Medical oncology at a glance

Medical oncology at a glance

Central pay range: MGMA 25th and 75th percentiles, 2001–$204,000 to $479,000. AMGA 20th and 80th percentiles, 2001–$178,000 to $288,000.

Pay direction: Upward for new fellowship grads and most experienced people in this relatively high-income specialty. Evidence of upward strides comes from MGMA, AMGA, Sullivan, Cotter, and practice managers. But falling profit margins on chemotherapy drugs are limiting income increases for groups. Driving income increases is the seeming epidemic of many types of cancer, including breast and prostate, and much increased incidences of disease among children and patients below age 40. Some health demographers, including those at CDC, predict cancer will replace heart disease as nation’s top killer some time between 2010 and 2020. Underlying the unusually wide breadth of income–MGMA 75th percentile income exceeds 25th percentile by 135%–is gap between physicians who share ownership in delivering chemotherapy drugs (and therefore share in drug markups) and those whose incomes are based strictly on professional fees. For those who do share in markups, income from drugs often is 25% to 50% of total professional income. The drugs are extremely expensive, and as a result oncology is the highest-cost specialty measured by overhead as a percent of revenue, even more expensive than primary care and ob/gyn.

Clinical practitioners: 19,000 to 21,000.

Entries to and exits from field per year: No good data, but exits on rise as many experienced oncologists approach retirement age. New people have done internal medicine residency, then three-year hematology/ oncology fellowship.

What oncologists do/subspecialties: Treat cancer of all kinds. Medical oncologists most commonly choose and supervise course of chemotherapy for patients, while radiation oncologists administer radiation treatments. Most oncologists are also hematologists, who deal with non-cancer blood diseases such as anemia as well as blood cancers such as leukemia.

Common reimbursement methods: Fee-for-service is most common. There is some global billing for episodes of cancer, because oncologists and staffs increasingly must provide informal counseling and testing to be sure patients can withstand bouts of “chemo.”

Common group structures: Full range of single and multispecialty.

Main professional society: American Society of Clinical Oncology, Alexandria, Va., (703) 299-0150, www.asco.org.

Previous PCR items on hematologist/oncologists: (1) compensation indicators, 10/01, p. 9; (2) factors affecting compensation, 9/01, p. 2; (3) income-sharing system between US Oncology and its affiliated groups, 7/01, p. 1; (4) compensation trends in 2000, 11/29/00, p. 3; (5) compensation trends in 2001, 1/02, p. 5; (6) MGMA oncologist cost survey, 6/02, p. 5; (7) US Oncology role in oncology market and as recruiter, 10/02, p. 5; (8) compensation indicators, 1/03, p. 5.

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