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Why Academic Divisions of Hematology/Oncology Are in Trouble and Some Suggestions for Resolution

From the Division of Hematology/Oncology, Department of Internal Medicine, Department of Medicine, Medical College of Virginia Campus of Virginia Commonwealth University, Richmond, VA.

Address reprint requests to T. Smith, MD, Division of Hematology/Oncology, 1101 E. Marshall St, MCV Box 980230, Richmond, VA 23298-0230; email tsmith{at}hsc.vcu.edu

PURPOSE: Academic divisions of hematology/oncology seem to have difficulty recruiting and retaining excellent productive clinicians. A major reason for this is that salaries do not compete with the private sector for similar work.

METHODS: We reviewed divisional finances productivity, and experiences from faculty members leaving.

RESULTS: The academic salaries are approximately one third of practice because the chemotherapy concession has been given to the academic hospital. In addition, there may be substantial problems in under-billing, lack of attention to detail in billing, and poor collection practices.

CONCLUSION: Academic practice still has much to offer, including opportunities for research and multidisciplinary team management, although the differences may narrow over the coming years. Attention to detail in the billing, collection for work performed, and increasing academic salaries to levels nearer to private practice are necessary components of the solution to recruit and retain quality pro-ductive clinicians.

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