Fair compensation

[UndecidedMS2]

So i’ve seen the $250-300k offers for big academic places in big cities, i’ve also seen $500-600k pp offers in middle of nowhere. Both have pros and cons. But my question is, what do you guys think the fair compensation should be for new grads in terms of base salary, expected RVUs etc.? Or in other terms, what would indicate a strong, healthy job market in your opinion?

---

Members don't see this ad.

 

[Neuronix]

This needs to be in private forum. We have a decent amount of data there already to answer your questions. Please PM me to verify your status as resident or attending.

 

[MidwestRadOnc]

Medical services are broken down into two payments, the technical component (the facility/hospital’s fee) and the professional component (the doctor’s fee). So unless you have an ownership stake, fair compensation is the PC for every service you provide minus a reasonable overhead for your benefits. The trick is calculating what this should be in an RVU based system. In general around $60-70/wRVU. Understanding the volume and payor mix is critical in evaluating an offer.

Of course, in reality, if it’s an employed job and there is a lot of competition the employer will be able to offer significantly less than the value of the PC due to supply and demand. This is basically every job in a HCOL area. So it would not be reasonable to expect $70/wRVU in these areas, even though it’s not “fair.”

 

[elementaryschooleconomics]

Or in other terms, what would indicate a strong, healthy job market in your opinion?

I dunno, whatever the opposite of RadOnc in 2024 is?

 

[yesmaster]

Or in other terms, what would indicate a strong, healthy job market in your opinion?

Loading…

x.com

If the chairmen say the rad onc job market is strong, you betcha it’s strong

 

[Mandelin Rain]

Or in other terms, what would indicate a strong, healthy job market in your opinion?

Jobs soliciting/courting residents rather than vice versa.

 

[medgator]

Jobs soliciting/courting residents rather than vice versa.

Has it ever happened in rad onc? I'm guessing it's happened as often as society has been under supplied with rad onc

 

[elementaryschooleconomics]

Loading…

x.com

If the chairmen say the rad onc job market is strong, you betcha it’s strong

Whenever I see a Chair or someone from ASTRO with an ENTIRE SLIDE about how "great" the job market is:

 

[Ray D. Ayshun]

Whenever I see a Chair or someone from ASTRO with an ENTIRE SLIDE about how "great" the job market is:

View attachment 383184

Bit from Ricky Gervais' new special

And now that I’m woke, the first thing I’ve gotta do is change my Twitter bio. ‘Cause at the moment, it’s, like, a list of the shows I’ve created. But now I’m woke, I’ve gotta pop in the word “anti-fascist”…

[audience laughing]

…so people know I’m not a fascist, ’cause that is a big problem at the moment.

Um… People come up to you and go, “Rick, have you been imprisoning journalists?”

I go, “No.”

They go, “Oh, interesting.”

[audience laughing]

They go, “Have you been gassing Jews?”

I go, “No.”

They go, “Pop it in your bio then, you silly *unt.”

 

[StIGMA]

Of course "good" and "great" in academics means below average. Above average is outstanding, exceptional, excellent etc. Not that a med student would know

 

[MidwestRadOnc]

Of course "good" and "great" in academics means below average. Above average is outstanding, exceptional, excellent etc. Not that a med student would know

The problem is if you are a fake academic, i.e., 100% clinical. This is a raw deal if you are expected to supplement the income of those who produce half the RVUs you do so that everyone makes approximately the same. Otherwise, why are you in an academic setting if you are not spending any meaningful time on academic endeavors but giving up the fruits your labor to those who do spend time on non-revenue generating activities? I understand wanting to go into academics because you actually want to investigate and publish. But why be there and be 100% clinical? You could work for HCA and write the local university a check out of the goodness of your heart if academic charity is your thing. It's the same thing in the end.

 

[drowsy12]

The problem is if you are a fake academic, i.e., 100% clinical. This is a raw deal if you are expected to supplement the income of those who produce half the RVUs you do so that everyone makes approximately the same. Otherwise, why are you in an academic setting if you are not spending any meaningful time on academic endeavors but giving up the fruits your labor to those who do spend time on non-revenue generating activities? I understand wanting to go into academics because you actually want to investigate and publish. But why be there and be 100% clinical? You could work for HCA and write the local university a check out of the goodness of your heart if academic charity is your thing. It's the same thing in the end.

I have friends in this setting, many of them decently happy. For them it comes down to:

1) location
2) they enjoy focusing on 1-2 disease sites
3) enjoy working with residents and having other support staff
4) even if they’re pretty clinical, having access to trials to offer
5) tech and other ancillary benefits of academic centers

None of them are getting paid like **** either. Which helps

 

[ramsesthenice]

Why do we still say academics and private? Isn’t employed vs partnership the more relevant consideration? I’d say the pay gap between academics and most community folks employed by a “private” firm is inconsistent at best.

 

[drowsy12]

Why do we still say academics and private? Isn’t employed vs partnership the more relevant consideration? I’d say the pay gap between academics and most community folks employed by a “private” firm is inconsistent at best.

Agree

 

[ramsesthenice]

I have friends in this setting, many of them decently happy. For them it comes down to:

1) location
2) they enjoy focusing on 1-2 disease sites
3) enjoy working with residents and having other support staff
4) even if they’re pretty clinical, having access to trials to offer
5) tech and other ancillary benefits of academic centers

None of them are getting paid like **** either. Which helps

Agree with all of it. The other thing I would add is that this model is pretty much all most of the recent and current generations know. Unless they have outside experience (ie, friends, mentors, or good ole nepotism), everyone trains in an employed academic setting. There will always be a certain degree of safety with what’s familiar. Unless of course, they train in a grossly abusive environment and decide they want literally anything else ☹️

 

[Haybrant]

If you’re seeing 6-8 consults a week with 15-20 on treat what’s the potential yearly RVUs that you may be generating? Just a ballpark.

Trying to eval a hospital based job offer right now in major metro area northeast. Any advice on how to find those numbers would be helpful, not really sure if the offer is reasonable In the current climate. It’s hcol location

 

[Neuronix]

If you’re seeing 6-8 consults a week with 15-20 on treat what’s the potential yearly RVUs that you may be generating? Just a ballpark.

Trying to eval a hospital based job offer right now in major metro area northeast. Any advice on how to find those numbers would be helpful, not really sure if the offer is reasonable In the current climate. It’s hcol location

Let's get you setup for private forum also

 

[MidwestRadOnc]

If you’re seeing 6-8 consults a week with 15-20 on treat what’s the potential yearly RVUs that you may be generating? Just a ballpark.

Trying to eval a hospital based job offer right now in major metro area northeast. Any advice on how to find those numbers would be helpful, not really sure if the offer is reasonable In the current climate. It’s hcol location

Ballpark:

7 consults/week x 52 weeks *(46/52 assuming 6 weeks vacation incl holidays) = 322 consults/year x 0.9 (typical conversion rate) = 290 new starts per year x 44 wRVU/new start (my data from typical community practice with SBRT/SRS and HDR, caveat low prostate volume) = 12,760 wRVU

This is the size of my current practice. Check with me in a year and I can give you better data!

 

[sloh]

Medical services are broken down into two payments, the technical component (the facility/hospital’s fee) and the professional component (the doctor’s fee). So unless you have an ownership stake, fair compensation is the PC for every service you provide minus a reasonable overhead for your benefits. The trick is calculating what this should be in an RVU based system. In general around $60-70/wRVU. Understanding the volume and payor mix is critical in evaluating an offer.

Of course, in reality, if it’s an employed job and there is a lot of competition the employer will be able to offer significantly less than the value of the PC due to supply and demand. This is basically every job in a HCOL area. So it would not be reasonable to expect $70/wRVU in these areas, even though it’s not “fair.”

Or in other words most employers first determine “fair compensation,” THEN back calculate $/wRVU

 

[evilbooyaa]

The problem is if you are a fake academic, i.e., 100% clinical. This is a raw deal if you are expected to supplement the income of those who produce half the RVUs you do so that everyone makes approximately the same. Otherwise, why are you in an academic setting if you are not spending any meaningful time on academic endeavors but giving up the fruits your labor to those who do spend time on non-revenue generating activities? I understand wanting to go into academics because you actually want to investigate and publish. But why be there and be 100% clinical? You could work for HCA and write the local university a check out of the goodness of your heart if academic charity is your thing. It's the same thing in the end.

There is much more to being an attending in academics that does not have to involve being a hard core researcher. Giving talks and working with and teaching residents may not be your interests, but are the interests of a significant proportion of those in academics.

 

[NotMattSpraker]

There is much more to being an attending in academics that does not have to involve being a hard core researcher. Giving talks and working with and teaching residents may not be your interests, but are the interests of a significant proportion of those in academics.

Very true. "Academics" is a useless term. We need to stop using it, I think it's actually harmful at this point.

 

[medgator]

Very true. "Academics" is a useless term. We need to stop using it, I think it's actually harmful at this point.

What do you call the cadre of interests at Astro? Not sure what else to call them

 

[yesmaster]

Academics is a misleading term because that would imply that academic rad onc:

- conducts life saving research (nope)
- trains the next generation (unnecessary at best, labor market price-fixing at worst)
- provides differentiated quaternary care (BgRT, protons, expensive & unproven toys)

We would like to maintain the illusion of academics to justify those sweet, inflated Medicare and private insurance payments cheddar across our main campus and sprawling satellites and network

What do you call the cadre of interests at Astro? Not sure what else to call them

ASTRO cartel? I’m fond of the big rad onc and little rad onc lingo too.

 

[medgator]

ASTRO cartel? I’m fond of the big rad onc and little rad onc lingo too.

They are overwhelmingly located at PPS -exempt places and/or places with an "academic" affiliation.

I get the big vs little label, I just don't see any community or pp interests being represented by Astro or it's leadership.

I guess all of ASTRO is academic but maybe not all of academics is ASTRO?

 

[evilbooyaa]

They are overwhelmingly located at PPS -exempt places and/or places with an "academic" affiliation.

I get the big vs little label, I just don't see any community or pp interests being represented by Astro or it's leadership.

I guess all of ASTRO is academic but maybe not all of academics is ASTRO?

That is, mostly, true.

Although Paul Wallner and Connie Mantz definitely aren't Academics!

Just call it Big RO vs Little RO

 

[NotMattSpraker]

What do you call the cadre of interests at Astro? Not sure what else to call them

Ha, I have my own names for them but Ill keep that to myself.

I guess what I meant is people should just stop labeling jobs entirely, especially when they are seeking a job. Evaluate each job on it's own merits. You don't actually even need a university anymore for a lot of types of research, especially in Rad Onc.

We would like to maintain the illusion of academics to justify those sweet, inflated Medicare and private insurance payments cheddar across our main campus and sprawling satellites and network

I strongly agree, this is a large effect. My question would be whether anyone even cares about Rad Onc in this discussion, at the level of the institution and lobbying congress.

Rad Onc's do for sure. But Rad Onc's have a unique talent for thinking they are far more important than they are in the grand plans of cancer center expansion.