Job market musings …

[deleted1111261]

Just some thoughts…

Seems like there are a lot of jobs. Quality? I don’t know. But, lots of hospital jobs. A lot of jobs keep popping back up. Very, very few posted private practice jobs. Seem to be less true academic jobs (as a proportion of jobs). Astro website is weird, at least when I look at it isn’t in chronological order and if you don’t flip through the pages, seem to miss new jobs. My small “n” of residents I spoke to said it didn’t seem as bad this year as compared to their seniors the last few years. Locums appear to be paying about same as usual.

Seems like experienced people are generally staying put. Speaking to a small “n” that are looking to hire, it seems vast majority of applicants are fresh grade or people unhappy in their first job and just a few years out.

Hospital salaries seem to be stable. Relatively high floor, low ceiling. Seems like most people live around the median and a few outliers do very well. Makes sense based on @TheWallnerus data.

The big change is hardly anyone gets to be in a single specialty or even a multi specialty private / independent practice - what used to be the jewel of radiation oncology. Most of us are employed now. I get this is all of medicine now.

What do you all think ?

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[Gfunk6]

I think that people will see what they want to see, empirical evidence be damned. I would live frugally, save heavily, and invest wisely. Hope for the best but prepare for the worst.

 

[deleted941485]

Just some thoughts…

Seems like there are a lot of jobs. Quality? I don’t know. But, lots of hospital jobs. A lot of jobs keep popping back up. Very, very few posted private practice jobs. Seem to be less true academic jobs (as a proportion of jobs). Astro website is weird, at least when I look at it isn’t in chronological order and if you don’t flip through the pages, seem to miss new jobs. My small “n” of residents I spoke to said it didn’t seem as bad this year as compared to their seniors the last few years. Locums appear to be paying about same as usual.

Seems like experienced people are generally staying put. Speaking to a small “n” that are looking to hire, it seems vast majority of applicants are fresh grade or people unhappy in their first job and just a few years out.

Hospital salaries seem to be stable. Relatively high floor, low ceiling. Seems like most people live around the median and a few outliers do very well. Makes sense based on @TheWallnerus data.

The big change is hardly anyone gets to be in a single specialty or even a multi specialty private / independent practice - what used to be the jewel of radiation oncology. Most of us are employed now. I get this is all of medicine now.

What do you all think ?

I don’t even know how you stay in single specialty at this point. You can thank years of govt insurance cuts falling on free standing and hospitals awash with cash to buy out referring docs. At this point any private still around are simply outside the cachement areas of the big health systems. It’s the same old story. If you want to be anywhere that you could possibly raise children or have a life chances are your friendly hospital system will be writing your checks.

I know of no one who owns a machine anymore. The last guy I knew who had one was thrown out of the hospital and replaced.

Locums rates are compete dog ****. I’ve been getting emails from staffing cos asking for vacation coverage or in some cases long term assignments in rural areas where they pay you 1000-1500/day with 20-30 on treat and consults and status checks to see. You are getting paid less than the FTs even in areas of “need”.

I can’t even tell what the job situation is anymore since astro changed the classifieds section. Another move motivated by greed. But I don’t think it’s any better. If a sudden increase in jobs emerges I would expect them to be of pretty low quality.

 

[Mandelin Rain]

I don’t even know how you stay in single specialty at this point. You can thank years of govt insurance cuts falling on free standing and hospitals awash with cash to buy out referring docs. At this point any private still around are simply outside the cachement areas of the big health systems. It’s the same old story. If you want to be anywhere that you could possibly raise children or have a life chances are your friendly hospital system will be writing your checks.

I know of no one who owns a machine anymore. The last guy I knew who had one was thrown out of the hospital and replaced.

Locums rates are compete dog ****. I’ve been getting emails from staffing cos asking for vacation coverage or in some cases long term assignments in rural areas where they pay you 1000-1500/day with 20-30 on treat and consults and status checks to see. You are getting paid less than the FTs even in areas of “need”.

I can’t even tell what the job situation is anymore since astro changed the classifieds section. Another move motivated by greed. But I don’t think it’s any better. If a sudden increase in jobs emerges I would expect them to be of pretty low quality.

Helps if in a CON state and you were there first.

 

[TheWallnerus]

Just some thoughts…

Seems like there are a lot of jobs. Quality? I don’t know. But, lots of hospital jobs. A lot of jobs keep popping back up. Very, very few posted private practice jobs. Seem to be less true academic jobs (as a proportion of jobs). Astro website is weird, at least when I look at it isn’t in chronological order and if you don’t flip through the pages, seem to miss new jobs. My small “n” of residents I spoke to said it didn’t seem as bad this year as compared to their seniors the last few years. Locums appear to be paying about same as usual.

Seems like experienced people are generally staying put. Speaking to a small “n” that are looking to hire, it seems vast majority of applicants are fresh grade or people unhappy in their first job and just a few years out.

Hospital salaries seem to be stable. Relatively high floor, low ceiling. Seems like most people live around the median and a few outliers do very well. Makes sense based on @TheWallnerus data.

The big change is hardly anyone gets to be in a single specialty or even a multi specialty private / independent practice - what used to be the jewel of radiation oncology. Most of us are employed now. I get this is all of medicine now.

What do you all think ?

me watching the rad onc job market

 

[CurbYourExpectations]

me watching the rad onc job market

Underrated post

 

[elementaryschooleconomics]

Underrated post

Omg completely agree - I had another dissertation lined up but really this video trumps the most compelling argument. To caption:

It looks good this year, but I've seen better. I don't know why it looks good, but I suspect it's artificial and transient. Will we ever figure it out? Maybe, maybe not. Do I want to see it again? Yes. Would I trust it in a life-or-death situation? No. Should you be wary of people telling you it's real? Yes. Could it potentially be real? Sure, but I also think the multiverse could be real and we might be living in a simulation.

 

[deleted1111261]

Omg completely agree - I had another dissertation lined up but really this video trumps the most compelling argument. To caption:

It looks good this year, but I've seen better. I don't know why it looks good, but I suspect it's artificial and transient. Will we ever figure it out? Maybe, maybe not. Do I want to see it again? Yes. Would I trust it in a life-or-death situation? No. Should you be wary of people telling you it's real? Yes. Could it potentially be real? Sure, but I also think the multiverse could be real and we might be living in a simulation.

Yeah, I’m not talking about any trends. Just at this moment it seems … fine

 

[fiji128]

Hospital employed here. 2% raise in 2020 and 2021. Making more compared to 2019 but in real terms making about 6% less. Hospital was absolutely not into matching my salary with inflation.

 

[OTN]

Hospital employed here. 2% raise in 2020 and 2021. Making more compared to 2019 but in real terms making about 6% less. Hospital was absolutely not into matching my salary with inflation.

That sucks, but those of us in freestanding centers are dealing with the same. Medicare reimbursements and private payer rates did not change simply due to inflation, unfortunately.

It's one of our big problems in medicine: we cannot simply raise our prices to take increasing costs into account. We had all better hope this inflation doesn't extend too far into next year/get too troublesome, or else it will not be easy to be profitable at all in the future, no matter the clinical setting.

 

[Mandelin Rain]

I wish my real pay was "only" down 6% in 2 years. 2% raises in salary are way better than the slow trickle ~3% reimbursement cuts we seem to get from medicare every year.

 

[Mandelin Rain]

That sucks, but those of us in freestanding centers are dealing with the same. Medicare reimbursements and private payer rates did not change simply due to inflation, unfortunately.

It's one of our big problems in medicine: we cannot simply raise our prices to take increasing costs into account. We had all better hope this inflation doesn't extend too far into next year/get too troublesome, or else it will not be easy to be profitable at all in the future, no matter the clinical setting.

The smart kids go to dental school.

 

[medgator]

The smart kids go to dental school.

No residency requirement, could do a GPR year if you want, still a lot of FFS etc

 

[Irradi8or]

Just some thoughts…

Seems like there are a lot of jobs. Quality? I don’t know. But, lots of hospital jobs. A lot of jobs keep popping back up. Very, very few posted private practice jobs. Seem to be less true academic jobs (as a proportion of jobs). Astro website is weird, at least when I look at it isn’t in chronological order and if you don’t flip through the pages, seem to miss new jobs. My small “n” of residents I spoke to said it didn’t seem as bad this year as compared to their seniors the last few years. Locums appear to be paying about same as usual.

Seems like experienced people are generally staying put. Speaking to a small “n” that are looking to hire, it seems vast majority of applicants are fresh grade or people unhappy in their first job and just a few years out.

Hospital salaries seem to be stable. Relatively high floor, low ceiling. Seems like most people live around the median and a few outliers do very well. Makes sense based on @TheWallnerus data.

The big change is hardly anyone gets to be in a single specialty or even a multi specialty private / independent practice - what used to be the jewel of radiation oncology. Most of us are employed now. I get this is all of medicine now.

What do you all think ?

Out of curiosity - I have called/interviewed at a few of these hospital positions. Compared to my current pp job, the salaries and production incentives are very low - like working excessively hard to make median MGMA. Many people competing for these positions

 

[jondunn]

our group isnt planning on any hires for at least 3 years.

 

[medgator]

our group isnt planning on any hires for at least 3 years.

Even if you are, it probably won't need to be posted if it's a semi desirable to desirable area. Prob can fill word of mouth these days with an experienced BC grad

 

[Irradi8or]

That sucks, but those of us in freestanding centers are dealing with the same. Medicare reimbursements and private payer rates did not change simply due to inflation, unfortunately.

It's one of our big problems in medicine: we cannot simply raise our prices to take increasing costs into account. We had all better hope this inflation doesn't extend too far into next year/get too troublesome, or else it will not be easy to be profitable at all in the future, no matter the clinical setting.

Managed care overall has greatly reduced the value of physician owned practices

 

[medgator]

Managed care overall has greatly reduced the value of physician owned practices

Not to mention reimbursements from CMS over the last decade in general...

 

[dieABRdie]

Managed care overall has greatly reduced the value of physician owned practices

Unless they get purchased by the local academic system and they crank up the cost of their services 5 fold.....

 

[Irradi8or]

Unless they get purchased by the local academic system and they crank up the cost of their services 5 fold.....

“physician-owned” is the operative phrase! Once a hospital (esp academic center) scoops it up more than likely a physician doesn’t have ownership in that hospital and that practice is no longer physician owned, in fact there was a moratorium on physician ownership of hospitals despite data suggesting physician owned hospitals have better outcomes at lower overall costs

 

[dieABRdie]

in fact there was a "moratorium on physician ownership of hospitals"

Just curious.... do you by chance know where exactly this language can be found? I've been meaning to find it myself at some point. I ask because I hear people citing it all the time (maybe in the ACA?) but I've never seen the primary source.

I have no doubt physician owned practices are the most efficient and low cost. As long as they are ethical they also provide the highest quality. I have seen some bad boomers out there unfortunately.

 

[medgator]

Just curious.... do you by chance know where exactly this language can be found? I've been meaning to find it myself at some point. I ask because I hear people citing it all the time (maybe in the ACA?) but I've never seen the primary source.

I have no doubt physician owned practices are the most efficient and low cost. As long as they are ethical they also provide the highest quality. I have seen some bad boomers out there unfortunately.

Someone is doing it. I'm guessing it's hard to get jcaho/CMS on board though

Physician-owned specialty hospital opens outpatient center in Texas — 5 details

San Antonio-based South Texas Spine & Surgical Hospital opened its new outpatient surgery center in August.

www.beckersasc.com

 

[Irradi8or]

Just curious.... do you by chance know where exactly this language can be found? I've been meaning to find it myself at some point. I ask because I hear people citing it all the time (maybe in the ACA?) but I've never seen the primary source.

I have no doubt physician owned practices are the most efficient and low cost. As long as they are ethical they also provide the highest quality. I have seen some bad boomers out there unfortunately.

Yes ACA has some language

Physician-Owned Hospitals | CMS

Section 1877(d) of the Social Security Act (the Act) sets forth exceptions to the physician self-referral law’s referral and billing prohibitions that are related to ownership or investment interests held by a physician (or an immediate family member of a physician) in an entity that furnishes...

www.cms.gov

 

[Irradi8or]

Someone is doing it. I'm guessing it's hard to get jcaho/CMS on board though

Physician-owned specialty hospital opens outpatient center in Texas — 5 details

San Antonio-based South Texas Spine & Surgical Hospital opened its new outpatient surgery center in August.

www.beckersasc.com

There are some nuances - if physicians already had ownership previously, can’t expand that proportion of ownership, and several other points

Physician-Owned Hospitals | CMS

Section 1877(d) of the Social Security Act (the Act) sets forth exceptions to the physician self-referral law’s referral and billing prohibitions that are related to ownership or investment interests held by a physician (or an immediate family member of a physician) in an entity that furnishes...

www.cms.gov

 

[dieABRdie]

Yes ACA has some language

Physician-Owned Hospitals | CMS

Section 1877(d) of the Social Security Act (the Act) sets forth exceptions to the physician self-referral law’s referral and billing prohibitions that are related to ownership or investment interests held by a physician (or an immediate family member of a physician) in an entity that furnishes...

www.cms.gov

Great. Thank you.