Private Equity Gloats Over A Doctor Glut

[elementaryschooleconomics]

I want to say upfront I don't believe that ASTRO/SCAROP/etc had a grand plan to create oversupply the same way I believe it was done by VC in EM.

Reading this article, it sure feels like you could just open "Find/Replace" in Word, plug in "RadOnc" and our numbers instead of "Emergency Medicine", and the essence of the story remains unchanged:

In terms of absolute numbers, we're working on a smaller scale. Those darn multi-million dollar linacs and the government issued Certificate of Needs!

I'm pretty sure the upfront capital required to open a new RadOnc department has "protected" us from more severe VC encroachment more than our silly board exams in physics and radbio could ever hope to achieve.

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[RickyScott]

On the flip side, er docs have outlets with critical care fellowships, urgent care clinics. Probably also very easy to retrain in primary care. Our chairs probably did not conspire in a coordinated effort, but just ran with their base self interest into this tragedy of the commons. And same self interest is why they have no desire to address problem.

Erfurt latrine disaster​

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In July 1184, Henry VI, King of Germany (later Holy Roman Emperor), held court at a Hoftag in the Petersberg Citadel in Erfurt. On the morning of 26 July, the combined weight of the assembled nobles caused the wooden second story floor of the building to collapse and most of them fell through into the latrine cesspit below the ground floor, where about 60 of them drowned in liquid excrement. This event is called Erfurter Latrinensturz (lit. 'Erfurt latrine fall') in several German sources.[1][2][3]

 

[medgator]

I want to say upfront I don't believe that ASTRO/SCAROP/etc had a grand plan to create oversupply the same way I believe it was done by VC in EM.

Reading this article, it sure feels like you could just open "Find/Replace" in Word, plug in "RadOnc" and our numbers instead of "Emergency Medicine", and the essence of the story remains unchanged:

View attachment 354976

In terms of absolute numbers, we're working on a smaller scale. Those darn multi-million dollar linacs and the government issued Certificate of Needs!

I'm pretty sure the upfront capital required to open a new RadOnc department has "protected" us from more severe VC encroachment more than our silly board exams in physics and radbio could ever hope to achieve.

PE and VC has had its grubby little fingers on rad onc since the turn of the century with the advent of IMRT..

Physician Oncology Services and Vantage Oncology Combine to Form Premier National Network of Outpatient Radiation Oncology Centers – Oak Hill

Vantage Oncology’s 50 centers and more than 350 affiliated physicians join The US Oncology Network - The US Oncology Network

The Woodlands, Texas (January 26, 2017) – The US Oncology Network (“The Network”) announced today, as part of McKesson Specialty Health’s ongoing integration with Vantage Oncology, that 50 centers in 13 states and more than 350 affiliated physicians have joined The Network. The US Oncology...

usoncology.com

21st Century Oncology joins KKR's GenesisCare in $1.1 bln deal | PE Hub

The PE-backed Aussie cancer care provider prevailed over two other parties in Jefferies-run sales process

www.pehub.com

 

[RickyScott]

PE and VC has had its grubby little fingers on rad onc since the turn of the century with the advent of IMRT..

Physician Oncology Services and Vantage Oncology Combine to Form Premier National Network of Outpatient Radiation Oncology Centers – Oak Hill

Vantage Oncology’s 50 centers and more than 350 affiliated physicians join The US Oncology Network - The US Oncology Network

The Woodlands, Texas (January 26, 2017) – The US Oncology Network (“The Network”) announced today, as part of McKesson Specialty Health’s ongoing integration with Vantage Oncology, that 50 centers in 13 states and more than 350 affiliated physicians have joined The Network. The US Oncology...

usoncology.com

21st Century Oncology joins KKR's GenesisCare in $1.1 bln deal | PE Hub

The PE-backed Aussie cancer care provider prevailed over two other parties in Jefferies-run sales process

www.pehub.com

Also pe highly involved in protons. medical college of wisconsins proton news release shows that it is pe backed.

 

[medgator]

Also pe highly involved in protons. Notes medical college of wisconsins proton news release that is pe backed.

Yeah, pretty much the majority of proton installations have smacked of vc/pe money

ProCure Treatment Centers Completes $40M Private Equity Financing Round - FinSMEs

ProCure Treatment Centers, Inc., a healthcare company that specializes in proton therapy, completed a $40m private equity financing round led by Maverick Capital. The funding will support the continued development and expansion of ProCure’s network of proton therapy centers. The financing...

www.finsmes.com

Proton Treatment Centers Get $87 Million in Bankruptcy Auction

A Tennessee-based proton cancer treatment center operator and its affiliates plan to sell nearly all of their assets for about $87 million following court-approved bankruptcy auctions.

news.bloomberglaw.com

 

[seper]

The job market in ER is bad. Full-time salaries are in high 200’s and stagnant

 

[elementaryschooleconomics]

The job market in ER is bad. Full-time salaries are in high 200’s and stagnant

The only thing keeping us from seeing those same numbers is that American Healthcare is designed to reward procedures.

I think it's unknowable (in that we could never truly obtain accurate data), but I suspect the relative salary loss/stagnation in RadOnc and EM are similar (in absolute numbers, of course, we started much higher so remain somewhat higher).

 

[CurbYourExpectations]

Palliative medicine fellowship is going to be more competitive than EM and RadOnc soon?

 

[RickyScott]

The only thing keeping us from seeing those same numbers is that American Healthcare is designed to reward procedures.

I think it's unknowable (in that we could never truly obtain accurate data), but I suspect the relative salary loss/stagnation in RadOnc and EM are similar (in absolute numbers, of course, we started much higher so remain somewhat higher).

I guess an er doc can always work harder, take more shifts, for the same salary. We can’t even do that.

 

[Reaganite]

In my neck of the woods full time physicists are starting to routinely command more than doctors. Overheard a recent convo where a physicist was asking 350k. As far as the future of Rad Onc, I work in a very densely populated area where APM type payment plans started years ago, and it has been a blood bath in terms of new hires and wages esp in private practice. The only thing propping up physician numbers is ridiculous satellites with <10 patients serviced by 2 university rad oncs and even these guys seem to be in a hiring freeze. Apm is amazing for existing docs and patients (same day sim and single fx bone met treatment is awesome), but the need for doctors drops precipitously. I don't need to see projections and powerpoint slides because I'm living it, and it's everything you guys are predicting. If apm reimbursement and 5 fraction breast becomes de rigueur nationally the breadlines for new grads are surely coming as our friend carbon would say.

 

[RadOncDoc21]

In my neck of the woods full time physicists are starting to routinely command more than doctors. Overheard a recent convo where a physicist was asking 350k. As far as the future of Rad Onc, I work in a very densely populated area where APM type payment plans started years ago, and it has been a blood bath in terms of new hires and wages esp in private practice. The only thing propping up physician numbers is ridiculous satellites with <10 patients serviced by 2 university rad oncs and even these guys seem to be in a hiring freeze. Apm is amazing for existing docs and patients (same day sim and single fx bone met treatment is awesome), but the need for doctors drops precipitously. I don't need to see projections and powerpoint slides because I'm living it, and it's everything you guys are predicting. If apm reimbursement and 5 fraction breast becomes de rigueur nationally the breadlines for new grads are surely coming as our friend carbon would say.

I would say putting out some feelers this year, this may be the only opportunity to make either a lateral move (location or salary) vs a true better position (both) as many docs seem to have left or semi-retired. I was able to learn about opportunities in places this year that were usually super competitive in the past. Maybe the last chance we get in awhile.

 

[elementaryschooleconomics]

More timely articles:

(classic expansion graph added for reference)

 

[RickyScott]

More timely articles:

View attachment 355000

(classic expansion graph added for reference)

Numbers of radoncs increasing, while medicare spending decreases is just further confirmation that CMS$/radonc is plummeting. Job market is only sustained by price gouging monopolistic centers that run huge profits despite docs seeing 4 or less consults per week on average.

 

[Mandelin Rain]

Numbers of radoncs increasing, while medicare spending decreases is just further confirmation that CMS$/radonc is plummeting. Job market is only sustained by price gouging monopolistic centers that run huge profits despite docs seeing 4 or less consults per week on average.

This is true.