Will the rad onc job market correct itself within the next 10 years?

[pbandjamie]

As a lowly M2, all I really know about the rad onc job market is from what I read on online forums such as this and Reddit. I came into medical school pretty set on rad onc, but now I'm having hesitations as I am starting to learn more about how residency program expansion has killed the job market. Is there any hope that the market will have corrected by the time I would be applying for attending positions in ~7 years?

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[RickyScott]

If all present residents are allowed to graduate, but we totally shut down every single residency, we still head into the 2030 with large oversupply. Issue is not just increased resident numbers, but demand issues: actual decrease in number/indications radiation treatment, loosening supervision requirements, apm etc

 

[TheWallnerus]

As a lowly M2, all I really know about the rad onc job market is from what I read on online forums such as this and Reddit. I came into medical school pretty set on rad onc, but now I'm having hesitations as I am starting to learn more about how residency program expansion has killed the job market. Is there any hope that the market will have corrected by the time I would be applying for attending positions in ~7 years?

Odds are low.

Headwinds against: falling RT utilization, slowing increase in incidence in main cancers ROs treat, RO-APM and payment reform, supervision laxity ("virtual supervision") decreasing need for constant physical presence, increasing efficacy of non-RT oncologic interventions, rising resident numbers, rising RO numbers, falling RO patient numbers (nationally), lack of survival-increasing maneuvers further available/achievable in RO space, hypofractionation not yet maximally implemented nationally

Wind in sails: sudden come to Jesus moment in RO causing everyone to come together and collectively fix RO's above problems (yet to happen)

 

[hal9k]

As a lowly M2, all I really know about the rad onc job market is from what I read on online forums such as this and Reddit. I came into medical school pretty set on rad onc, but now I'm having hesitations as I am starting to learn more about how residency program expansion has killed the job market. Is there any hope that the market will have corrected by the time I would be applying for attending positions in ~7 years?

it is a risky route since residency is 5 years and it is hard to switch after you finish. If I knew about the job market earlier, I would totally choose med onc. They are in high demand right now and will probably stay that way for at least 10-15 years

 

[OTN]

No

 

[Mandelin Rain]

Residency is 5-years long. If a supply-side change is made today, it won't be felt for at least that long. Though I have no faith anything will change significantly there until the bottom falls out completely. Demand-side trends are subject to change but currently very unfavorable.

 

[RickyScott]

Also going to put this out there: since DEI has become an almost religious ideology in universities-who do most the hiring- I would hate to be a white or Asian male entering residency today. All things being equal, you won’t get that scarce instructorship.

 

[fiji128]

Absolutely zero chance. Do not bet your entire future on the worst run specialty in medicine!

Just to maintain our current worst in class job market we need to be graduating only about 80 or 90 residents a year to replace the rad oncs that are retiring. We are currently pumping out 180 to 190 new grads each year. There is zero evidence that programs will be contracting/closing in a substantial way outside a few that have say they will be taking one less while other programs are still expanding.

 

[metallica81788]

To echo the above - if all residencies shut down immediately there would still be massive oversupply for 10-15 years. Even if the dinosaurs start to die/retire (spoilers: they won't), it won't help that much as the younger attendings/partners absorb that volume to prop up their salaries.

The worst is not even here yet, saying this while committed to the field/future and only two years out from residency.

 

[hal9k]

To echo the above - if all residencies shut down immediately there would still be massive oversupply for 10-15 years. Even if the dinosaurs start to die/retire (spoilers: they won't), it won't help that much as the younger attendings/partners absorb that volume to prop up their salaries.

The worst is not even here yet, saying this while committed to the field/future and only two years out from residency.

they wont retire...I see 80 yo rad oncs almost everywhere I interviewed/visited

 

[communitydoc13]

Strongly discourage anyone at your level from going into radonc. Firstly, job market will not correct.

When you rotate through, you will like it. Evidence based, patient contact, deliberate with typically low acuity patients, the obvious reward of giving an often effective therapeutic. The people are smart (many of them really smart).

But it will continue to become less significant during the course of your professional lifetime barring a remarkable and unforeseen development. Seven years from now you should be looking forward to a 30 year career. You should be excited not only about what you can do at the end of residency but what role you will play 10 or even 20 years down the road. Will you be giving new therapeutics or managing patients in a completely different way or spearheading groundbreaking clinical trials? (I see damn near giddy 70 year old medoncs and endocrinologists who don't want to retire because they can do so much more now than 10 years ago).

Will you become a more or less important part of your patient's cancer journey as your career advances?

To gauge the future, look at the present research.

Some fields are fundamentally about taking care of patients (their culture, their compensation model, what is valued professionally). These will always be solid (peds, IM, FM).

 

[pbandjamie]

I really appreciate all of this transparency from you folks. I have talked to multiple rad onc attendings at our affiliated hospitals and our academic advisor, and they all keep telling me that it really isn't that bad and that I shouldn't have any issues if I choose to purse RO. But after putting in so much time, energy, and money into school, I don't want to risk not being able to find a good job once all is said and done.

I will steer clear and think about med onc/hem onc. Thank you all

 

[Gfunk6]

I disagree with the above posters. The RO job market will correct.

In the same way availability of food is "corrected" during a catastrophic famine because people slowly die of starvation resulting in untold suffering. After half the population dies this way, there is now more food for everybody. However, the oligarchy will be eating caviar no matter what.

 

[DebtRising]

I don’t think it will correct because no field as much demand destruction as radiation.

Radiology corrected with both pulling back slots and technology increasing the number of scans(how much demand creation occurred with mri prostate, and now PMSA pet?), further growth of IR, the engulfment of nuc med.

Everything is geared towards doing less or no radiation. Such a drastic supply readjustment is needed based on this trajectory that it seems almost impossible to achieve. To date we have had a sustained supply increase.

 

[elementaryschooleconomics]

I don’t think it will correct because no field as much demand destruction as radiation.

Radiology corrected with both pulling back slots and technology increasing the number of scans(how much demand creation occurred with mri prostate, and now PMSA pet?), further growth of IR, the engulfment of nuc med.

Everything is geared towards doing less or no radiation. Such a drastic supply readjustment is needed based on this trajectory that it seems almost impossible to achieve. To date we have had a sustained supply increase.

Can't wait to hear about how hypofrac is the new standard of care for salvage prostate on Monday!

 

[OTN]

I don’t think it will correct because no field as much demand destruction as radiation.

Radiology corrected with both pulling back slots and technology increasing the number of scans(how much demand creation occurred with mri prostate, and now PMSA pet?), further growth of IR, the engulfment of nuc med.

Everything is geared towards doing less or no radiation. Such a drastic supply readjustment is needed based on this trajectory that it seems almost impossible to achieve. To date we have had a sustained supply increase.

I don't agree with this take. With SBRT for oligomets and an aging Boomer population, although we have seen some decrease in demand over the last decade, I don't think it's been quite as dramatic as this suggests. It hasn't in my practice at least, and it's not as if we hired a ton of medoncs/surgeons which led to the demand- those inputs for my practice are more or less the same. Obviously if you're a single-site radonc, and your site is lymphoma or GI...well that would be different. Yet another reason it's nonsensical to tie yourself to a single disease site if you can help it. Hypofractionation is big, sure, but again with a well-rounded patient base it wouldn't be world-ending.

The increase in supply has been THE issue. If we still had the same number of residents now we did 10-15 years ago, we'd still be fielding "can I make it into the field??" questions, rather than "should I go into this dumpster fire?"

 

[RickyScott]

I really appreciate all of this transparency from you folks. I have talked to multiple rad onc attendings at our affiliated hospitals and our academic advisor, and they all keep telling me that it really isn't that bad and that I shouldn't have any issues if I choose to purse RO. But after putting in so much time, energy, and money into school, I don't want to risk not being able to find a good job once all is said and done.

I will steer clear and think about med onc/hem onc. Thank you all

you should sue “advisors” who give bad self serving advice if things turn out badly.

 

[RickyScott]

I don't agree with this take. With SBRT for oligomets and an aging Boomer population, although we have seen some decrease in demand over the last decade, I don't think it's been quite as dramatic as this suggests. It hasn't in my practice at least, and it's not as if we hired a ton of medoncs/surgeons which led to the demand- those inputs for my practice are more or less the same. Obviously if you're a single-site radonc, and your site is lymphoma or GI...well that would be different. Yet another reason it's nonsensical to tie yourself to a single disease site if you can help it. Hypofractionation is big, sure, but again with a well-rounded patient base it wouldn't be world-ending.

The increase in supply has been THE issue. If we still had the same number of residents now we did 10-15 years ago, we'd still be fielding "can I make it into the field??" questions, rather than "should I go into this dumpster fire?"

A lot of the decrease in demand comes from the fact that many radoncs historically have had a cushy work schedule so when paid less due to apm/hypofract, they will just work more and not hire. For example, that group north of Boston who fired the Astro gold medalist at Lahey, only work 4 days a week.

 

[OTN]

A lot of the decrease in demand comes from the fact that many radoncs historically have had a cushy work schedule so when paid less due to apm/hypofract, they will just work more and not hire. For example, that group north of Boston who fired the Astro gold medalist at Lahey, only work 4 days a week.

Very, very correct. My group has specifically talked about doing precisely this (the not hiring part, not the firing of gold medalists part).

 

[hal9k]

I think most senior academic rad oncs don't realize how difficult the job market is compared to other fields. They haven't looked for jobs for many years. Younger generations really feel the pain since they are currently in the job market and it is especially painful when you compare with your peers who didn't do as well in med school but are in high demand now because they selected a different specialty. Most annoying part is, it is difficult to retrain after rad onc residency if you regret since it is five years and did not require internal medicine residency

 

[fiji128]

The private practice were I got my first job recently folded and went out of existence after being around since the 1970’s in a large very competitive market. This would not happen if the market and demand for our services was healthy.

I won’t be at Astro this year but it almost seems we are at the point where “leadership” risks being heckled when they and get up on stage and start making their ridiculous claims about increasing med student exposure, URM recruitment or whatever nonsense they try to glom onto to fill their residency programs.

 

[Lamount]

I disagree with the above posters. The RO job market will correct.

In the same way availability of food is "corrected" during a catastrophic famine because people slowly die of starvation resulting in untold suffering. After half the population dies this way, there is now more food for everybody. However, the oligarchy will be eating caviar no matter what.

Agree with this (in spirit, albeit a little less). I would guess that APM inspires many to retire in affected zips. Wouldn’t shock me to see these areas with a tremendous under supply by the end of the five years. Whether or not that dooms APM is another story.

 

[RickyScott]

Agree with this (in spirit, albeit a little less). I would guess that APM inspires many to retire in affected zips. Wouldn’t shock me to see these areas with a tremendous under supply by the end of the five years. Whether or not that dooms APM is another story.

Entrenched, senior guys don’t retire- they hire new grads to do their work at low salaries. A tremendous undersupply. Come on.

 

[Lamount]

Entrenched, senior guys don’t retire- they hire new grads to do their work at low salaries. A tremendous undersupply. Come on.

I know little about PP, but it is my understanding that many cannot afford mandatory upgrades, increased documentation requirements

 

[medgator]

Agree with this (in spirit, albeit a little less). I would guess that APM inspires many to retire in affected zips. Wouldn’t shock me to see these areas with a tremendous under supply by the end of the five years. Whether or not that dooms APM is another story.

No way, the quality of care will suffer but someone will be there benefitting at the end

 

[elementaryschooleconomics]

No way, the quality of care will suffer but someone will be there benefitting at the end

Someone (or some entity) will find a way to profit on the APM, somehow. Obviously, the Andersons and Sloans of the world have a clear path to benefiting, but people will find something to exploit. Who, what, and how remains to be seen, but the why - making money - motivates humans to figure out...anything.

 

[TheWallnerus]

Someone (or some entity) will find a way to profit on the APM, somehow. Obviously, the Andersons and Sloans of the world have a clear path to benefiting, but people will find something to exploit. Who, what, and how remains to be seen, but the why - making money - motivates humans to figure out...anything.

Will make money by
1) single fractioning
2) short staffing (including MDs) Dosim, RTTs, physics
3) low teching the equipment

The richest doctors in APM will be those who can treat hundreds of patients per year with the absolute least fractions and a skeleton staff.

 

[medgator]

Someone (or some entity) will find a way to profit on the APM, somehow. Obviously, the Andersons and Sloans of the world have a clear path to benefiting, but people will find something to exploit. Who, what, and how remains to be seen, but the why - making money - motivates humans to figure out...anything.

Will make money by
1) single fractioning
2) short staffing (including MDs) Dosim, RTTs, physics
3) low teching the equipment

The richest doctors in APM will be those who can treat hundreds of patients per year with the absolute least fractions and a skeleton staff.

Bingo.

We will see a lot of used equipment hitting the secondary market once APM gets up and running. Pandemic nothwithstanding, it's generally cheaper to let someone else drive the expensive car off the lot and buy used.

Find a cheap used truebeam (which will be easier to do once 30-40% of the practices forced to bill under APM try to consolidate and close superfluous satellite offices as much as possible), outsource your physics/set up a cheap remote dosimetry contract and collect bundled payments till the cows come home.

Varian didn't sell their business to seimens on accident. The domestic Linac market is going nowhere fast

 

[thecarbonionangle]

I disagree with the above posters. The RO job market will correct.

In the same way availability of food is "corrected" during a catastrophic famine because people slowly die of starvation resulting in untold suffering. After half the population dies this way, there is now more food for everybody. However, the oligarchy will be eating caviar no matter what.

remember in the end of grapes of wrath where the starving chick breast feeds other starving people, while the oranges are burnt in piles. In the end she “smiles mysteriously”. There will not be enough bosoms to feed all.

 

[RickyScott]

Entrenched, senior guys don’t retire- they hire new grads to do their work at low salaries. A tremendous undersupply. Come on.

Bingo.

We will see a lot of used equipment hitting the secondary market once APM gets up and running. Pandemic nothwithstanding, it's generally cheaper to let someone else drive the expensive car off the lot and buy used.

Find a cheap used truebeam (which will be easier to do once 30-40% of the practices forced to bill under APM try to consolidate and close superfluous satellite offices as much as possible), outsource your physics/set up a cheap remote dosimetry contract and collect bundled payments till the cows come home.

Varian didn't sell their business to seimens on accident. The domestic Linac market is going nowhere fast

I heard varian is trying to pull a tesla, and charging 400k for rapid arc and other licenses if you buy a used linac?

 

[TheWallnerus]

I heard varian is trying to pull a tesla, and charging 400k for rapid arc and other licenses if you buy a used linac?

You can get some really nice linacs on the market right now that 10 years ago were considered high-end for $300K. Can easily do simple lung SABR and cranial SRS with these.

 

[medgator]

I heard varian is trying to pull a tesla, and charging 400k for rapid arc and other licenses if you buy a used linac?

Have not seen or heard of that. You can buy used linacs with or without the vmat upgrades/software installed. Have seen trilogy, Novalis TX, iXs which are stereo capable for well under 7 figures

 

[bubbachuck]

I think we're generally overconfident in our prognostication 10 years out. We make assumptions about RO in the future using current knowledge of, say, radiology in the present. But clearly when radiology was decreasing in competitiveness 5-10 years ago, people didn't know what the future would hold. If they did, it would have remained competitive throughout. Did we know that immunotherapy and targeted therapies were going to make med onc super competitive, or that IMRT was going to make rad onc super competitive before they happened? Not that I know of.

I think there's too much uncertainty to say for sure that field A is a good bet vs. field B. Will med onc still be lucrative once immunotherapy drugs become generic in 10 years? I suppose that will depend on its advancements in the interim.

I would say that radiation oncology technology is moving at a pretty fast clip and we're better at immobilization and targeting than 5-10 years ago.
Ablating oligometastatic disease is a pretty awesome concept now, and I think it's becoming more widely accepted that it's effective.

Similarly to radiology, RO is also procedure-based and generates revenue for hospital. That should be a good bet.

My honest opinion is that if you see yourself as a multidisciplinary oncologist and not a technician, you will be OK.
You probably shouldn't expect amazing reimbursements back 2000s when IMRT was exploding, but I think it's a very rewarding career. We have a very strong role to play for increasing survival in both local and (increasingly) metastatic disease.

 

[Lamount]

I think we're generally overconfident in our prognostication 10 years out. We make assumptions about RO in the future using current knowledge of, say, radiology in the present. But clearly when radiology was decreasing in competitiveness 5-10 years ago, people didn't know what the future would hold. If they did, it would have remained competitive throughout. Did we know that immunotherapy and targeted therapies were going to make med onc super competitive, or that IMRT was going to make rad onc super competitive before they happened? Not that I know of.

I think there's too much uncertainty to say for sure that field A is a good bet vs. field B. Will med onc still be lucrative once immunotherapy drugs become generic in 10 years? I suppose that will depend on its advancements in the interim.

I would say that radiation oncology technology is moving at a pretty fast clip and we're better at immobilization and targeting than 5-10 years ago.
Ablating oligometastatic disease is a pretty awesome concept now, and I think it's becoming more widely accepted that it's effective.

Similarly to radiology, RO is also procedure-based and generates revenue for hospital. That should be a good bet.

My honest opinion is that if you see yourself as a multidisciplinary oncologist and not a technician, you will be OK.
You probably shouldn't expect amazing reimbursements back 2000s when IMRT was exploding, but I think it's a very rewarding career. We have a very strong role to play for increasing survival in both local and (increasingly) metastatic disease.

Agree with this... but I will caution you, optimism is usually punished swiftly on this forum.

 

[medgator]

I think we're generally overconfident in our prognostication 10 years out. We make assumptions about RO in the future using current knowledge of, say, radiology in the present. But clearly when radiology was decreasing in competitiveness 5-10 years ago, people didn't know what the future would hold. If they did, it would have remained competitive throughout. Did we know that immunotherapy and targeted therapies were going to make med onc super competitive, or that IMRT was going to make rad onc super competitive before they happened? Not that I know of.

I think there's too much uncertainty to say for sure that field A is a good bet vs. field B. Will med onc still be lucrative once immunotherapy drugs become generic in 10 years? I suppose that will depend on its advancements in the interim.

I would say that radiation oncology technology is moving at a pretty fast clip and we're better at immobilization and targeting than 5-10 years ago.
Ablating oligometastatic disease is a pretty awesome concept now, and I think it's becoming more widely accepted that it's effective.

Similarly to radiology, RO is also procedure-based and generates revenue for hospital. That should be a good bet.

My honest opinion is that if you see yourself as a multidisciplinary oncologist and not a technician, you will be OK.
You probably shouldn't expect amazing reimbursements back 2000s when IMRT was exploding, but I think it's a very rewarding career. We have a very strong role to play for increasing survival in both local and (increasingly) metastatic disease.

You're speaking in platitudes without concretely making a case as to why radiology rebounded. While we've been busy cutting fractions, indications for low dose CT chest screening have been increasing and more pet tracers have been hitting the market increasing demand for their services.

You really think oligomets are going to make up for prostate and breast going to 5 fx with apm staring us down the barrel?

 

[medgator]

Agree with this... but I will caution you, optimism is usually punished swiftly on this forum.

Unrealistic optimism sure is

 

[metview]

So I asked our radiology friends how they turned things around to see if we could replicate that, but unfortunately, their issues were completely different from ours. The radiology job market improved because of increasing number or retirees and an increase in mid-levels who in turn ordered more imaging, and thus, increasing the demand. In rad onc, it is the complete opposite. Rad oncs are practicing for a longer period of time and there is a decline in the use of radiation given hypofractionation. And most importantly, their issues were not due to residency expansion, while ours are. There is no way to solve this mess unless there is contraction. Not SOAPing is not enough.

Job Market in Radiology

Hello Radiology friends, I come from the rad onc forum. Given the current issues in our field with overexpansion and lack of jobs, I was wondering how Radiology fixed their issues? Correct me if I'm wrong, but I think there was concern about an oversupply of Radiologists/lack of jobs about 10...

forums.studentdoctor.net

 

[RickyScott]

What does immuno being generic or cost of targeted therapy have to do with medonc salaries? Medonc salaries are set by supply and demand like everything else.

 

[Chartreuse Wombat]

from babbachuck
"My honest opinion is that if you see yourself as a multidisciplinary oncologist and not a technician, you will be OK.
You probably shouldn't expect amazing reimbursements back 2000s when IMRT was exploding, but I think it's a very rewarding career. We have a very strong role to play for increasing survival in both local and (increasingly) metastatic disease."

Where is the (new) evidence that local control improves survival...Something new in the last 5 years? In 2021 the major killers where XRT plays a role as local treatment are breast, prostate, lung...all of the research in the last decade has been to lower the number of fractions and get equivalent results...I am happy to be proven wrong but please let me know if there is a new indication for local treatment that improves survival

I think your enthusiasm for improving survival in metastatic disease is not supported by strong evidence. I expect you will say SABR-COMET but I am very concerned that this enormous effect in a very small study will not pan out in the large Phase III trials.

STAMPEDE was a nice surprise in prostate but this evidence is now being marginalized because most men didn't receive SOC systemic therapy. Other trials analogous to STAMPEDE (i.e. treat the primary in the setting of metastatic disease have been negative)

It is fine to be hopeful but given all of the other downward pressures on utilization combined with oversupply.

 

[Chartreuse Wombat]

False positive rate of Phase II has been discussed for decades. This paper was published last millenium

 

[RickyScott]

I think we're generally overconfident in our prognostication 10 years out. We make assumptions about RO in the future using current knowledge of, say, radiology in the present. But clearly when radiology was decreasing in competitiveness 5-10 years ago, people didn't know what the future would hold. If they did, it would have remained competitive throughout. Did we know that immunotherapy and targeted therapies were going to make med onc super competitive, or that IMRT was going to make rad onc super competitive before they happened? Not that I know of.

I think there's too much uncertainty to say for sure that field A is a good bet vs. field B. Will med onc still be lucrative once immunotherapy drugs become generic in 10 years? I suppose that will depend on its advancements in the interim.

I would say that radiation oncology technology is moving at a pretty fast clip and we're better at immobilization and targeting than 5-10 years ago.
Ablating oligometastatic disease is a pretty awesome concept now, and I think it's becoming more widely accepted that it's effective.

Similarly to radiology, RO is also procedure-based and generates revenue for hospital. That should be a good bet.

My honest opinion is that if you see yourself as a multidisciplinary oncologist and not a technician, you will be OK.
You probably shouldn't expect amazing reimbursements back 2000s when IMRT was exploding, but I think it's a very rewarding career. We have a very strong role to play for increasing survival in both local and (increasingly) metastatic disease.

What sane trainee would even take the risk with their career. Risks in radonc are just not on par with other fields no matter how optimistic you are. Trainees in this field face existential career risks that don’t exist anywhere else in medicine.

 

[hal9k]

What sane trainee would even take the risk with their career. Risks in radonc are just not on par with other fields no matter how optimistic you are. Trainees in this field face existential career risks that don’t exist anywhere else in medicine.

For rad onc, there is also no real backup plan. If you don't end up getting a job in rad onc, you really have to retrain or go to another profession, unlike hem/onc/cardiology/GI where you can always just become a hospitalist. You may also end up in a location that is far away from family for the rest of your life. Hope is just not enough to justify those risks.

 

[RickyScott]

Risks in RadOnc are perceived much higher than other fields. I had 3 high caliber residents in my prelim year who switched from RadOnc to Radiology.

I am probably 90% confident that radonc is headed off a cliff in next 5-7 years, but even if my “Bayesian prior”was 10%, I wouldn’t risk my entire career and choose something else. A good radonc means knowing how to balance risk/benifits.

 

[Lamount]

from babbachuck
"My honest opinion is that if you see yourself as a multidisciplinary oncologist and not a technician, you will be OK.
You probably shouldn't expect amazing reimbursements back 2000s when IMRT was exploding, but I think it's a very rewarding career. We have a very strong role to play for increasing survival in both local and (increasingly) metastatic disease."

Where is the (new) evidence that local control improves survival...Something new in the last 5 years? In 2021 the major killers where XRT plays a role as local treatment are breast, prostate, lung...all of the research in the last decade has been to lower the number of fractions and get equivalent results...I am happy to be proven wrong but please let me know if there is a new indication for local treatment that improves survival

To flip the question on its head... are there any recent data showing a solid tumor can be cured without a local therapy? So long as the answer to the question is 'no', and so long as there are unresectable tumors or medically inoperable patients, there will be a role for radiation.

 

[Gfunk6]

Guys, keep in mind that RO are bottom-feeders on the referral chain. The primary source of our referrals will always be Medical Oncology, the majority of whom don't know the difference between traditional mantle fields and ISRT with VMAT and 4D planning. You will be competing with ever emerging immunotherapies and targeted inhibitors.

I would say that I am in the best case scenario in that I am in a multi-specialty group with lots of MOs. However, even I have to plead my case with them to convince them at times to send me patients.

It is simple logic folks, more workers being produced + less work to do = catastrophic job market. You can dance around this issue with all the platitudes you want but it will be brutal and it is only a matter of time. Caveat emptor.

 

[TheWallnerus]

more workers being produced + less work to do = catastrophic job market

Every calculation I've ever posted on here is basically just this statement in numerical form.

 

[medgator]

Guys, keep in mind that RO are bottom-feeders on the referral chain. The primary source of our referrals will always be Medical Oncology, the majority of whom don't know the difference between traditional mantle fields and ISRT with VMAT and 4D planning. You will be competing with ever emerging immunotherapies and targeted inhibitors.

I would say that I am in the best case scenario in that I am in a multi-specialty group with lots of MOs. However, even I have to plead my case with them to convince them at times to send me patients.

It is simple logic folks, more workers being produced + less work to do = catastrophic job market. You can dance around this issue with all the platitudes you want but it will be brutal and it is only a matter of time. Caveat emptor.

No reason for med onc to be sending RO h&n, prostate, skin, heck even breast or skin unless that's the referral pattern you walked into and have no interest in changing. They aren't even involved with the management of much of our bread and butter at all

 

[Chartreuse Wombat]

To flip the question on its head... are there any recent data showing a solid tumor can be cured without a local therapy? So long as the answer to the question is 'no', and so long as there are unresectable tumors or medically inoperable patients, there will be a role for radiation.

Yes but the point was in the context of expanding indications....to mitigate the oversupply

 

[RickyScott]

To flip the question on its head... are there any recent data showing a solid tumor can be cured without a local therapy? So long as the answer to the question is 'no', and so long as there are unresectable tumors or medically inoperable patients, there will be a role for radiation.

Yes but the point was in the context of expanding indications....to mitigate the oversupply

There is also a role for travel agents today, just not as much as in the past.

 

[Lamount]

Yes but the point was in the context of expanding indications....to mitigate the oversupply

Fair point.

At this point, about half of my practice is definitive hypofractionated RT for oligoprogressive disease in the chest. When you are giving someone the best IO money can buy and a large mass is pinching off their LMSB… who are you gonna call??

That is where our future lies… spot welding.