Rad Onc Twitter

Another new chair who only took about a decade to get there. Good for WashU

drowsy12 said:

https://x.com/jordanj65544091/status/1785277310649696621

Click to expand...

I like how the MD salary went down.

Especially if you adjusted for inflation it is even more of a pay cut. This is not a rad onc only problem, it is a medicine problem as a whole. Our profession hasn't even kept up with inflation.

udrag14 said:

I like how the MD salary went down.

Click to expand...

Every one else in the clinic pay is up 50% or more in past 15 years while the physician's is down over 10%. Well done.

I talked to an academic dosimetrists. They had their main job and two remote full time jobs. They said they just planned while at work and on weekends. If you are pulling 100-150k per job, you are approaching MD salaries. Way less school and way more flexibility. It is a great gig right now

A lot of reports have small n and reporting bias

udrag14 said:

I like how the MD salary went down.

Click to expand...

Everything went up in price after covid....except medicare reimbursement.

thecarbonionangle said:

I talked to an academic dosimetrists. They had their main job and two remote full time jobs. They said they just planned while at work and on weekends. If you are pulling 100-150k per job, you are approaching MD salaries. Way less school and way more flexibility. It is a great gig right now

Click to expand...

We had a dosimetrist not too long ago and I sat down at her computer to work on a plan. SHe had her laptop open beside it as well and I looked at the screen and it wasn't our planning system and I thought I was stroking out. I put it together and she was remote planning another hospital and forgot to close it out.

With that said, I didn't say anything to admin because she was a fantastic dosimetrist.

She ended up leaving to go be closer to family but I think these new grads that are very tech savvy are pulling double duty a lot. As you all know CT sims often come in waves, I'll go a day or two with maybe just 1 sim a day, then some days have five. On those slower times the dosimetrists certainly could be pulling double duty and I wouldn't know.

My dosimetrist has multiple other jobs, w2 and 1099.

As long as the work gets done I don’t care. Funny when other docs get bent out shape because the dosimetrist is hustling and making doctor level income, which has been a concern. Good for them.

drowsy12 said:

https://x.com/jordanj65544091/status/1785277310649696621

Click to expand...

lol at 70k for front desk. My old place was paying them like 14 an hour or something.

thecarbonionangle said:

I talked to an academic dosimetrists. They had their main job and two remote full time jobs. They said they just planned while at work and on weekends. If you are pulling 100-150k per job, you are approaching MD salaries. Way less school and way more flexibility. It is a great gig right now

Click to expand...

Maybe rad onc MDs could also get certified in dosimetry as well so we could get in on this double dipping thing.

fiji128 said:

Every one else in the clinic pay is up 50% or more in past 15 years while the physician's is down over 10%. Well done.

Click to expand...

I can't imagine going into medicine in this environment.

thecarbonionangle said:

I talked to an academic dosimetrists. They had their main job and two remote full time jobs. They said they just planned while at work and on weekends. If you are pulling 100-150k per job, you are approaching MD salaries. Way less school and way more flexibility. It is a great gig right now

Click to expand...

Ditto for med physics. Approaching $300k for chief positions in some markets

Mandelin Rain said:

I can't imagine going into medicine in this environment.

Click to expand...

Things can look much better when demand for specialties' services increase rather then constantly decrease.

Mandelin Rain said:

I can't imagine going into radiation oncology/peds/pathology/fp in this environment.

Click to expand...

Ftfy

fiji128 said:

Maybe rad onc MDs could also get certified in dosimetry as well so we could get in on this double dipping thing.

Click to expand...

I've looked into this.

A lot.

Unfortunately, and similar to the Palliative Care cert, there is no longer a "practical pathway" to sit for the exam based on experience.

Now, I stopped short of contacting the AAMD to see if an exception could be made for physicians because I assume no one has asked before...it does remain on my long-term, "potential to-do list".

However, there doesn't really appear to be any regulations around this, other than perhaps something like APEx. There's no overt prohibition on a RadOnc working as a Dosimetrist - and there are, of course, the tales floating around of a solo RadOnc here and there doing their own Dosimetry for their practice.

The real world is the Wild West.

fiji128 said:

Things can look much better when demand for specialties' services increase rather then constantly decrease.

View attachment 386133

Click to expand...

Fair.

fiji128 said:

Things can look much better when demand for specialties' services increase rather then constantly decrease.

View attachment 386133

Click to expand...

Wow! Looks like I’ve chosen the wrong “Rad”😂 is it even possible to pull this kind of money as a rad onc nowadays unless you’re a chair or a boomer with a well-established busy PP?

It's actually a pathway to combat the overtraining if you think about it.
Instead of reducing resident numbers, because that would be way too simple, instead have the residents spend a year on dosimetry, so when they get pumped out by the hundreds and only have 5-10 OTVs a week, they will have plenty of time to do their own plans and supplement their income with what dosimetry was being paid.

MidwestRadOnc said:

It's actually a pathway to combat the overtraining if you think about it.
Instead of reducing resident numbers, because that would be way too simple, instead have the residents spend a year on dosimetry, so when they get pumped out by the hundreds and only have 5-10 OTVs a week, they will have plenty of time to do their own plans and supplement their income with what dosimetry was being paid.

Click to expand...

I can see this happening and better use of time during residency.

RadOncDoc21 said:

I can see this happening and better use of time during residency.

Click to expand...

Because god knows it Will never be integrated with medical oncology

DrProtonX said:

Wow! Looks like I’ve chosen the wrong “Rad”😂 is it even possible to pull this kind of money as a rad onc nowadays unless you’re a chair or a boomer with a well-established busy PP?

Click to expand...

Chair? Yes. Do not sell yourself short. There really is no limit to enriching yourself at the expense of the growing junior RO masses. You could be the first chair to get someone to pay you to work for you. A "visiting student-attendingship", or something.

MidwestRadOnc said:

It's actually a pathway to combat the overtraining if you think about it.
Instead of reducing resident numbers, because that would be way too simple, instead have the residents spend a year on dosimetry, so when they get pumped out by the hundreds and only have 5-10 OTVs a week, they will have plenty of time to do their own plans and supplement their income with what dosimetry was being paid.

Click to expand...

Yes. It would be a SIGNIFICANTLY better use of time in residency, from just a pure educational perspective - even if someone never ends up opening the Optimizer section of whatever TPS they use for the entire career.

But also, there's the possibility - the unspoken possibility - you end up in a situation without a Dosi/Physics arrangement that can produce minimally competent plans for your patients, and it's either do it yourself or be OK with the plan isocenter being set 7cm off the actual isocenter, etc etc etc

DrProtonX said:

Wow! Looks like I’ve chosen the wrong “Rad”😂 is it even possible to pull this kind of money as a rad onc nowadays unless you’re a chair or a boomer with a well-established busy PP?

Click to expand...

It’s possible to pull that money but almost impossible to get that 9-11 weeks PTO with it

TheWallnerus said:

It’s possible to pull that money but almost impossible to get that 9-11 weeks PTO with it

Click to expand...

Yeah it is possible. It is also possible to win the lottery. If you look at the MGMA data, most people clearly make less. I know more people at the median than at 600+.

thecarbonionangle said:

Yeah it is possible. It is also possible to win the lottery. If you look at the MGMA data, most people clearly make less. I know more people at the median than at 600+.

Click to expand...

$750K salary = 1 in 100
$750K salary and 11 weeks PTO = 1 in a million
Kids going into rad onc now... I'm saying there's a chance

thecarbonionangle said:

Yeah it is possible. It is also possible to win the lottery. If you look at the MGMA data, most people clearly make less. I know more people at the median than at 600+.

Click to expand...

We all run in different circles and locations but with my closer friends from residency (scattered all over the country albeit no huge cities) if you're at 600 you are at the bottom of the compensation/comparison. Guess we all just got lucky. I am fortunate and unfortunate to know quite a few radoncs with these "unicorn" type jobs at least on the pay front.

metallica81788 said:

We all run in different circles and locations but with my closer friends from residency (scattered all over the country albeit no huge cities) if you're at 600 you are at the bottom of the compensation/comparison. Guess we all just got lucky. I am fortunate and unfortunate to know quite a few radoncs with these "unicorn" type jobs at least on the pay front.

Click to expand...

Agree. Flyover country and coasts are very different.

MidwestRadOnc said:

Agree. Flyover country and coasts are very different.

Click to expand...

Most graduates will never be interested in fly over. The ones who state they are are currently single mostly. Life changes and you get a partner, they have a career too. You have kids and all of a sudden need help and need to be closer to family or in better schools etc etc. Life comes at you fast.

I work in a "desirable" area and no question the income opportunities for enterprising dosimetrists and physicists exceeds that of physicians. Many dosimetristd covering multiple sites. Of course, that's totally illegal per RonD if they aren't billing the services from the location they are performing the planning.

Reaganite said:

I work in a "desirable" area and no question the income opportunities for enterprising dosimetrists and physicists exceeds that of physicians. Many dosimetristd covering multiple sites. Of course, that's totally illegal per RonD if they aren't billing the services from the location they are performing the planning.

Click to expand...

Doesn't Varian offer remote dosimetry?

Lol at RonD mansplaining to Varian.

MidwestRadOnc said:

Doesn't Varian offer remote dosimetry?

Lol at RonD mansplaining to Varian.

Click to expand...

Hmmm a varian qui Tam could be worth billions? RonD can be our expert witness and maybe we can get in on the selfie?

MidwestRadOnc said:

Doesn't Varian offer remote dosimetry?

Lol at RonD mansplaining to Varian.

Click to expand...

Yes they do. Remote planning widespread and totally legit. Ron D should stick to mansplaining the benefits of heavy ion therapy on X

medgator said:

Yes they do. Remote planning widespread and totally legit. Ron D should stick to mansplaining the benefits of heavy ion therapy on X

Click to expand...

Varian now employs more medical physicists than any entity in the world

You want Varian to do your physics for a year at your two linac center? And keep a physicist on site? One million minimum price of entry

Varian/Siemens all in on remote planning (and AI stuff etc)

They also own 16 radiation centers in India treating 70,000 people a year (second largest cancer care provider in that country)

We are living in interesting times (the Chinese curse!)

evilbooyaa said:

Hallahan retiring? I wonder if he succeeded in dropping clinical ROs salaries sufficiently during his tenure.

Michalski always the bridemaid, never the bride?

Wonder if Karam can slow down the hemorrhaging of Rad Onc talent out of Wash U. Although I see that they've recently got some good pickups from other facilities...

Click to expand...

did michalski want the chair position? the guy spent his career as Perez's b and invested so much time w/astro, advocating advantages/profits for large medical systems to the detriment of 95% of his colleagues, and this is his reward?

elementaryschooleconomics said:

But also, there's the possibility - the unspoken possibility - you end up in a situation without a Dosi/Physics arrangement that can produce minimally competent plans for your patients, and it's either do it yourself or be OK with the plan isocenter being set 7cm off the actual isocenter, etc etc etc

Click to expand...

I feel personally attacked

RickyScott said:

did michalski want the chair position? the guy spent his career as Perez's b and invested so much time w/astro, advocating advantages/profits for large medical systems to the detriment of 95% of his colleagues, and this is his reward?

Click to expand...

Bootlickers are not always rewarded. He can keep bringing the diet coke when the button is pressed

RickyScott said:

did michalski want the chair position? the guy spent his career as Perez's b and invested so much time w/astro, advocating advantages/profits for large medical systems to the detriment of 95% of his colleagues, and this is his reward?

Click to expand...

Yes he did, but WashU was always going to go with someone with R01 grants and a translational science background. They always have and always will.

Neuronix said:

Very kind to say so.

Maybe in a few years if someone wants me.

I'm not ready yet. It's not my goal to be chair--seems like a major headache.

My goal is to be a physician-scientist. The only reason I'd do it would be to help others be physician-scientists.

Click to expand...

Yep. Chair, POTUS, no thanks

elementaryschooleconomics said:

I've looked into this.

A lot.

Unfortunately, and similar to the Palliative Care cert, there is no longer a "practical pathway" to sit for the exam based on experience.

Now, I stopped short of contacting the AAMD to see if an exception could be made for physicians because I assume no one has asked before...it does remain on my long-term, "potential to-do list".

However, there doesn't really appear to be any regulations around this, other than perhaps something like APEx. There's no overt prohibition on a RadOnc working as a Dosimetrist - and there are, of course, the tales floating around of a solo RadOnc here and there doing their own Dosimetry for their practice.

The real world is the Wild West.

Click to expand...

There are no regulations of who can do dosimetry other than HR. Ultimately no one cares who did the plan, bc the Rad Onc is responsible. But don't begrudge the current slate of dosimetrists making as much bank as possible. The profession won't disappear but the current numbers will no longer be necessary. Writing has been on the wall for 15 years, but starting to see quality auto-planning solutions emerging from the Varians and Raysearch companies of the world. I feel sorry for those who just paid the CMD school fees over the last several years and don't have an RTT to fall back on, or some other profession.

HolySmokes said:

I feel personally attacked

Click to expand...

If only people knew what was happening in the Wild West...

(this also is a big component of my opinion on supervision, in that the horrifying atrocities I've seen/experienced under the guise of "Dosimetry" and "Physics" could not be fixed by any form of supervision...only me, learning on the fly how to be my own Dosimetrist...)

elementaryschooleconomics said:

If only people knew what was happening in the Wild West...

(this also is a big component of my opinion on supervision, in that the horrifying atrocities I've seen/experienced under the guise of "Dosimetry" and "Physics" could not be fixed by any form of supervision...only me, learning on the fly how to be my own Dosimetrist...)

Click to expand...

If you're a rural doc I don't see on site dosimetry as being a good option. Maybe you get very lucky but for the most part it's not very qualified people as opposed to having some badass do things remotely.

I did locums once in the middle of nowhere and was given a garbage plan by the dosimetrist without a scorecard. I asked her to work on it and make a scorecard, and the answer was no. Eye opening.

Ray D. Ayshun said:

If you're a rural doc I don't see on site dosimetry as being a good option. Maybe you get very lucky but for the most part it's not very qualified people as opposed to having some badass do things remotely.

Click to expand...

I'm not sure why remote dosimetry isn't bigger than it is.

i have had fleeting thoughts abt doing remote dosimetry. I think I can plan 3x faster and better than most and could probably make a killing on a per plan basis.