Unsolicited Jobs Thread

[deleted1180461]

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Wild that anyone would have a dream to become a doctor as a kid and try hard in junior high, take advanced classes in high school, go to college and do all the things necessary to get into med school, go to med school and almost kill yourself studying and working there, and then do a 5 year medical residency…

All so a person could get a job watching Netflix.

Soul crushing to a person if the person didn’t know that was the endgame. But a fair number of kids have to know this might be the endgame, now. And they’re still choosing the Netflix and the soul crushing! Again, wild.

Oh, one other observation. Supervision doesn’t save souls, it crushes them.

The Sterling job would fill if they would let someone come out from Denver 3 days a week and keep all the wRVUs. 10:1 odds they won't and want someone to move to their frontier town and never leave and will just use locums forever until this mythical creature magically materializes. Like someone whose retirement plan is playing powerball. Maybe today will be the day!

 

[CurbYourExpectations]

You want a middle ground that will make it optimal for physicians, that would be great. I don't think that is what will happen, it will either be the mythical creature or it will be locums or it will be paying a remote doc that never set foot inside the facility and giving them a fraction of the pay as a supplement while they're sitting in a cush city job, ultimately driving up supply significantly and demand down. Either way it's not going to be something that is perfect for the physician.

 

[DrProtonX]

The Sterling job would fill if they would let someone come out from Denver 3 days a week and keep all the wRVUs. 10:1 odds they won't and want someone to move to their frontier town and never leave and will just use locums forever until this mythical creature magically materializes. Like someone whose retirement plan is playing powerball. Maybe today will be the day!

$500k+ to live in Denver and work 3 days a week… now it sounds like an attractive job!
Crazy how even a little common sense can change things drastically! Such a shame common sense is a rarity these days!

 

[communitydoc13]

and the locum was not comfortable doing an electron setup for keloid so patient missed his treatment window

Terrible behavior by admin...very sorry for your situation and wishing you a joyful exit and new place of employment.

But...the above. How did someone miss this basic aspect of training (RA and inverse planning for all cases?).

Look up the Flickinger paper...pick a reasonable dose and treat. You are not going to hurt someone with an 80-90% isodose line plan and 6e. There is a wide variation in prescriptions that I would view as reasonable (if not perhaps optimal).

Who are these locums?

 

[deleted1180461]

Update regarding cheyenne (all very pertinent info)

- People asked why I deleted my posts. Well, I received accusations of "slander" from cheyenne admin and concerns from potential employers about the posts on here. Nothing said on here is untrue or factually incorrect.
- A member of the cheyenne staff contacted my new employer and tried to get my contract withdrawn
- My manager was strictly told not to provide a reference for me for a locum position I applied for
- They notified me my pay/bonus will be withheld until my end date for "fear I would leave and owe them more back pay." It's just blackmail. They know this is a breach of my contract but there's nothing I can do so they're just playing with me at this point.
- The new FT physician that was supposed to start a couple weeks ago didn't come. They blamed me. So now they are scrambling to hire a locum, any locum. I was out this week and the locum was not comfortable doing an electron setup for keloid so patient missed his treatment window.
- Did I mention they took my PTO away when I had to take my dog to the emergency vet and subsequently had to put him down. All patients were seen and 40+ hours were worked that week (per my contract) despite dealing with trauma and heartache. And still took my PTO since I was not on site the whole days. John Wick will avenge me hopefully.

F that place man. Good on you for calling them out. My first job was with a carbon copy of that place and they sabotaged me after I left by contacting future employers. I eventually had to get an NDA with them to stop the sabotaging.

When I interviewed with Cheyenne red flag alarm bells were going off everywhere. It was the same thing. Zero respect for physicians and physician autonomy.

 

[deleted1180461]

Terrible behavior by admin...very sorry for your situation and wishing you a joyful exit and new place of employment.

But...the above. How did someone miss this basic aspect of training (RA and inverse planning for all cases?).

Look up the Flickinger paper...pick a reasonable dose and treat. You are not going to hurt someone with an 80-90% isodose line plan and 6e. There is a wide variation in prescriptions that I would view as reasonable (if not perhaps optimal).

Who are these locums?

These locums are almost universally between the ages of 65-80 often with major health and personality problems willing to work for $1500/day. They are often not BC and have been doing locums their entire career because they can’t get full time employment. They can’t make a living on the coasts so gravitate to undesirable areas in the interior. Shockingly there are multiple rural hospitals in the Midwest and Great Plains region who operate by rotating these guys in and out because it saves on staffing costs and allows them to scalp pro fees.

I likely know this locums.

They screw the job market up in these regions for everyone.

 

[deleted1180461]

- They notified me my pay/bonus will be withheld until my end date for "fear I would leave and owe them more back pay." It's just blackmail. They know this is a breach of my contract but there's nothing I can do so they're just playing with me at this point.

One more thing. At this point, lawyer.

It sound like they have caused measurable damages to you. You need to protect yourself from sabotaging and recoup damages.

Lawyer.

Good luck to you BTDT.

 

[TheWallnerus]

Update regarding cheyenne (all very pertinent info)

- People asked why I deleted my posts. Well, I received accusations of "slander" from cheyenne admin and concerns from potential employers about the posts on here. Nothing said on here is untrue or factually incorrect.
- A member of the cheyenne staff contacted my new employer and tried to get my contract withdrawn
- My manager was strictly told not to provide a reference for me for a locum position I applied for
- They notified me my pay/bonus will be withheld until my end date for "fear I would leave and owe them more back pay." It's just blackmail. They know this is a breach of my contract but there's nothing I can do so they're just playing with me at this point.
- The new FT physician that was supposed to start a couple weeks ago didn't come. They blamed me. So now they are scrambling to hire a locum, any locum. I was out this week and the locum was not comfortable doing an electron setup for keloid so patient missed his treatment window.
- Did I mention they took my PTO away when I had to take my dog to the emergency vet and subsequently had to put him down. All patients were seen and 40+ hours were worked that week (per my contract) despite dealing with trauma and heartache. And still took my PTO since I was not on site the whole days. John Wick will avenge me hopefully.

Maybe ASTRO attorneys will contact your admins and threaten them

 

[seper]

admins are undisputed kings in these type of RadOnc centers. Physicians have close to 0 leverage

 

[CurbYourExpectations]

Outrageous how many threatened legal actions there have been in such a small field in a small amount of time. Imagine calling someone else's employer and tattling on them for saying things you don't like. Sad.

 

[thesauce]

Outrageous how many threatened legal actions there have been in such a small field in a small amount of time. Imagine calling someone else's employer and tattling on them for saying things you don't like. Sad.

There’s a lot of money in our field. Whenever that happens, there’s going to be lawsuits and fights and a lot of anger. I can name 5 people off the top of my head that have had other docs including their partners run them out out of jealousy. Sad.

 

[deleted1180461]

There’s a lot of money in our field. Whenever that happens, there’s going to be lawsuits and fights and a lot of anger. I can name 5 people off the top of my head that have had other docs including their partners run them out out of jealousy. Sad.

This is exactly it.

Once someone has control of the technical reimbursement (whether through hard work investment and calculated risks or just dumb luck), and whether that person is a rad onc, med onc, or hospital administrator, they transform into Gollum and protect their precious at all costs.

 

[radoncle]

There’s a lot of money in our field. Whenever that happens, there’s going to be lawsuits and fights and a lot of anger. I can name 5 people off the top of my head that have had other docs including their partners run them out out of jealousy. Sad.

Jealousy is one hell of an emotion especially when money is the root of the jealousy. I’ve learned sadly from personal experience that there are certain rad oncs who can’t stand to see someone “doing better” than themselves and will stop at nothing to run them out of a practice even if they’re the ones who built it (particularly in certain southern states - one of which is notorious)

 

[DrProtonX]

I’m starting to think the days of going somewhere middle of nowhere and making $700-800k+ is really over for Rad Onc. Is this where we are? $420k to live in Mason City IA (27k population). I also attached a GI job post for Mason City… the difference is INSANE!!!

 

[medgator]

I’m starting to think the days of going somewhere middle of nowhere and making $700-800k+ is really over for Rad Onc. Is this where we are? $420k to live in Mason City IA (27k population). I also attached a GI job post for Mason City… the difference is INSANE!!!

"The goal is a job"

- Thomas Eichler, Former ASTRO president

 

[RickyScott]

I’m starting to think the days of going somewhere middle of nowhere and making $700-800k+ is really over for Rad Onc. Is this where we are? $420k to live in Mason City IA (27k population). I also attached a GI job post for Mason City… the difference is INSANE!!!

Psych would def clear 400k in this location and so might primary care

 

[radoncftw]

I’m starting to think the days of going somewhere middle of nowhere and making $700-800k+ is really over for Rad Onc. Is this where we are? $420k to live in Mason City IA (27k population). I also attached a GI job post for Mason City… the difference is INSANE!!!

that is awful.
I have been to that city.
i have a feeling the rad onc job is hospital employed
GI is probably private, especially with mention of a ASC investment opportunity.
Can't believe they are not even offering MGMA median

 

[medgator]

Psych would def clear 400k in this location and so might primary care

Psych easily. Many psychs are cash only, no insurance in much larger metros than where that job is posted

 

[thesauce]

Jealousy is one hell of an emotion especially when money is the root of the jealousy. I’ve learned sadly from personal experience that there are certain rad oncs who can’t stand to see someone “doing better” than themselves and will stop at nothing to run them out of a practice even if they’re the ones who built it (particularly in certain southern states - one of which is notorious)

Ironically, California, the Midwest, and the Northwest are the places I know about. It is absolutely rampant.

 

[medgator]

Ironically, California, the Midwest, and the Northwest are the places I know about. It is absolutely rampant.

Isn't there a certain Cali practice that has been posted for over a decade on this forum that falls into that category? Have also heard it happens in a certain island practice as well

I suspect as these boomers (some are older Gen X) age out or practices are acquired, this will be seen less and less

 

[deleted1180461]

I’m starting to think the days of going somewhere middle of nowhere and making $700-800k+ is really over for Rad Onc. Is this where we are? $420k to live in Mason City IA (27k population). I also attached a GI job post for Mason City… the difference is INSANE!!!

They’ll negotiate up. I’m at a place that initially was trying offer something like that. My comp is much higher now. The more important thing is what the RVU rate is, what the volume is, and making sure they true up monthly.

 

[drowsy12]

They’ll negotiate up. I’m at a place that initially was trying offer something like that. My comp is much higher now. The more important thing is what the RVU rate is, what the volume is, and making sure they true up monthly.

Lesson as always IMO is to not let job posting details deter you. They are infamously incorrect. Not that I can imagine why but if you want to be in this region, apply and find out more

It’s a play or be played world. You gotta play.

 

[RickyScott]

They’ll negotiate up. I’m at a place that initially was trying offer something like that. My comp is much higher now. The more important thing is what the RVU rate is, what the volume is, and making sure they true up monthly.

Possibly, but that salary would never have been posted 10 years ago.

 

[yesmaster]

Takeaway: There’s a lot of crap rad onc jobs out there, even in crap locations.

 

[deleted1180461]

Possibly, but that salary would never have been posted 10 years ago.

It’s a stupid “salary” to post.

It is possible they are staffing with locums and just converted their daily rate to a salary.

A lot of boneheaded admins in that region that will take the locums route. It’s worth investigating to see if they will give you the numbers from the clinic. If they won’t, agree pass as you will never see more than your base.

 

[RickyScott]

locums salaries in every other specialty are more than employment.

 

[TheWallnerus]

locums salaries in every other specialty are more than employment.

Was just informed by an OB GYN resident in WVa that OB Locums in that state now getting 5K a day to mostly “sit on their a$$” per the resident

 

[RickyScott]

B

Was just informed by an OB GYN resident in WVa that OB Locums in that state now getting 5K a day to mostly “sit on their a$$” per the resident

physicists earn 3k a day locums?

 

[deleted1180461]

I was offered 400k fixed salary in WV a few years ago. It's the poorest payor mix in the nation.
Where do you think the 1.3M/yr for ob locums is coming from? You. It's coming from you.
Also, if you ever needed proof "Stark Law" was complete BS, here you go. The only Stark Law case I am familiar with involved paying OB in WV 1.2M/yr.

 

[TheWallnerus]

I was offered 400k fixed salary in WV a few years ago. It's the poorest payor mix in the nation.
Where do you think the 1.3M/yr for ob locums is coming from? You. It's coming from you.
Also, if you ever needed proof "Stark Law" was complete BS, here you go. The only Stark Law case I am familiar with involved paying OB in WV 1.2M/yr.

The vastly different ways and means the Stark Law gets applied in different situations and locales is very… stark

 

[Fpg1245]

The vastly different ways and means the Stark Law gets applied in different situations and locales is very… stark

It’s basically used when you’re employer doesn’t want to pay you or thinks your being paid too much or if they really hate you to investigate and sue you

 

[TheWallnerus]

It’s basically used when you’re employer doesn’t want to pay you or thinks your being paid too much or if they really hate you to investigate and sue you

WTG ChatGPT

 

[RickyScott]

I was offered 400k fixed salary in WV a few years ago. It's the poorest payor mix in the nation.
Where do you think the 1.3M/yr for ob locums is coming from? You. It's coming from you.
Also, if you ever needed proof "Stark Law" was complete BS, here you go. The only Stark Law case I am familiar with involved paying OB in WV 1.2M/yr.

It’s basically used when you’re employer doesn’t want to pay you or thinks your being paid too much or if they really hate you to investigate and sue you

Usually, the employer is lying. Salary doesn’t have to exactly match production or mean. You just can’t be 10-% Fte earning in the 99% like the West Virginia case, where there was an obvious quid pro quo. It is perfectly ok to pay full time Fte in an very undesirable location in the 90%.

 

[deleted1180461]

Usually, the employer is lying. Salary doesn’t have to exactly match production or mean. You just can’t be 10-% Fte earring in the 99% like the West Virginia case, where there was an obvious quid pro quo. It is perfectly ok to pay full time Fte in an very desirable location in the 90%.

My comeback to the "we can't pay you more than 75th percentile because that is high risk for stark law violation" line has always been, "so one quarter of rad oncs are committing medicare fraud?"

The answer almost always is, "oh well, those are private practice doctors, so that doesn't count." Stark law only applies to hospital employees. Got it. Oh, you paid a third party consultant to tell you where the limit is? There wasn't a conflict of interest of payment for their recommendation being where you want it to be? Ok, if you say so.

Generally, if you've found yourself having a debate about stark law, you've already lost.

 

[yesmaster]

The diagnostic radiologist getting paid $1.2M through w2 or psa/contractor relationship because the hospital is desperate is not getting cautioned by admin about fmv boogeyman

 

[TheWallnerus]

I should have reported Medicare and BlueCross for Stark violations in some years when I did my own billing. They really paid way too much for my work.

 

[DrProtonX]

The diagnostic radiologist getting paid $1.2M through w2 or psa/contractor relationship because the hospital is desperate is not getting cautioned by admin about Stark Law boogeyman

At my community hospital, majority of specialties are either completely or at least partially covered by private groups… rad oncs are among few who are all employed.

 

[CurbYourExpectations]

My comeback to the "we can't pay you more than 75th percentile because that is high risk for stark law violation" line has always been, "so one quarter of rad oncs are committing medicare fraud?"

The answer almost always is, "oh well, those are private practice doctors, so that doesn't count." Stark law only applies to hospital employees. Got it. Oh, you paid a third party consultant to tell you where the limit is? There wasn't a conflict of interest of payment for their recommendation being where you want it to be? Ok, if you say so.

Generally, if you've found yourself having a debate about stark law, you've already lost.

I was always under the impression stark law was more geared towards PP and that big hospital systems and academic systems are mostly exempt from it (especially if someone within the system is referring). Is this not the case?

 

[RickyScott]

I was always under the impression stark law was more geared towards PP and that big hospital systems and academic systems are mostly exempt from it (especially if someone within the system is referring). Is this not the case?

That is the spirit of the stark law. You basically aren’t so supposed to be paying for referrals. I am sure Ron D’s administrative counterparts spew crap why they can’t pay more than x percentile, but at the end of the day, percentile and salaries are set by the market and supply and demand and it all comes back to Astro/scarop expansion. It’s easy for administrators to blow smoke abt stark, but they will pay what the market dictates.

 

[TheWallnerus]

I was always under the impression stark law was more geared towards PP and that big hospital systems and academic systems are mostly exempt from it (especially if someone within the system is referring). Is this not the case?

You would think, but it depends

United States Resolves $237 Million False Claims Act Judgment against South Carolina Hospital that Made Illegal Payments to Referring Physicians

This is archived content from the U.S. Department of Justice website. The information here may be outdated and links may no longer function. Please contact [email protected] if you have any questions about the archive site.

www.justice.gov

 

[RickyScott]

You would think, but it depends

United States Resolves $237 Million False Claims Act Judgment against South Carolina Hospital that Made Illegal Payments to Referring Physicians

This is archived content from the U.S. Department of Justice website. The information here may be outdated and links may no longer function. Please contact [email protected] if you have any questions about the archive site.

www.justice.gov

Sounds like a quid pro quo arrangement. Hospital “employed”- took over practices of private docs in their community” with certain referral expectations. One stark law violation, I have never heard of: recruiting a specialist from a distant location and paying a very high salary.

 

[CurbYourExpectations]

You would think, but it depends

United States Resolves $237 Million False Claims Act Judgment against South Carolina Hospital that Made Illegal Payments to Referring Physicians

This is archived content from the U.S. Department of Justice website. The information here may be outdated and links may no longer function. Please contact [email protected] if you have any questions about the archive site.

www.justice.gov

That is interesting. "Secret sweethearts deals" are a whole new concept to me. I have heard that some places do not let physicians refer out, or strongly discourage it, so is that a secret sweetheart deal?

 

[TheWallnerus]

Sounds like a quid pro quo arrangement. Hospital “employed”- took over practices of private docs in their community” with certain referral expectations.

Tuomey had been around for years in that part of SC and was arguably integral to the community. A few nice contracts with a few physicians put them on the hook for a quarter billion dollars, got the hospital sold and under new management (I’m sure all the other docs were thrilled about that), majorly disrupted healthcare for the region, and ruined the CEO’s career. “We are from the federal government and we are here to help”… and to completely ruin physicians’ lives whenever we would like, and nuke your hospital from space, etc

 

[Gfunk6]

WYOMING

So is "potential income" the new recruiting buzzword? I saw a job ad posted in my local Subway for a sandwich artist advertising up to $1,000,000 in potential compensation!*

*Includes income from robbing banks and other high-value financial instiutions. Does not take into account bail or loss of income due to imprisonment.

 

[DrProtonX]

WYOMING
View attachment 390982

So is "potential income" the new recruiting buzzword? I saw a job ad posted in my local Subway for a sandwich artist advertising up to $1,000,000 in potential compensation!*

*Includes income from robbing banks and other high-value financial instiutions. Does not take into account bail or loss of income due to imprisonment.

Compare that to the Iowa hem-onc job post my friend who’s applying hem-onc this year sent me…
$800k “potential” vs. $760k guaranteed!

 

[RickyScott]

Compare that to the Iowa hem-onc job post my friend who’s applying hem-onc this year sent me…
$800k “potential” vs. $760k guaranteed!

Someone mentioned that Wyoming had 2 docs and 30pts. There is no potential for 800k

 

[TheWallnerus]

 

[RickyScott]

View attachment 390995

Wow

 

[OTN]

Someone mentioned that Wyoming had 2 docs and 30pts. There is no potential for 800k

Two doctors for 30 patients. Is radonc the only field where a clinic will intentionally hire two doctors when one would suffice? Has anyone seen this anywhere else within the house of medicine?

 

[TheWallnerus]

Two doctors for 30 patients. Is radonc the only field where a clinic will intentionally hire two doctors when one would suffice? Has anyone seen this anywhere else within the house of medicine?

I kind of suspect it's always been predicated on the back of supervision and any high-level admin or CEO ever having to waste one neuron about worrying about compliance. If there's two docs, they can always... with no guilt... "force" a doctor to be there.