I think you’re overestimating the enthusiasm of rural centers to have full remote coverage. Every hospital wants a face of their program and every hospital wants their patients to be seen in person at least most of the time. They want someone who is going to “be part of the local community” and who will build the practice. We have CMS approval of virtual supervision currently and hospitals aren’t embracing this. There are plenty of Radiation Oncologists who would be eager to do full-time remote clinical work if this were truly an option.
Correct.
This is my exact scenario.
Obviously, I'm about as pro "Virtual Direct" as anyone could be.
When I first came to my solo, 5-day-a-week job, I had dreams of convincing the hospital of letting me do one day/week as virtual/WFH.
Within...maybe a week? Maybe two weeks? I realized it wouldn't be something I could even admit I was thinking about.
This is incredibly weird to say - and even weirder to experience - but you become a local celebrity. Quickly. Very quickly.
As in, less than a month after coming here, my spouse gave our last name to check in for a haircut. Some random lady sitting in the waiting room overhears it and starts talking about seeing me on some random advertisement the hospital had put me in. That means this lady - who was not a patient - had to see the advertisement, read it enough to memorize my name, and then immediately recognize my name out in "the wild", weeks later, to correctly identify my spouse.
People know my car, and will tell me their sister saw me in the Home Depot parking lot the other day. Which means the sibling/friend/whatever not only recognized my vehicle, but then talks about my vehicle/where I've been.
By maybe...the third month, ~75% of my new patient consults would tell me that I had seen/treated a family member or friend of theirs.
I cannot emphasize enough how important this additional awareness/skillset is for the hospital and the community. This is a sharp, sharp, sharp sword.
You know how we all know "bad" doctors, but it's hard for non-doctors to tell? And we all know bad doctors with good bedside manner so patients love them, right?
This is the first time I've seen random, low-health literacy people in the community know who the "bad" doctors are, and ask me to make sure I send them elsewhere if they need that kind of specialist.
A lot of my patients have dial-up internet. Or no internet. I don't ever have to worry about people finding out their test results before I do because, at most, 10% of my patients use the hospital portal. Most don't even know what that is if you ask them.
It would not be received well if the "young, new, hotshot doctor" who took over for the community pillar that was the prior RadOnc who retired "worked from home" every week.
Now obviously, if my hospital - or the rural hospital category in general - couldn't recruit a permanent RadOnc, then yeah, having some sort of locums/TeleRadOnc setup would basically be their only choice. Patients would still come here, but you can bet a billion dollars a lot of people would choose to drive a little further for the linac being run by the in-person permanent RadOncs.
I will definitely, one day, push for some level of "virtual" workday setup.
Mentally, I've sort of earmarked 2030 to start that conversation.