Unsolicited Jobs Thread

[A_DeMichele]

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AI cuts treatment time for cancer radiotherapy

The technology will be offered at cost price to all NHS trusts in England, following successful pilot studies.

www.bbc.com

Not sure where else to put this but figured this is as good of a place as any.

what are they talking about? new TPS?

 

[Fpg1245]

what are they talking about? new TPS?

They only cut time if you have no idea what you’re doing. What might be the goal in this case.

 

[OTN]

what are they talking about? new TPS?

AI auto-contouring

 

[sirspamalot]

Did you say TPS? You're going to need a cover sheet for those reports my friend.

 

[Gfunk6]

We use MIM Protege which is the new “deep learning” assisted AI. In general it does a very fast and quality job on OARs. However I always verify OARs at risk manually. It sometimes does a poor job on some structures like the optic chaism.

Caveat emptor - you cannot sue MIM (yet) for optic neuritis

 

[madchemist89]

The radformation product does a better job than our dosimetrists. Definitely not perfect, but dosimetry had no clue how to contour the cochlea prior.

 

[RickyScott]

The radformation product does a better job than our dosimetrists. Definitely not perfect, but dosimetry had no clue how to contour the cochlea prior.

It contours the brachial plexus w quite well.

 

[Surf Rx]

It contours the brachial plexus w quite well.

It really does. I was surprised the first time we used it. Saves so much time now.

 

[RickyScott]

It really does. I was surprised the first time we used it. Saves so much time now.

On the recent version, it also does a good job segmenting the hippocampus on a Ct data set.

 

[medgator]

If you are looking for ways to improve your work-life balance, live a laid-back lifestyle, receive great benefits and competitive pay (up to $653,000 includes $100,000 sign-on bonus) - MercyOne North Iowa Medical Center is the place for you! We are accepting J1 applications for this opportunity and recently received our Health Professional Shortage Area (HPSA) designation!

Check out our hospital employed full-time BC/BE Radiation Oncology physician position we have available. There's some great info about the opportunity, compensation package, our organization / community and much more.

I'd love to learn more about your career goals/needs and thoughts on joining our team— any chance you have time next week to chat with Morgan Staley at 641-428-6631 to learn more about this amazing opportunity at MercyOne North Iowa?

 

[Gfunk6]

If you are looking for ways to improve your work-life balance, live a laid-back lifestyle, receive great benefits and competitive pay (up to $653,000 includes $100,000 sign-on bonus) - MercyOne North Iowa Medical Center is the place for you! We are accepting J1 applications for this opportunity and recently received our Health Professional Shortage Area (HPSA) designation!

Check out our hospital employed full-time BC/BE Radiation Oncology physician position we have available. There's some great info about the opportunity, compensation package, our organization / community and much more.

I'd love to learn more about your career goals/needs and thoughts on joining our team— any chance you have time next week to chat with Morgan Staley at 641-428-6631 to learn more about this amazing opportunity at MercyOne North Iowa?

Is the meth any good? Or is it more of an oxy town?

 

[medgator]

Is the meth any good? Or is it more of an oxy town?

 

[elementaryschooleconomics]

If you are looking for ways to improve your work-life balance, live a laid-back lifestyle, receive great benefits and competitive pay (up to $653,000 includes $100,000 sign-on bonus) - MercyOne North Iowa Medical Center is the place for you! We are accepting J1 applications for this opportunity and recently received our Health Professional Shortage Area (HPSA) designation!

Check out our hospital employed full-time BC/BE Radiation Oncology physician position we have available. There's some great info about the opportunity, compensation package, our organization / community and much more.

I'd love to learn more about your career goals/needs and thoughts on joining our team— any chance you have time next week to chat with Morgan Staley at 641-428-6631 to learn more about this amazing opportunity at MercyOne North Iowa?

My favorite part is you taking the time to format this with bold text and hyperlinks.

 

[RickyScott]

My favorite part is you taking the time to format this with bold text and hyperlinks.

Would be interesting to know what IM pays in this location.

 

[medgator]

My favorite part is you taking the time to format this with bold text and hyperlinks.

That was straight from recruiter email. Their formatting

 

[NotMattSpraker]

That was straight from recruiter email. Their formatting

How does HPSA impact an employee, does that allow for more flexibility in negotiation? Some kind of a waiver of Stark and FMV?

I tried to look this up but it was hard to find why a recruiter would advertise that status.

 

[HolySmokes]

How does HPSA impact an employee, does that allow for more flexibility in negotiation? Some kind of a waiver of Stark and FMV?

I tried to look this up but it was hard to find why a recruiter would advertise that status.

Loan forgiveness for PCPs, so maybe just copied and pasted straight from one of their other non-rad onc listings? This entire ad looks like you can plug and play any salary/specialty.

 

[Mandelin Rain]

How does HPSA impact an employee, does that allow for more flexibility in negotiation? Some kind of a waiver of Stark and FMV?

I tried to look this up but it was hard to find why a recruiter would advertise that status.

https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/hpsafctsht.pdf

Looks like a 10% CMS Medicare bonus. No idea how that translates to the doc in this employed scenario. Probably not at all.

 

[sirspamalot]

https://www.cms.gov/outreach-and-education/medicare-learning-network-mln/mlnproducts/downloads/hpsafctsht.pdf

Looks like a 10% CMS Medicare bonus. No idea how that translates to the doc in this employed scenario. Probably not at all.

Negotiation?

"if you want me to consider working there it'll be 950k as a 1099 plus 5 weeks vacation coverage. Let me know if there is a serious need for a high quality experienced radonc."

#

 

[sirspamalot]

Negotiation?

"if you want me to consider working there it'll be 950k as a 1099 plus 5 weeks vacation coverage. Let me know if there is a serious need for a high quality experienced radonc. Also I do require a 6 months notice. "

#

 

[deleted1168505]

Negotiation?

"if you want me to consider working there it'll be 950k as a 1099 plus 5 weeks vacation coverage. Let me know if there is a serious need for a high quality experienced radonc."

#

We would love to pay you 950k but that is a violation of Stark law.

Instead, we can pay you 500k + a complicated RVU system that we basically make up as we go along. Collections? How do you know about those! What, you don't like RVUs? Technical? Technically there's the door!

 

[deleted1111261]

I want to see the lawsuits of violating FMV

This is a trash argument

 

[communitydoc13]

I want to see the lawsuits of violating FMV

This is a trash argument

The successful suits I have seen have all been egregious (PITT with their surgical setup (billing multiple rooms) or cards getting millions and millions in Iowa).

My experience with legal counsel quoting Stark has shaped the way I view law in general. Take a supreme court ruling. You may read the actual language and think it's pretty granular and won't really do major things, but it is the cultural use of the ruling and not the word of the ruling that matters for behavior. The hospitals want to pay less, they can use stark and claim fear of suit.

The whole qui tam thing is so perverse. If anyone is going to bring a qui tam suit regarding physician comp, it might well be a mid level admin looking to cash in.

If anyone were to bring a qui tam suit regarding limiting residency expansion, it would be an academic center themselves.

 

[Mandelin Rain]

FMV varies widely; see salaries of medical association CEOs.

 

[deleted1168505]

It's funny how fair market value only goes one way.
If the only way you can get somebody to go to a god forsaken place is to pay them 950k, then that is market value by definition. Is it fair? Well what's the alternative? Somebody treating 30 in a VHCOL area with a 300k salary -- that's market value. Is that fair? You bet!

Look at this email we all get spammed with every week:

Radiation Oncology	Munster	IN	Chicago 30m
Radiation Oncology	Columbus	NE	Omaha 80m; Lincoln 80m
Radiation Oncology	Alma	MI	Midland 30m, Detroit 150m
Radiation Oncology	Gratiot	MI	Grand Rapids 70m
Radiation Oncology	Albuquerque	NM	Albuquerque
Radiation Oncology	Cooperstown	NY	Albany 75m; New York City 190m
Radiation Oncology	Morristown	TN	Knoxville 45m
Radiation Oncology	San Angelo	TX	San Angelo

It's the same places advertising for years. I can pretty much promise none of them are willing to pay true "market value" hence remaining on this list of flaming crap forever.

 

[RickyScott]

Fair market value violations occurr when there is an egregious difference ie 99% salary for 10% Rvu/collection. I have had administrators falsely claim that it means salary has to exactly match collections. You can certainly as a rural center pay someone in the 90% for 50-% work because of location as well as give them directorship fee etc

 

[sirspamalot]

Yup. Live that # dream all day erry day.

Live the dream or bow to the nightmare.. The choice is yours.

# my brothers and sistahs

 

[deleted1168505]

I have had administrators falsely claim that it means salary has to exactly match collections.

Oh, I've heard worse.

They have told me with a straight face that even if you are paid less than pro collections, it can still be a violation if the number is too high. So they have to cap you at a certain number no matter how much work you do.

The only proper response to this is "oh F off"

 

[radoncftw]

I would literally sirspamalot response to that job.
I have negative 50% interest in moving to Mason City, but may email recruiter and say that I'd be interested for 1 million

 

[NotMattSpraker]

I want to see the lawsuits of violating FMV

This is a trash argument

Me too. I know very little about it, but it seems like if a center cant get a permanent rad onc for many months or more, then the pay is not fair. Isn't that supply and demand, the American way?

 

[radoncftw]

Me too. I know very little about it, but it seems like if a center cant get a permanent rad onc for many months or more, then the pay is not fair. Isn't that supply and demand, the American way?

i feel like we've talked about this before.
its cheaper for centers to have permalocums possibly right? if they don't really care at least.
there are a few centers like 3 hr from where i practice in the boonies that operate on this model.
i think they all have jobs posted...but no one is going there for MGMA median.
these are normally the type of places that patients will not touch with a 10 foot pole, but some don't have a choice.

 

[deleted1168505]

i feel like we've talked about this before.
its cheaper for centers to have permalocums possibly right? if they don't really care at least.
there are a few centers like 3 hr from where i practice in the boonies that operate on this model.
i think they all have jobs posted...but no one is going there for MGMA median.
these are normally the type of places that patients will not touch with a 10 foot pole, but some don't have a choice.

Hospitals pay about 3300/day for locums in the boonies (agency rate or direct + expenses)
x 252 days/year = $831,600

So you are not getting 950k 1099 from a hospital anywhere, ever. Sorry. Typical benefit package is about 100k, so W2 salary is probably going to max out in mid 700s before the bean counters decide to staff with locums. Income at that level will be very high production at the rare hospital that doesn't jerk you around with moving goalpost RVU targets.

Less reputable places will direct hire non-BC locums or others who can't find work anywhere else for whatever reason and take the numbers above down a lot. Happens a lot in the rural midwest.

 

[TheWallnerus]

Hospitals pay about 3300/day for locums in the boonies (agency rate or direct + expenses)
x 252 days/year = $831,600

So you are not getting 950k 1099 from a hospital anywhere, ever. Sorry. Typical benefit package is about 100k, so W2 salary is probably going to max out in mid 700s before the bean counters decide to staff with locums. Income at that level will be very high production at the rare hospital that doesn't jerk you around with moving goalpost RVU targets.

Less reputable places will direct hire non-BC locums or others who can't find work anywhere else for whatever reason and take the numbers above down a lot. Happens a lot in the rural midwest.

I have collected 950K in one year on professional in the boonies FWIW (attn: young rad oncs)

 

[deleted1168505]

I have collected 950K in one year on professional in the boonies FWIW (attn: young rad oncs)

A hospital paid you that as a 1099 locums? When was that? Or you collected that much on your own? Big difference. Good luck getting the latter unless the place is slow as a Siemens Primus. Even average-busy hospitals will insist billing be kept in house, preferably a black box in the no-physicians-allowed C-suite biller office.

 

[sirspamalot]

They can do whatever they want as long as their check clears every month.

#ing it out in a rural area is just fine.

 

[TheWallnerus]

A hospital paid you that as a 1099 locums? When was that? Or you collected that much on your own? Big difference. Good luck getting the latter unless the place is slow as a Siemens Primus. Even average-busy hospitals will insist billing be kept in house, preferably a black box in the no-physicians-allowed C-suite biller office.

to be clear: doing my own billing and collecting my own professional

 

[sirspamalot]

to be clear: doing my own billing and collecting my own professional

Or just get a guarantee and let them worry about it.

 

[sirspamalot]

Hospitals pay about 3300/day for locums in the boonies (agency rate or direct + expenses)
x 252 days/year = $831,600

So you are not getting 950k 1099 from a hospital anywhere, ever. Sorry. Typical benefit package is about 100k, so W2 salary is probably going to max out in mid 700s before the bean counters decide to staff with locums. Income at that level will be very high production at the rare hospital that doesn't jerk you around with moving goalpost RVU targets.

Less reputable places will direct hire non-BC locums or others who can't find work anywhere else for whatever reason and take the numbers above down a lot. Happens a lot in the rural midwest.

Hospitals pay WHATEVER THEY MUST when things get tight and suddenly the hole cannot go away for "market rate".

3300/d is fantasy when this happens. I've charged 4500 a day to babysit for 3 days. That was years ago.

Agencies get their margins compressed when I engage because # and something is better than nothing esp if the contract is long term. Your most powerful tool is to say "no."

You absolutely can and should make # (or more) preferably in a guaranteed basis and with a gentle workload. How about a 3.5 to 4 day work week (but you are paid for the entire week) too mkay..

Otherwise, uh, you're doing it wrong lol.

 

[deleted1111261]

I’m having to deal with this issue with a low volume center in our network, not mine.

With the numbers we have, paying $1500 a day is a stretch. Really. I’m at a place where I have advised for $2000/day b/c I want a certain person usually, but our margins get slim every time I go to Asia.

If the center is treating 3-4 day, it makes more sense to shut down then have locums for 6 weeks a year. Even as a loss leader, we can’t make it worthwhile. Needs to be 7-9, then can pay $2k locums. But you’re right if 20+, $3k absolutely should be minimum.

Your strategy works for you, but if you came to me with that, I’d laugh and say either come down to something reasonable or we can find someone else. Or shut down, if we can’t.

 

[RickyScott]

I’m having to deal with this issue with a low volume center in our network, not mine.

With the numbers we have, paying $1500 a day is a stretch. Really. I’m at a place where I have advised for $2000/day b/c I want a certain person usually, but our margins get slim every time I go to Asia.

If the center is treating 3-4 day, it makes more sense to shut down then have locums for 6 weeks a year. Even as a loss leader, we can’t make it worthwhile. Needs to be 7-9, then can pay $2k locums. But you’re right if 20+, $3k absolutely should be minimum.

Your strategy works for you, but if you came to me with that, I’d laugh and say either come down to something reasonable or we can find someone else. Or shut down, if we can’t.

The problem is that some of us want to work. If I were to locums in the middle of nowhere, 5 pts on beam is not a selling point. What am I going to do for the rest of the day?

 

[deleted1111261]

Go home at 1, keep your cell phone on til 4, then hit the dive bar on Gratiot just south of the hospital (dodgy part of Port Huron)

 

[RickyScott]

Go home at 1, keep your cell phone on til 4, then hit the dive bar on Gratiot just south of the hospital (dodgy part of Port Huron)

Honestly, I would rather take a nap in the office, speak on the phone, or surf the internet until 4 while babysitting 20 on beam for more money.

 

[sirspamalot]

"Hard pass."

I don't care how many you have on treatment nor do I care about your Financials. Close it down then.

You need the service, this is the cost. My time is valuable and if you don't pay then I go where they do.

Business: it's what for lunch.

Our peers who work for cheap destroy the value of our profession. Learn to say no.... And thrive.

#

 

[RickyScott]

This can be a problem with some of these rural jobs. When they have 10 on beam, the hospital thinks they shouldn’t pay 750k. 5-10 on beam is not a selling point for me. I would actually want additinal compensation for less pts as there is nothing to do in the middle of the New Mexico desert.

 

[sirspamalot]

This can be a problem with some of these rural jobs. When they have 10 on beam, the hospital thinks they shouldn’t pay 750k. 5-10 on beam is not a selling point for me. I would actually want additinal compensation for less pts as there is nothing to do in the middle of the New Mexico desert.

Trust me when I tell you that indeed you are correct.

For the love of all things holy, don't stay in Carlsbad for more than 2 weeks or you will go insane.

 

[deleted1111261]

I think that’s the dive bar in Port Huron, Carl’s Bad Bar

 

[RadOncDoc21]

Trust me when I tell you that indeed you are correct.

For the love of all things holy, don't stay in Carlsbad for more than 2 weeks or you will go insane.

I’ve seen Breaking Bad!

 

[sirspamalot]

I’ve seen Breaking Bad!

ABQ is palatial compared to CarlsReallyBad (caverns though are amazing).

Speaking of Carl..

 

[deleted1168505]

Trust me when I tell you that indeed you are correct.

For the love of all things holy, don't stay in Carlsbad for more than 2 weeks or you will go insane.

There is an empty quarter of the US where rad oncs go to die. It's conveniently color coded from space because everything else is dead there too. God help the poor souls that take the # jobs in these parts.

 

[sirspamalot]

There is an empty quarter of the US where rad oncs go to die. It's conveniently color coded from space because everything else is dead there too. God help the poor souls that take the # jobs in these parts.

Thank goodness I'm not in that zone. Maybe we should call that area *...

* working here may have adverse consequences on your mental health


Ps. Your line excluded Laredo, no bueno