Jobs with both academic and satellite appointments

[Barcelona PSG]

Has anyone has experience in working with an academic job appointment at a university hospital system and also covering satellite two days a week in terms of how busy it gets, salary and managing workload at both the places?

---

Members don't see this ad.

 

[drowsy12]

Wait until 2040 and this will be every job - multi site hospital employed, whether ‘academic’ or ‘community’ won’t matter, you work for a company

 

[MidwestRadOnc]

Has anyone has experience in working with an academic job appointment at a university hospital system and also covering satellite two days a week in terms of how busy it gets, salary and managing workload at both the places?

This is one of the worst kinds of jobs in our specialty.
It actually has an official name (there was a vote at an ASTRO meeting a few years back with overwhelming majority opinion): Chairman's b*tch
These jobs universally have very high turnover. You will be driving all over the place providing suboptimal care to patients you're not seeing every day producing a ton of RVUs that, well, are going somewhere and it's not to you!

As noted above, you are generally better off working for the smallest size organization possible. The larger the organization, the more likely there will be strict rules on what you can do and how you are paid. You do an ever-increasing amount for a flat rate.

 

[RadOncMegatron]

This is one of the worst kinds of jobs in our specialty.
It actually has an official name (there was a vote at an ASTRO meeting a few years back with overwhelming majority opinion): Chairman's b*tch
These jobs universally have very high turnover. You will be driving all over the place providing suboptimal care to patients you're not seeing every day producing a ton of RVUs that, well, are going somewhere and it's not to you!

As noted above, you are generally better off working for the smallest size organization possible. The larger the organization, the more likely there will be strict rules on what you can do and how you are paid. You do an ever-increasing amount for a flat rate.

On point. This kind of arrangement reeks of "we hired you just for to earn money" and takes wind of the "I'm here to help patients in their time of need and cure their cancer" sails. I'm not blaming any of us who have to take these jobs, as I know folks who try their best and are great docs in these unfortunate situations, but those in charge and those who make these jobs have to know this is truly scummy and a spit in the face of our noble profession.

 

[RickyScott]

most “academic” jobs are like this. Sometimes the main center is so malignant, it is good to get away for a few days a week.

 

[elementaryschooleconomics]

Just to pile on, in my experience, this is indeed a relatively common arrangement.

Anecdotally, I think the likelihood of getting a "pure", single-site job as a new grad/early career doc decreases as reputational prestige increases.

At places that enjoy huffing their own smug, main campus jobs are bestowed upon senior faculty, usually the kind that at least one pharmaceutical company has referred to as "KOL". Usually the kind that sees only one disease site, has universal resident coverage, and never has more than 5-10 on beam.

 

[RickyScott]

Just to pile on, in my experience, this is indeed a relatively common arrangement.

Anecdotally, I think the likelihood of getting a "pure", single-site job as a new grad/early career doc decreases as reputational prestige increases.

At places that enjoy huffing their own smug, main campus jobs are bestowed upon senior faculty, usually the kind that at least one pharmaceutical company has referred to as "KOL". Usually the kind that sees only one disease site, has universal resident coverage, and never has more than 5-10 on beam.

Come to think of it “kol” in xrt are loosing their clout/prominence.

 

[radoncftw]

Just to pile on, in my experience, this is indeed a relatively common arrangement.

Anecdotally, I think the likelihood of getting a "pure", single-site job as a new grad/early career doc decreases as reputational prestige increases.

At places that enjoy huffing their own smug, main campus jobs are bestowed upon senior faculty, usually the kind that at least one pharmaceutical company has referred to as "KOL". Usually the kind that sees only one disease site, has universal resident coverage, and never has more than 5-10 on beam.

i honestly don't know what i would do if i had a job like this. that is like a 0.2 FTE

 

[metallica81788]

i honestly don't know what i would do if i had a job like this. that is like a 0.2 FTE

You'd go to lots of meetings and not much else

 

[A_DeMichele]

very common job… main center can have long linac hours and a lot of inpatient consults… so driving 30-40 miles out to cover a satellite is not bad

 

[deleted1111261]

Has anyone has experience in working with an academic job appointment at a university hospital system and also covering satellite two days a week in terms of how busy it gets, salary and managing workload at both the places?

I would enjoy this arrangement if the pay was comparable to community practice. But, it won’t be, usually.

 

[yesmaster]

Come to think of it “kol” in xrt are loosing their clout/prominence.

One of my favorite things when talking to a so-called bigwig is to be clueless as to who they are. 99% of the time, I am clueless and it's funny watching the ones with big egos squirm.

 

[elementaryschooleconomics]

One of my favorite things when talking to a so-called bigwig is to be clueless as to who they are. 99% of the time, I am clueless and it's funny watching the ones with big egos squirm.

Even if we can't agree on the exact number, we can say for certain RadOnc is tiny compared to the rest of Medicine.

Rounding way, WAY up on the highest estimate, there can't be more than 6,000 American RadOncs (my current, personal estimate - more data driven than the Workforce Taskforce - is 5,300).

My current best guess for the "academic RadOncs at programs with residents" is ~1,200 (based on 2016-era work from Emma Holiday).

The majority of the echo chamber publishing we see in the ASTRO-associated journals comes from those 1,200. Just like any specialty, there's a smaller subset of those folks who have a significantly higher output in terms of volume/velocity.

But...Los Angeles High School alone has around 2,000 kids. There are more high school students at that one school in that one city than there are all academic faculty at residency-associated departments in all of America.

Put another way:

Being a "RadOnc KOL" is like being a popular high school kid. Sure, a certain group of people will "know who you are" and you build an entire identity around that.

...however, it's healthy to remember (for all of us) that most people have no idea who we are.

I find it freeing!

 

[Doctorer]

I mean this is true for any specialty in medicine. I have zero clue who the most "famous" ENT or urologist is.

 

[RickyScott]

Even if we can't agree on the exact number, we can say for certain RadOnc is tiny compared to the rest of Medicine.

Rounding way, WAY up on the highest estimate, there can't be more than 6,000 American RadOncs (my current, personal estimate - more data driven than the Workforce Taskforce - is 5,300).

My current best guess for the "academic RadOncs at programs with residents" is ~1,200 (based on 2016-era work from Emma Holiday).

The majority of the echo chamber publishing we see in the ASTRO-associated journals comes from those 1,200. Just like any specialty, there's a smaller subset of those folks who have a significantly higher output in terms of volume/velocity.

But...Los Angeles High School alone has around 2,000 kids. There are more high school students at that one school in that one city than there are all academic faculty at residency-associated departments in all of America.

Put another way:

Being a "RadOnc KOL" is like being a popular high school kid. Sure, a certain group of people will "know who you are" and you build an entire identity around that.

...however, it's healthy to remember (for all of us) that most people have no idea who we are.

I find it freeing!

More broadly, with the democratization of info on internet and forums etc, Kols are loosing their impact in this field. Ex: Who is a kol today in breast- and would you care much abt their opinion? Even astro classes are often now given by junior faculty. In most sites, kols are same who they were 20 years ago. (Very rare that a new one emerges like Dan spratt)

 

[deleted1111261]

More broadly, with the democratization of info on internet and forums etc, Kols are loosing their impact in this field. Ex: Who is a kol today in breast- and would you care much abt their opinion? Even astro classes are often now given by junior faculty. In most sites, kols are same who they were 20 years ago. (Very rare that a new one emerges like Dan spratt)

Haha!

TheMedNet says people ask for me by name for some questions. If people want an opinion from the radonc version of Matt Foley, the people will get what they want.

 

[yesmaster]

We also don’t have a whole lot of {new} vendor drugs/products to promote, for better or worse, so KOL’s have less to do in rad onc.

 

[ramsesthenice]

To the OP, I have a few thoughts and questions that would come to my mind.

Would you be the only (or one of the only) faculty doing this much satellite coverage or would most of your colleagues be doing it as well? It’s much easier to feel valued in the latter.

What does success look like in this role? You won’t be able to any meaningful scholarly work in this set up. Best you can hope for us to accrue to cooperative group trials. This may not matter to you at all but if it’s expected for promotion or retention…what’s the point?

Do they plan for this to be a long term set up or do they have a lot of unfilled needs at the moment that they plan to eventually fill?

these can be decent jobs in the right situation for the right person. They are typically more equitable at pseudo academic departments; ie clinical departments affiliated with a medical school which are probably closer to private practices and at least admit generating clinical revenue is the primary mission. I think it’s a lot harder to feel valued doing this at a true academic center where you are one of the only people doing this. Heck, by having this set up permanently they have already shown they are not willing to shell out the money to adequately staff their sites. Not exactly a commitment to excellence ☹️

 

[evilbooyaa]

Not an uncommon set-up for sure, especially for new academic positions, in the era of academic institutions continually expanding and buying out not only private practices, but entire hospitals (or hospital networks), combined with the lack of interest in applicants to work full-time at some place in the boonies 1 hour+ from nearest real city.

Would ensure that your promotion pathway is not dependent on 'traditional academic' metrics if you sign up for this. Some academic institutions have a 'Clinical Radiation Oncologist' or 'Clinical Practice Radiation Oncologist' track to properly facilitate this, while others will abuse you by expecting you to be as academically productive as the 80/20 research scientists and give themselves an out to never promote you.

Some satellites are 'sleepy' where it will hurt your RVUs but have potential downtime, while others are 'busy' where you'll get your RVUs and put yourself in position for RVU bonuses (but still paid less than traditional community hospital employed models or true PP) but won't have time to pursue academic interests.

Will you be in clinic 5 days a week in this model, or would you still have a protected academic/administrative day?

 

[Oldmen]

Just to pile on, in my experience, this is indeed a relatively common arrangement.

Anecdotally, I think the likelihood of getting a "pure", single-site job as a new grad/early career doc decreases as reputational prestige increases.

At places that enjoy huffing their own smug, main campus jobs are bestowed upon senior faculty, usually the kind that at least one pharmaceutical company has referred to as "KOL". Usually the kind that sees only one disease site, has universal resident coverage, and never has more than 5-10 on beam.

Please pardon my ignorance. What is KOL?

 

[elementaryschooleconomics]

Please pardon my ignorance. What is KOL?

Key Opinion Leader

Ignorance of this acronym, I would argue, is actually a good thing...

 

[RickyScott]

Key Opinion Leader

Ignorance of this acronym, I would argue, is actually a good thing...

Their presence in radonc has really diminished over past 15 years