With the ultra hcol. Double whammy
Can someone explain why someone would be paid to babysit when babysitting is no longer required. Paying someone to keep up appearances?
Yep. Technically if freestanding and you need to be "immediately available" via app, how can you be available when you are vacationing in Bora bora or skiing in the Alps or something?
The free market in SoCal different than the free market in Iowa or Wisconsin
Immediately available via app? Like remotely offsite? (WhatsApp?) Then why would someone need to physically babysit. If saying that someone can’t do this from an international location is impossible, I don’t know. Technically any time away from the clinic is “vacation.”
The “ski lift” aspect is a distractor though right. If you’re not in the clinic, you’re doing non clinical, non rad onc things… unless you are perched in some rad onc authorized hermetically sealed remote supervision isocube.
You’re not going to be taking vacations in bora bora or the alps after socal COL at $116/hr. Vegas at the Luxor, maybe.
Wow, locum therapists may make more than that in my neck of the woods.
Cali is terrible for physicians and professionals in general. Col is very high and reimbursement is low. There also seems to be a large supply of young physicians who want to work in the area, while the supply of non physician ancillary staff (therapists, techs, etc) is low. This has led to a severely f'd up market where ancillary staff salaries are very high while doctor wages are some of the lowest in the country. Some physicists are definitelt being offered physician type salaries, and I've heard dental hygienists are starting to command close to what a salaried dentist makes.
Sounds like elementary school economics.
Love the pun. And yes, the his is about as elementary as it gets. Employers will always offer the lowest possible wage the market is willing to accept. I’m saying this a totally non judgmental way, but the younger generating in my experience seems to place more of an emphasis on other factors like location and hours than reimbursement. Combined with coming up where some of these rates are just normal to them, it’s not ever getting better.
Rates are up post covid vs pre and so is demand IMO.
This is probably true, but the other factor to consider is that even if you wanted to work more, the work isn't there. If you want to be independent and cover 3 or 4 different clinics and have 70+ patients on treatment and work through the nights and weekends getting caught up, well there's just not enough work to go around and plenty of people comphealth can find to fill in instead. I knew guys who were doing this 20 years ago, driving through the night all over the place to cover places with rural exceptions and making nearly a typical annual starting salary now in a month. Yeah it's unusual, but at least it was possible. Just scrounging up 40 hours of work a week is hard now. I'm at a point in my life for various reasons and poor investment choices where I would absolutely bust my tail and pull 20k wRVU per year if I could. I'm just trying to get half that right now. Too many rad oncs, not enough treatments needed.
So many factors and they all go hand in hand. Academics gobbled up clinics and consolidation moved us to employed jobs with the limited scope you describe. It took willing participants to get there. It would take a lot of extremely motivated individuals to even try to change it. The point I was making is I think a growing contingency is actually fine with the overall model. It’s here to stay.
There are certain area codes that I auto-ignore at this point. 801 is the biggest offender (comp health). 754 and 678 runners up. God forbid anybody in Utah actually needs me for something legitimate.
Amen. Also another way of saying “there are some of us who want to make more than 400 a year.”
I guess I should clarify that I don't understand it from a high level executive standpoint in terms of incentivizing production vs. having a cattle call to hire unmotivated low paid salaried staff who are more interested in punching a clock for steady pay and benefits.
Esp if some hard to recruit places are paying you closer to 30 than 15 on your census
HERE I AM!
Also the numbers thing is way more meaningless now. If you do all at 1.8-2 you have more patients on beam. Hypofractionation and more SBRT has changed many things. I know people who carrry 15 and work pretty hard, constant sims and consults and shorter courses. So people are working harder and making less. SAD
Payment structure obviously matters. Hospital employed and salaried with limited incentive bonus = enough patients to keep you busy and stimulated but not bleed into your nights and weekends. I personally have zero issues with the "standard" job being something in the $400K range if it is set up fairly. IE, the pay is commiserate with the workload. Where I take issue are the places that want to pay you $400K to do north of $1M effort. Or worse...take over your practice, consume your revenue, and offer you half of what you were making to do the same amount of work.
