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I think you weeded yourself outBefore you interview me, I just have two requests... 3 days off per week and a starting salary of 500k. I look forward to working with you soon!
I think you weeded yourself outBefore you interview me, I just have two requests... 3 days off per week and a starting salary of 500k. I look forward to working with you soon!
It's tough. But really it boils down to how badly people want to be here versus "oh gee whiz, let me apply and see what happens." Surrogates like growing up here, having connections here or otherwise having a compelling reason to be here are all critical in the screening process. We really want a partner, not a physician employee so we are looking for longevity.
Excellent (and really smart) way to think about it. I can’t remember the last time I heard of a colleague (in Rad onc or otherwise) upon making partner cutting a check for the “buy in” ... rather the “excess” from the first 2 years is used as “sweat equity.” If you’re treating 25 patients and being paid for 8-10 (sounds about right for 4500 RVU) and they are just pocketing the difference vs considering it the “buy in” then they are making a killing (like literally multiple hundreds of thousands of dollars/yr) off of you!
It’s almost impossible to “fire” a partner but it’s relatively easy to let an employee go - just say patient volume, compensation, etc has decreased so we are not renewing your service agreement, sorry! In this market I would definitely take a job that offered partnership (and hope they don’t screw me over)vs one that didn’t but paid a little more.
If they have endless supplies of graduating residents what’s to stop them from just letting everybody go after they get what sounds like small annual pay increases when they can just replace with newer doctors who cost them less?
I was been in exact same situation about 5 years ago. Employed salaries (assuming you're competent) are dictated by local market, not MGMA. You may have to switch jobs to get any pay raise, unfortunately.
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Obviously, being busy will help prevent a rad onc from just being let go. Going beyond that, are there potential things one can do to make themselves "irreplaceable" where the partners might be like - 'damn, we can't let this guy go' and potentially have leverage to renegotiate a contract? Perhaps like honing a particular skill, developing a program (brachy?), etc? Of course it depends on who you are working for,
Generate lots of business. The three A's etc.
Harder to let you go when you are keeping the linac full with referrals you've generated
In the city I am looking for a job, the rad onc only groups appear to be slowly dying. The place I referenced above is a multi-specialty group. Only one of the rad oncs is partner for a tiny portion of the company. I brought up MGMA and Doximity data for me and they said that's reasonable for someone in their mid career, so hopefully I can get that in writing. Based on that, the compensation seems like it will be fair, so I guess the only thing I am really worried about is job security...
Obviously, being busy will help prevent a rad onc from just being let go. Going beyond that, are there potential things one can do to make themselves "irreplaceable" where the partners might be like - 'damn, we can't let this guy go' and potentially have leverage to renegotiate a contract? Perhaps like honing a particular skill, developing a program (brachy?), etc? Of course it depends on who you are working for, but assuming they are reasonable people. Wishful thinking? I'm going to be a new grad looking to be in a big city so not much to negotiate at the moment, but just thinking of what I can do to bring more to the bargaining table in the future...
And the way to do that is keep the linac fullFor an employed RadOnc, protecting your job security is no different from any other occupation. The safest way is to maintain close and cordial relationships with your bosses (i.e. practice owners (MedOncs?) in your situation).
And the way to do that is keep the linac full
COC/NAPBC/APEX/Insert Accreditation is a ton of thankless, unpaid work that no one wants to do. If you want to make yourself indispensable volunteer for that nonsense.
Yeah... Not always foolproof esp if you're dealing with a non md hospital administrator with a bad personality who is too shortsighted to see the value you may bring to the practice/DeptThat's only one part. Personal experience has demonstrated to me that just because you're working hard and bringing in referrals doesn't mean that they won't find a reason to replace you if they want to.
It depends on the group/financial set-up. If you are in an integrated system in a major city, most of the referrals come from within the system and if you leave, they will just go to someone else or the next guy. Increasingly, because of the consolidation and financial arrangements, in general we are quite replaceable.That's only one part. Personal experience has demonstrated to me that just because you're working hard and bringing in referrals doesn't mean that they won't find a reason to replace you if they want to.
Yeah... Not always foolproof esp if you're dealing with a non md hospital administrator with a bad personality who is too shortsighted to see the value you may bring to the practice/Dept
It depends on the group/financial set-up. If you are in an integrated system in a major city, most of the referrals come from within the system and if you leave, they will just go to someone else or the next guy. Increasingly, because of the consolidation and financial arrangements, in general we are quite replaceable.
This is actually a really good point. In those places I bet they don't have many options and choice to refer to Dr. X (awesome new graduate they really love working with) to discuss RT so much as a referral pattern of no choice just "refer to RT" and whoever is in that position sees the patient so easier to be replaced.
As opposed to the freestanding setting where most of my referrals come with my name on it from networking and relationships that have taken years to buildThis is actually a really good point. In those places I bet they don't have many options and choice to refer to Dr. X (awesome new graduate they really love working with) to discuss RT so much as a referral pattern of no choice just "refer to RT" and whoever is in that position sees the patient so easier to be replaced.
New question from a mostly lurker. I'm going for an academic job this year and have an offer on the table, want to possibly negotiate, but I know salary can be tough to negotiate for academic places, do other people have suggestions in terms of bargaining chips? Loan repayment, educational fund, research money? Just curious to hear some suggestions.
New question from a mostly lurker. I'm going for an academic job this year and have an offer on the table, want to possibly negotiate, but I know salary can be tough to negotiate for academic places, do other people have suggestions in terms of bargaining chips? Loan repayment, educational fund, research money? Just curious to hear some suggestions.
Honestly, I think when you're a new grade the only bargaining chips that both work and don't come across pompous are competing offers. Do you have other academic offers that are higher? Do you have any private offers that are in that city and higher?
I have another offer from an "academic" center that is higher (by 100k), though calling it academic may be a stretch and it is in a less desirable location. Not sure how far that will get me, definitely do not want to come off greedy. Any other fringe benefits that I could ask for? Relocation assistance?Honestly, I think when you're a new grad the only bargaining chips that both work and don't come across pompous are competing offers. Do you have other academic offers that are higher? Do you have any private offers that are in that city and higher?
I have another offer from an "academic" center that is higher (by 100k), though calling it academic may be a stretch and it is in a less desirable location. Not sure how far that will get me, definitely do not want to come off greedy. Any other fringe benefits that I could ask for? Relocation assistance?
Now that's some fake news...I thought median salary was 400-450k per my limited research.
Now that's some fake news...
All I have to say is “WOW. I’m not sure how things are now but my experience was different in “desirable” areas. I’ll be the first to tell you that I’m no superstar either.
My offers were lower than the Terry Wall data, both academic and private side.
I tried to negotiate my two academic job offers for more research time and resources and was told that the offers were "take it or leave it".
All I have to say is “WOW. I’m not sure how things are now but my experience was different in “desirable” areas. I’ll be the first to tell you that I’m no superstar either.
I guess location really is that important to some people.
According to Terry Wall's talk at ASTRO this year:
PP starting salary: Median 330K, Average: 353K
Academic starting: Median 310K, Average: 300K
So no...400-450k is not the median starting salary. Not to say that you can't be offered 400k+ starting but prob more likely in a rural area, small town, Mid West, etc. Less likely in a bigger city.
You have to be part of a group typically but according to this link, you can buy it individually for $965 A recruiter’s guide to physician salary and compensation surveysWhere exactly does one go to purchase or view those MGMA compendiums with the Rad Onc compensations?
MGMA and other groups are moving away from individuals being able to purchase the surveys. I think part of the idea is requiring submission by the organizations they sell to. With that being said, surveys are really just one piece and in my experience provide a tool but not a great one. The reason being most organizations do not use one survey and most organizations use proprietary updated data based upon experience. The reason being that in MGMA or other surveys it is all respondents lumped into one. However, if you pull out academic, it basically resets the medians, or if you pull out new physicians, it resets the medians. Just a thought.Where exactly does one go to purchase or view those MGMA compendiums with the Rad Onc compensations?
MGMA and other groups are moving away from individuals being able to purchase the surveys. I think part of the idea is requiring submission by the organizations they sell to. With that being said, surveys are really just one piece and in my experience provide a tool but not a great one. The reason being most organizations do not use one survey and most organizations use proprietary updated data based upon experience. The reason being that in MGMA or other surveys it is all respondents lumped into one. However, if you pull out academic, it basically resets the medians, or if you pull out new physicians, it resets the medians. Just a thought.
In my experience from job searching a couple years ago hospitals tend to use the surveys with the lowest salaries reported
approximate total comp numbers:
10%tile: 305k (4700 wRVUs)
25th:450k
Median:525k (8200 wRVUs)
75th:620k
90th:760k (13400 wRVUs)
So keep in mind if you are getting paid 300k, you are getting paid for around 4500 wRVUs. That's like, what 8-10 patients on treatment at most? If you're treating 25 patients, getting paid that much, and not having an opportunity to buy in at all in the future, someone is making a HUGE profit off of your labor.
Would be interesting if they broke the data up by metro area and not just geographic region.
Again, very clear if you want to get a salary that is going to approach anywhere near your actual collections, you need to get out of the big cities.
Sad.
Is there a difference between wRVUs and just regular "RVUs?" The wRVU notation is new to me. And, the above comp numbers are wRVUs per MONTH, right? That's the only way the numbers would add up in my practice...
wrvu = work rvu (professional component)
trvu = total rvu (includes technical component)
wRVUs annually, per provider.
If you yourself are generating 8200 wRVUs per month then you are 10 people and making 8 figures.
Are you looking at the total wRVUs for your practice or per provider? Whole practice numbers are obviously going to be a lot larger.