekend calls.

I thought TXonc was essentially an eat what you kill model, are they cool with 4 day workweeks?

 

[MD46]

Hospitals covered I guess is location dependent? The TXOncs I know all cover at least three hospitals on their weekend calls.

I thought TXonc was essentially an eat what you kill model, are they cool with 4 day workweeks?

Its individual practices in Texas Onc, each would be covering their area of hospitals. Which ever group you interview with should be able to tell your required coverage.

Some hospitals are small and rarely need to go in, most things are dealt with a phone call. Best is to interview and find out.

Compensation model might differ between locations. US Oncology practice i was with was a pooled practice model where all partners saw same average number of patients. At the end of the year after overheads/expenses/salaries etc what ever was left was distributed as a bonus. Partners all also set a base salary around 50th percentile of heme onc.

Other places i hear also do a rvu model where there may be more discrepancies in rvu numbers as some one doing 12,000 rvus is expected to be paid more than some one doing 5000 rvus etc

Managing partners usually get a little more