Kaiser Rad Onc Jobs

[Particler]

Does anyone have experience with Kaiser Rad Onc jobs?

What is it like in terms of compensation, W/L balance, workload, job satisfaction, etc?

How would it compare to a similar hospital-employed position?

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[medgator]

Have heard it is most similar to va gigs, maybe not as much of a lobotomy required

 

[Particler]

Have heard it is most similar to va gigs, maybe not as much of a lobotomy required

In terms of low clinical volume + lower pay + mostly bread/butter?

 

[medgator]

In terms of low clinical volume + lower pay + mostly bread/butter?

Decent benefits, slower pace than pp/no pressure to produce since salaried

 

[RadRadRad]

Years ago I looked in to them
Things could have changed
Docs seemed very happy. Good work life balance if that’s important to you. They were working 3-4 days per week . Pay obviously not like true pp.

 

[RadRadRad]

I would add that the docs actually seemed like good doctors who just were choosing a path with less hours worked. Did not seem like frequent fliers or malcontents who got “stuck” in that job bc couldn’t go elsewhere

 

[seper]

No recent personal contacts, but these are competitive jobs

 

[RadOncDoc21]

No recent personal contacts, but these are competitive jobs

Competitive also because of mostly being in desirable locations (west coast, Atlanta, DC, etc).

Edit: Forgot Hawaii

 

[Fpg1245]

Competitive also because of mostly being in desirable locations (west coast, Atlanta, DC, etc).

And they are really the only show in town in a lot of locales. These jobs were not competitive even 15 years ago.

 

[RickyScott]

I

And they are really the only show in town in a lot of locales. These jobs were not competitive even 15 years ago.

norcal was competitive in the past, but with California becoming unlivable, I am not sure if that is still the case.

 

[dogjam]

I knew a Kaiser locale in CA where the docs seemed to work pretty hard (5 days/week) for non-optimal pay, but they were happy and were doing it for the pension/retirement. They were definitely straight-up employees who I believe were expected to follow the Kaiser way of doing things in terms of dose/fractionation. They even logged their weekly hours.

 

[medgator]

I

norcal was competitive in the past, but with California becoming unlivable, I am not sure if that is still the case.

Yep. Essentially upper middle class with decent home ownership out of reach if you are an RO in the bay area imo

How Long Will the Exodus from California Cities Last?

A new report found that 60 percent of moves in California during the first year of the pandemic were families leaving the state. San Jose, San Francisco and Los Angeles all saw population decreases in the last two years.

www.governing.com

 

[RickyScott]

If you are part of Kaiser, you are actually “doing good” from a utilitarian perspective vs price gouging society on behalf of a large academic system. At the end of the day America would be better off if mdacc’s radonc department no longer existed; not so with Kaiser.
When society is charged 10-20x what something is worth, we are all worse off.

 

[sirspamalot]

Rickybobby come on bro!

#750orGTFO lol.

The cost of care ain't the doctor pay folks.

 

[RickyScott]

Rickybobby come on bro!

#750orGTFO lol.

The cost of care ain't the doctor pay folks.

View attachment 363119

Yes, doctors salaries don’t contribute much to health care costs. I don’t in anyway mean to imply that when large academic institutions price gouge, they share it with the docs.

 

[medgator]

Yes, doctors salaries don’t contribute much to health care costs. I don’t in anyway mean to imply that when large academic institutions price gouge, they share it with the docs.

Probably not as much as they enrich their institutions and executives

 

[RadRadRad]

I knew a Kaiser locale in CA where the docs seemed to work pretty hard (5 days/week) for non-optimal pay, but they were happy and were doing it for the pension/retirement. They were definitely straight-up employees who I believe were expected to follow the Kaiser way of doing things in terms of dose/fractionation. They even logged their weekly hours.

Logging hours weekly would be a red flag for me and probably enough of a turn off to say “no thanks”

 

[RadOncDoc21]

Logging hours weekly would be a red flag for me and probably enough of a turn off to say “no thanks”

The “logging hours” is done at all employed institutions whether it’s being done by you or someone else. Vice versa, had a private doc in my first job tell me I needed to have my butt in a chair 10 hrs a day without a timesheet.

The question isn’t if your hours are being logged but if someone is controlling what you do with those hours.

At most places it was just a formality for someone from HR to remember to pay me.

 

[RickyScott]

Logging hours weekly would be a red flag for me and probably enough of a turn off to say “no thanks”

From what I understand, it is to your advantage in that you get paid overtime/more time off after set number of hours

 

[sirspamalot]

Logging hours weekly would be a red flag for me and probably enough of a turn off to say “no thanks”

Do you make mcnuggets? No? Then yaint an hourly worker.

I said that to a CEO last month or so. Just say no to the nonsense.

 

[RadRadRad]

Until pay (not for me but in general) is based on something other than work done, hours is not a useful metric of my worth

 

[sirspamalot]

Agreee.

Inevitable: "What about wRVUs? Your wRVUs are.."

Anyone looked into the actual table of your wRVUs? They're 'worth' up to 25% less than a real RVU. Why? The value of your RVU's are reduced because 'overhead' (for which a hospital already gets yet another bump, a facility fee) thus its.. nonsense. #85wRVUorGTFO

What you earn as global pro fee billings.. is doubled that in profit for most centers if not more depending on volume. If you're taking less, I hope you're getting something else truly valuable.

 

[RadOncDoc21]

Agreee.

Inevitable: "What about wRVUs? Your wRVUs are.."

Anyone looked into the actual table of your wRVUs? They're 'worth' up to 25% less than a real RVU. Why? The value of your RVU's are reduced because 'overhead' (for which a hospital already gets yet another bump, a facility fee) thus its.. nonsense. #85wRVUorGTFO

What you earn as global pro fee billings.. is doubled that in profit for most centers if not more depending on volume. If you're taking less, I hope you're getting something else truly valuable.

The most valuable asset is time in my opinion. We earn money in most cases to either buy time now for convenience or in the future (for retirement).

 

[seper]

The “logging hours” is done at all employed institutions whether it’s being done by you or someone else. Vice versa, had a private doc in my first job tell me I needed to have my butt in a chair 10 hrs a day without a timesheet.

The question isn’t if your hours are being logged but if someone is controlling what you do with those hours.

At most places it was just a formality for someone from HR to remember to pay me.

At my current hospital job, a junior admin actually walks around doctors' offices in the morning and notes times when we arrive. So I have to buy him a coffee once in a while to get off the tardy list.

However, having to physically clock in and out is much worse. A bummer for Kaiser docs if true

 

[sirspamalot]

Jesus that is horrible, totally unacceptable, I cannot believe you have to work in that environment. Only if I cannot "make it in" does the dept admin have to mention it to anyone else, and its usually for a darn good reason (weather or less likely, illness). Unless I'm "gone" and they've hired someone else, there is no vacation/sick leave/whatever. You can check the films remotely and be available by phone that day (ie General Supervision).

If you are tasked with TAKING CARE OF CANCER PATIENTS then there should be zero, and I mean zero, oversight of anything unless it (ie YOU) is way way off course. They should be BUYING YOU a cup of coffee every morning. Oh, and did I mention, you are also generating 2X your value in pure profit for the hospital?

What. the F. If you have less than 20 on treatment its a 3.5/d a week job in a HOPPS setting with good staff.

Stop taking this nonsense folks. Really, its beneath our profession and dignity. Sorry (not really) to get fired up, but I cannot stand seeing my peers abused in this fashion.

As long as the quality of work is high, the department is making its nut, and patients/referrers are happy, what the F is the micromanagement bs all about? The only metrics that matter are the ones I just said. What time you come in is irrelevant unless its disruptive.

 

[RickyScott]

Jesus that is horrible, totally unacceptable, I cannot believe you have to work in that environment. Only if I cannot "make it in" does the dept admin have to mention it to anyone else, and its usually for a darn good reason (weather or less likely, illness). Unless I'm "gone" and they've hired someone else, there is no vacation/sick leave/whatever. You can check the films remotely and be available by phone that day (ie General Supervision).

If you are tasked with TAKING CARE OF CANCER PATIENTS then there should be zero, and I mean zero, oversight of anything unless it (ie YOU) is way way off course. They should be BUYING YOU a cup of coffee every morning. Oh, and did I mention, you are also generating 2X your value in pure profit for the hospital?

What. the F. If you have less than 20 on treatment its a 3.5/d a week job in a HOPPS setting with good staff.

Stop taking this nonsense folks. Really, its beneath our profession and dignity. Sorry (not really) to get fired up, but I cannot stand seeing my peers abused in this fashion.

As long as the quality of work is high, the department is making its nut, and patients/referrers are happy, what the F is the micromanagement bs all about? The only metrics that matter are the ones I just said. What time you come in is irrelevant unless its disruptive.

Oversupply means we are beholden to the whims of administrators, toxic personalities, and departmental politics. The administrator may have been taught during his leadership seminar that running a tight ship is important, which it may be at a Taco Bell. If administrators have to be there on the dot, why shouldn’t their doc employees/providers? Punctuality and excessive documentation are a direct reflection of medical competence.
We gotta get over the simple fact that our value is not tied to how much revenue we produce. It is tied to supply and demand like everything else.

 

[communitydoc13]

If you are tasked with TAKING CARE OF CANCER PATIENTS then there should be zero, and I mean zero, oversight of anything unless it (ie YOU) is way way off course.

We gotta get over the simple fact that our value is not tied to how much revenue we produce. It is tied to supply and demand like everything else.

@RickyScott has it right, unfortunately.

If you are involved with admin duties and oversight of a community medical oncology clinic now, you are abandoning any quality improvement initiatives, meaningful review process and goals for improved patient satisfaction. Your one and only goal is to keep the clinic staffed and hopefully with full time docs. The market has imploded and the core of rural medical oncology (IMG docs, often approaching 60) have all decided to go locums or renegotiate their contracts and they have tremendous leverage. It is toxic AF. Some of these docs are great, but others are and have always been marginal. There is no recourse. It is an example of a market that does not provide for societal needs but does provide for high physician salaries.

Regarding your radonc clinic, admin can still do whatever they want. I had an admin (a decent guy) ask me, "Why is your clinic such a better partner with the hospital, you seem to want to make things better". I had to reply, "because we are grateful for the opportunity we have and we want our community hospital to succeed."

A world full of mercenary locums docs will not sustain rural community medicine. When these clinics fail, we will all suffer. (Exempting large system chairs and administrators).

Kaiser model not that bad IMO.

 

[TheWallnerus]

Oversupply means we are beholden to the whims of administrators, toxic personalities, and departmental politics. The administrator may have been taught during his leadership seminar that running a tight ship is important, which it may be at a Taco Bell. If administrators have to be there on the dot, why shouldn’t their doc employees/providers? Punctuality and excessive documentation are a direct reflection of medical competence.
We gotta get over the simple fact that our value is not tied to how much revenue we produce. It is tied to supply and demand like everything else.

As an addendum and Goreian inconvenient truth, our value is also inversely tied to how much we hypofractionate. A rad onc universally following the accepted standards of care of either 5-fractioning or altogether unirradiating older women (breast cancer median diagnosis age of 62) with favorable early breast cancer would be in the running for Least Valuable Radiation Oncologist in the United States.

 

[sirspamalot]

A world full of mercenary locums docs will not sustain rural community medicine

Neither will a world of underpaid lesser qualified physicians bub.

The fact is, it always has been, and always we be, about them dollars. Now, you can hate on those who say "not me" and negotiate like a mofo, but I'm gonna do me. Until WE stand up for the benjamins, the power and the authority to run our world, NOBODY IS GIVING IT TO US.

I think the tidal shift to locums (and the cost) has run the (very dense) bell of administrators: we aren't necessarily interchangeable. Better start treating us with some respect.

Historically (20 years ago) locums docs were marginal by default. No longer. Stand up and get yours, or get out of the way homie.

mike drop

 

[communitydoc13]

Stand up and get yours, or get out of the way homie.

Whatever.

This attitude, when applied globally effs us all. Really....and it is unsustainable. It seems to be epidemic. I'm hearing of multiple practices (not in radonc), who have had good quality, QOL and sustainability for years, falling apart at their seems because everyone wants theirs and no one wants to compromise.

BTW, there is no room for this behavior in radonc. Sounds like you've carved out a niche via extreme flexibility and flying. If one of my colleagues said, "eff this, I'm going locums", I would say, "good luck working in another part of the country".

 

[sirspamalot]

Whatever.

This attitude, when applied globally effs us all. Really....and it is unsustainable. It seems to be epidemic. I'm hearing of multiple practices (not in radonc), who have had good quality, QOL and sustainability for years, falling apart at their seems because everyone wants theirs and no one wants to compromise.

BTW, there is no room for this behavior in radonc. Sounds like you've carved out a niche via extreme flexibility and flying. If one of my colleagues said, "eff this, I'm going locums", I would say, "good luck working in another part of the country".

Does it f us all or does being treated like a McDonald's worker with pay headed in that direction?

You think we should take whatever scraps they throw us. I'm talking about working for a hospital/system not pp and you know it.

I commented elsewhere recently on what I think about the greed and abuse of peers.

Take your anger out on those that deserve it cause it ain't me.

 

[medgator]

Whatever.

This attitude, when applied globally effs us all. Really....and it is unsustainable. It seems to be epidemic. I'm hearing of multiple practices (not in radonc), who have had good quality, QOL and sustainability for years, falling apart at their seems because everyone wants theirs and no one wants to compromise.

BTW, there is no room for this behavior in radonc. Sounds like you've carved out a niche via extreme flexibility and flying. If one of my colleagues said, "eff this, I'm going locums", I would say, "good luck working in another part of the country".

You can thank overpaid hospital execs and insurance admins/CEOs for this. Why suffer through the grind when you can have a lighter, more controllable schedule at better pay by geographic arbitrage.

The hospital admins in bumble**** know better than to mistreat docs. You get paid well for less work and are often treated like royalty because of how hard it is to recruit out there. Why again is taking this deal a bad thing?

 

[communitydoc13]

Take your anger out on those that deserve it cause it ain't me.

Not angry at you at all. You've carved out a niche in radonc. Good on you.

But I do have some administrative role, and my job as a radonc (through a professional services contract) is contingent on the health of an independent community hospital away from a major metro. That health is being compromised by a number of factors, but I would put staffing, including physician staffing at the very top.

Do I disagree with the narrative of "just leave docs alone and they will do the right thing? I do. There is admin overreach all the time, and the most valuable medical provider remains the physician, but the physician who believes that they are not beholden to anyone is typically pretty dangerous. This is opinion based on experience. It is also true that I have seen particularly bad behavior from docs who are aware of their market status and have the "I'll walk away" attitude in response to reasonable critique and concern for patients.

In the context of this thread "kaiser-rad-onc-jobs", I think it's important that we both present our cases. From my perspective, seeing the vulnerability of smaller hospital systems directly and the behavior or larger systems through peers, I believe that, as of today, those Kaiser jobs are reasonable. I've known several happy Kaiser docs. All believe that they have good support and provide good care. They are fine making a little less than some.

 

[communitydoc13]

The hospital admins in bumble**** know better than to mistreat docs. You get paid well for less work and are often treated like royalty because of how hard it is to recruit out there. Why again is taking this deal a bad thing?

Not a bad deal at all. Roughly the deal that I took (not really bumble**** but not major metro). The issue is the global undersupply of many specialties (medonc in particular) and the response to this undersupply. The speed at which this market change has hit has been remarkable.

Docs believing that centers will really just pay locums forever and employed docs believing that locums contracts represent how full time docs should be compensated. It is tough to retain full time staff, which is necessary for the best care IMO.

Those same forces that have improved the radonc job market "a little bit" have made medoncs absolute kings of the castle out in the community.

 

[RickyScott]

Neither will a world of underpaid lesser qualified physicians bub.

The fact is, it always has been, and always we be, about them dollars. Now, you can hate on those who say "not me" and negotiate like a mofo, but I'm gonna do me. Until WE stand up for the benjamins, the power and the authority to run our world, NOBODY IS GIVING IT TO US.

I think the tidal shift to locums (and the cost) has run the (very dense) bell of administrators: we aren't necessarily interchangeable. Better start treating us with some respect.

Historically (20 years ago) locums docs were marginal by default. No longer. Stand up and get yours, or get out of the way homie. No one is “standing up

mike drop

3-4k radonc produced in the last 20 years are for the mosr part good enough/interchangeable.

 

[RadRadRad]

i don’t think that’s true. I still see variety of skill and work ethic. Also even from admin standpoint there are so many grey areas of radonc (pancreas, lymphoma, over 70 breast ca, oligomets) that the number on treat could vary substantially based on aggressiveness of the radonc. That doesn’t even count practice building / affability etc which still matters in some markets

 

[RickyScott]

i don’t think that’s true. I still see variety of skill and work ethic. Also even from admin standpoint there are so many grey areas of radonc (pancreas, lymphoma, over 70 breast ca, oligomets) that the number on treat could vary substantially based on aggressiveness of the radonc. That doesn’t even count practice building / affability etc which still matters in some markets

I meant from a competence to cover a locums stint,not personality/motivation/practice building. Radonc is not rocket science and most everyone over the past 20 years did well in medical school. The worst personalities are often syphoned off into academia anyway.

 

[Particler]

So I assume 40-50 hr work week, making MGMA median-Ish but limited salary ceiling/growth?

I assume the be benefits (healthcare, pension/401k, etc) must be quite good.

Would the limitations on dose/fx or other choices on treatment decisions be that different than being at a big institution (academic more so) with certain traditions of treatment choice?

Any other factors (besides geography) that would sway someone more towards a Kaiser job?

 

[sirspamalot]

and they have tremendous leverage

 

[sirspamalot]

Docs believing that centers will really just pay locums forever and employed docs believing that locums contracts represent how full time docs should be compensated. It is tough to retain full time staff, which is necessary for the best care IMO.

 

[RO28]

Does anyone have experience with Kaiser Rad Onc jobs?

What is it like in terms of compensation, W/L balance, workload, job satisfaction, etc?

How would it compare to a similar hospital-employed position?

Hey, DM me if you want salary/number details. I have interviewed for a Kaiser position in the past and ended up not taking it for various reasons.

They are very sought after jobs where I'm at. The doctors are good quality doctors who are good people to work with and care a lot about patients (this is true across multiple centers). Support staff is also good (dosi, physics). There is no RVU/productivity so that is a really nice perk. It is a salaried position with % increase annually for 5 or so years. The vacation allocation wasn't as good as some other positions. Does not qualify for PSLF. Benefits are pretty good, but also entirely within the Kaiser system, so depends on if you want Kaiser for yourself which has its perks and downfalls. Does require drinking the kool-aid, which could be a good or bad thing depending on what you are looking for.

 

[OTN]

Hey, DM me if you want salary/number details. I have interviewed for a Kaiser position in the past and ended up not taking it for various reasons.

They are very sought after jobs where I'm at. The doctors are good quality doctors who are good people to work with and care a lot about patients (this is true across multiple centers). Support staff is also good (dosi, physics). There is no RVU/productivity so that is a really nice perk. It is a salaried position with % increase annually for 5 or so years. The vacation allocation wasn't as good as some other positions. Does not qualify for PSLF. Benefits are pretty good, but also entirely within the Kaiser system, so depends on if you want Kaiser for yourself which has its perks and downfalls. Does require drinking the kool-aid, which could be a good or bad thing depending on what you are looking for.

I would argue that the salary/number details should be posted for all of us to see (in the business of radonc forum, of course) so that we may have better information in the job marketplace.

 

[RO28]

I would argue that the salary/number details should be posted for all of us to see (in the business of radonc forum, of course) so that we may have better information in the job marketplace.

Yes, this would be great, but I might doxx myself in doing so. I'll think about it. Maybe I already have?