State of the Field

[stephew]

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Int J Radiat Oncol Biol Phys. 2007 Oct 1;69(2):518-27. Epub 2007 May 10. Links
Radiation oncologists in the United States.

Lewis RS, Sunshine JH.
Research Department, American College of Radiology, Reston, VA 20191, USA. [email protected]
PURPOSE: To provide an extensive and detailed portrait of radiation oncologists, their professional activities, and the practices in which they work. METHODS AND MATERIALS: We analyzed non-individually identified data from the American College of Radiology's 2003 Survey of Radiation Oncologists, a stratified random sample survey that guaranteed respondents' confidentiality and achieved a 68% response rate, with a total of 472 responses. Responses were weighted to make them representative of all radiation oncologists in the United States. We use two-tailed z tests of percentages and means to compare information from the current survey with those from a similar 1995 survey. RESULTS: The number of posttraining, professionally active radiation oncologists grew from nearly 2900 in 1995 to nearly 3500 in 2003, an increase of approximately 21%. Twenty-three percent of posttraining, professionally active radiation oncologists were women. Among posttraining, professionally active radiation oncologists, 95% were board-certified. Forty-eight percent of radiation oncologists were in nonacademic, radiation-oncology-only private practices; 20% in academic practice; 14% in nonacademic, multispecialty practices; and 11% in solo practice. The largest percentage of radiation oncologists worked in the South (34%). The average annual number of patients treated (curative and palliative) per radiation oncologist was 264. On average, radiation oncologists preferred a 4% increase in their workload. The proportion of radiation oncologists planning a career change decreased from 8% in 1995 to 4% in 2003, and in 2003 34% said they were enjoying radiation oncology more than 5 years earlier, compared with 21% in 1995. CONCLUSION: Despite concerns in 2003 about lower-than-optimal workload, professional satisfaction, if anything, increased since 1995.

 

[deleted4401]

steph/anyone with experience...

264 patients per year/(52 weeks - 4 weeks of vacation) = 5.5 new consults treated a week.

Is this about right or is there a huge # of oncologists working part-time or am I just misunderstanding that statistic? Doesn't sound like a whole lot.

S

 

[PimpMyRad]

If you're putting 5 pts per week on treatment, and the average course of RT is 6 weeks (typical for my practice), you will have around 30 patients on treatment on average. That is probably average for most practices, and will generate a very reasonable income. Certainly there are busier practices, and those with a different case mix, but the figure in the article is probably accurate. Seeing five new patients a week doesn't sound like much, but you will also see some pts that aren't treated, and many followups. Also, we are spending far more time in dosimetry countouring and working on plans that ever before, not to mention reviewing MVCT and/or Acculoc images.

 

[stephew]

private practices are typically busier than that.

 

[PimpMyRad]

At the risk of being ejected from this forum, I would beg to differ with our all-knowing and mild to moderately condescending moderator. The very study you posted here confirms that those numbers are what most radiation oncologists in this country see. Perhaps there was some sampling error, and those who responded were those in less busy practices, but the numbers jibe with my own experience. As I said, there are busier practices, and also practices that see fewer patients. You might be surprised at the number of small sites treating 10 or 15 patients per day. Stephew, what has your experience in private practice been?

 

[stephew]

A good point. I have no real private practice experience. Thank you for demonstrating how to graciously make a point.

At the risk of being ejected from this forum, I would beg to differ with our all-knowing and mild to moderately condescending moderator. The very study you posted here confirms that those numbers are what most radiation oncologists in this country see. Perhaps there was some sampling error, and those who responded were those in less busy practices, but the numbers jibe with my own experience. As I said, there are busier practices, and also practices that see fewer patients. You might be surprised at the number of small sites treating 10 or 15 patients per day. Stephew, what has your experience in private practice been?

 

[xraydude]

Well.....I'm not sure where you practice and see 5 new consults a week. I average close to 10-12, with about 25-35 on treatment. Certainly if you are doing brachy, you'll have less on tx, but if you treat a lot of breast, 10-12 is a piece of cake. However, our practice also earns at a high rate than most due to our volume.

One note - studies like these can be inaccurate. Those who are busy would likely not respond to it, while those who were not might. This might bias the results.

Stephanie - your correct in your assessment.

 

[stephew]

one question our new but experienced friend can answer- how frequently do we see procedures such as brachy and radiosurgery in private practice? And do you see general application of these techniques (ie all sorts of brachy) or more niche practices (ie prostate)

 

[xraydude]

We're a busy private practice.....averaging about 5-8 prostate implants a week, usually a few mammosites (ie 3-4 week), some gyne - T&O's, cylinders, etc., and 5-8 stereotactic procedures a week.
We're not the norm, I'd say, but we can do it because of our good technology.

 

[radiaterMike]

We're a busy private practice ... We're not the norm, I'd say ... However, our practice also earns at a high rate than most due to our volume.

and thus the RedJ article may not be that far off (and may in fact be correct). There are plenty of practices where fewer consults are seen, perhaps exchanging a bit of QOL for less $$, or perhaps because their referral base is smaller, and they are not as busy as they'd like to be.