having a cattle call to hire unmotivated low paid salaried staff who are more interested in punching a clock for steady pay and benefits.
Regarding our present job market? Thank goodness that we have administrators not so focused on productivity.
While academic medicine is certainly not predicated on efficiency, a culture where everyone feels overworked is easy to come by in private practice (not as common for radonc as all the other docs). Volume has a cost as well. We complain about our medonc colleagues not addressing fundamental issues of a cancer diagnosis with their patients, but so much of this has to do with their daily schedule (maybe some cultural stuff as well).
Docs who aren't "too" busy tend to be more willing to be involved with committees, community outreach, quality improvement initiatives, etc. While the value of any one of these things is easy to question, collectively they make up a positive and progressive culture.
I have seen first hand the downside of chasing RVUs or collections in terms of clinical decision making and care. (in all specialties)
In my own place of work, I have tried to emphasize a generous base salary with minimum productivity, which is easily achievable, and some production bonus when necessarily very busy as opposed to an RVU heavy model. The docs were doing lots of low value/high RVU stuff under a prior RVU heavy model and it created a pretty toxic environment. Not everything you do as a doc needs to get billed.
Regarding my own practice with a PSA? All docs are partners after 3 years (we have basically no assets) and all are paid the same per day once they are granted partnership. We don't look too close at clinical volume, but if a big disparity emerges, it gets addressed. I like to work more and make more than my colleagues, so I am a limiting factor for hiring.
I like the younger generation. I have a hard time recruiting them (outside of radonc of course) because they typically want to live in big, diverse metros, but they generally seem reasonable regarding contract negotiations and expectations. QOL is important to them, and they are not wrong.
I have had a much harder time with docs close to 70 (I'm in a location where professionals retire) who believe that they are significantly more valuable than the docs already here and in their prime (40-50 y/o). Many are still trying to maximize every bit of compensation while already financially independent. Maybe it's a boomer thing. I have no intention of working at 70, and am very aware that I will if anything be less valuable than most of my junior colleagues in terms of clinical care once I hit my mid 60s (if not earlier).
The work hard/make bank and take on massive personal responsibility model of true PP? That's disappearing with consolidation, but be ware the entrenched seniors in these practices. They just think you have no balls.
