Folding back into radiology more of a long term solution. Near term future is f’ed no matter what course is taken at this point since we have no alternative means of employment in the medical field.
As many avenues as possible. If there is one thing the people who entered into peak RO under false pretenses in the last 10 years should have its options (IR, Rads, Oncology)
Now, if someone were to offer "remote" Fellowships, where I could stay in my current job but have supervised practice prescribing things like Temodar and Tamoxifen leading to some sort of certification (or whatever would satisfy the hungry, gaping maw of the insurance companies for reimbursement and keep the malpractice lawyers from coming for my soul), I would jump on that IMMEDIATELY.
I’ve always felt that neuro oncology med oncs had it good… 90% of patients receive Temodar, the remaining Avastin when Temodar fails. Sure there may be some who may do PCV but it seems like a good niche.
Assuming you get a lot of primary CNS.
Now wait. Why can't/don't rad oncs do that now
You lost me on this one. There are a few rad oncs in the US who prescribe some of their own concurrent oral chemo, who are just rad onc trained. I assumed it was more of a risk management issue.
I prescribed xeloda on one occasion due to special circumstances
/sarcasm
Too many were true!
Derms prescribe chemo for sure. Rheums prescribe "chemo" too I suppose.
Lol. All meant to be not true, just truthy.
Earned more as a resident in upstate ny 2200 a day 10 years ago through comp health
Chairs of places like LIJ or UCLA were not making 1-2 million 10 years ago. When I graduated the average chair salary was on par with the average in private practice. Now lou makes almost 2 million …
Honestly... even two years ago you could fetch $2500 for that location. But that was back when they needed your daily presence in order to collect revenue from the treatments.
So even even bother advertising if they don't even need you for that?
Yup, earned more as a resident covering as well.
It exists still but seems pretty rare. I personally know maybe 10 people who were able to moonlight in clinical positions over perhaps the last 5 years, myself included, though only one of those people were moonlighting in Radiation Oncology (and that person was, sadly, not me).
2010s. A sweet deal if I’m honest, although amazing training for the future.
I somewhat agree with you, but there is no agency here. Cms really does not care what any of us thinks.
So then why do they need a daily locums at all?
That supervision as defined—which currently equals watching YouTube in your office while the patients are treated—equals value is a logical fallacy. It only feels that way because rad onc is oversupplied. If there were 2000 rad oncs in America virtual supervision would be hailed as a modern breakthrough... in, like, 2005.
I bet they haven't been able to find someone permanent. I check practicelink occasionally and this job has been posted and re-posted for at least one year.
If you think that “value” = standing by a machine, that a retired doc that knows nothing and treats 2D provides more value standing by the machine than a highly skilled doc who is able to do it remotely, than we have very different ideas of value…
There is absolutely nothing preventing an enterprising individual or group from doing this, now, other than there are a lot of conservative/risk averse people in medicine and especially Radiation Oncology.
It doesn't matter how we see it. It happened without ASTROs input, considering they never cared about "safety" at all those exempt rural centers to begin with.
ASTRO hasn't lately.. lots of swings and misses
Vast majority of us are employed and don’t benefit from supervision changes financially. Sentiment of these postings is more along the lines of “look at these locums rates, field truly has gone over the cliff.”
oh absolutely. and i get that
I think they were reasonable and inevitable. I think most feel the same way. "Great" may be editorializing a bit. Having some 80 year old dinosaur "babysit" the linac was among the lowest value propositions in all of medicine.
slippery slope. many things we do can be called into question in terms of the amount of money per unit work.
Yes it's great i can finally go see an inpatient at a reasonable hour or not delay treating because I'm at tumor board. Amazing changes
Many things have been. Hence the discussion here trying to inform Student Doctors on this Network of the future pitfalls of this specialty.
absolutely agree.
Every rad onc in the US thought the supervision changes were great. In 2009.
First time being able to see the dentist in a decade, IMO.
Curious, @jondunn, what don’t I get? I’ve always been open to learning and my positions change if I get more information. I know it’s fashionable to pop your cherry, come on here and drop bombs … and that’s cool. But, I’d love to know what I’m not understanding? I think a lot is wrong with this field. If you think it’s about chasing likes, maybe turn the mirror onto yourself for a moment?
Exactly! I don't think anyone is advocating for completely virtual clinics; it's these day-to-day nuisances we're all tired of. It's getting reported to admin for grabbing lunch off campus; T1 breast cancer patients having to wait to start their treatment because you got stuck in traffic; therapists scheduling a Medicare patient at 645 AM...that's the stuff we're all sick of.
I had a patient get mad at me because I wasn’t the one “delivering the radiation.” I spent a good hour explaining to her my role as the radiation oncologist but in her mind, the most important person was the therapist. Maybe this is how the bean counters feel about what we do. All the other stuff is for fun.
That's strange, my therapists also think the most important people are the therapists, too! Is it part of their (super quick) training?
