ASTRO vs. ACRO

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thesauce

thesauce

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Is anyone here able to help me to understand the difference between ASTRO and ACRO and specifically the focus of each one of these organizations?

ASTRO was crammed down our throat in residency as the best of the two, but their recent focus on things that frankly don’t help our specialty has gotten me a little concerned and looking for a change. Can anyone speak to ACRO and what makes them better/different?
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ACRO has a much better and egalitarian focus on legislative efforts (a good PAC) on preventing payments cuts to ALL of rad onc, academic and community. They make a compelling case they have been a lot more effective than ASTRO in this regard (citations needed).
 
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Hopefully it doesn't become a left vs. right thing. I am hopeful that ASTRO's all-in embrace of DEI and critical race theory will unite us as I believe the vast majority of us on all sides of the spectrum can appreciate that judging (or at least identifying and separating) people based on their immutable characteristics/skin melanin is wrong at a basic moral level.
 
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I don't want to elaborate too much on this, simply because I don't think it has much meaning on the present and future (I'm an ACRO member myself, definitely not an ASTRO member):

ACRO was started - allegedly - after there was some leveraging of industry relationships for personal gain, which caused either being blocked from becoming FASTRO or being kicked out entirely (I don't remember, it's been awhile since I've thought about this). Obviously, ACRO wasn't exclusively founded by a single person, and I've never tried to be so deep in the gossip that I have a "black book" of names, and honestly I've assumed that there has always been some percentage of RadOncs unhappy with ASTRO.

So putting together various stories I've heard, I think the original group was like...the original misanthropes. ASTRO doesn't like misanthropes.

But the people who taught most of us, the people who did residency in the 1980s - they knew this story because they knew these people. So that's the reason ACRO is often looked down upon in residency, or at least: this is the only thing that can explain the weird snubbing of ACRO.

I think this has absolutely no effect on the organization today, and I'm just sharing what I've heard because I'm tired of seeing ACRO catch attitude for some weird stuff that went down before the first Gulf War.
 
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"Today, ASTRO announced that our CEO, Laura Thevenot, plans to retire at the end of this year after leading the organization since 2002. During Laura’s tenure at ASTRO, membership grew by over 50% to its current level of more than 10,500 physicians, biologists, physicists, radiation therapists, dosimetrists and other health care professionals."

"It has been my privilege to work on behalf of our ASTRO members these past 22 years. "

a new hope?
 
winstonfoot5 said:
"Today, ASTRO announced that our CEO, Laura Thevenot, plans to retire at the end of this year after leading the organization since 2002. During Laura’s tenure at ASTRO, membership grew by over 50% to its current level of more than 10,500 physicians, biologists, physicists, radiation therapists, dosimetrists and other health care professionals."

"It has been my privilege to work on behalf of our ASTRO members these past 22 years. "

a new hope?
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Is she stepping down because SDN (and online anonymous twitter accounts) published her salary as being a cool 750k/yearly simply to continue to guide RO as a field further into the bottomless pit?

Many are saying!
 
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winstonfoot5 said:
"Today, ASTRO announced that our CEO, Laura Thevenot, plans to retire at the end of this year after leading the organization since 2002. During Laura’s tenure at ASTRO, membership grew by over 50% to its current level of more than 10,500 physicians, biologists, physicists, radiation therapists, dosimetrists and other health care professionals."

"It has been my privilege to work on behalf of our ASTRO members these past 22 years. "

a new hope?
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She’s a saleswoman. Her job is into increase sales of a dubious product. It’s not about advocacy for the field or patients.
 
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I am pretty sure that with any corporation, the CEO oversees all aspects the operations - not only sales. Usually all the C_Os report to the CEO - CMO, COO, CFO, CTO ... and if there not people with those (or similar) titles, the CEO takes on those roles.
 
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I would guess the CEO position at something like astro is not exactly the same as a CEO of a profit seeking corporation. Many of the things people get upset about with astro probably has more to do with the board's leadership/guidance.
 
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I don't know whether shifting $$ from ASTRO to ACRO changes anything. I am uncertain that these organizations do a whole lot of valuable things. Maybe some successful lobbying to protect us at times, but I don't know. ASTRO is acting against our best interests many times. ACRO is neutral at best - I don't see what they've accomplished since IGRT lobbying (which did help us immensely).

Time will tell.

I'm a member of neither at moment.
 
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RealSimulD said:
I don't know whether shifting $$ from ASTRO to ACRO changes anything. I am uncertain that these organizations do a whole lot of valuable things. Maybe some successful lobbying to protect us at times, but I don't know. ASTRO is acting against our best interests many times. ACRO is neutral at best - I don't see what they've accomplished since IGRT lobbying (which did help us immensely).

Time will tell.

I'm a member of neither at moment.
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I would agree. I generally caution against falling into the trap that ACRO is some special group. They’re just like any other group. They exist to earn more money than they spend, that’s it. People at the top of ACRO have many of the same biases and relationships as those involved with Astro. Act accordingly.
 
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drowsy12 said:
I would agree. I generally caution against falling into the trap that ACRO is some special group. They’re just like any other group. They exist to earn more money than they spend, that’s it. People at the top of ACRO have many of the same biases and relationships as those involved with Astro. Act accordingly.
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well the main difference as I see it is the implicit support for residency expansion is not present in acro.
 
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RickyScott said:
well the main difference as I see it is the implicit support for residency expansion is not present in acro.
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Explicit

"Today, ASTRO announced that our CEO, Laura Thevenot, plans to retire at the end of this year after leading the organization since 2002. During Laura’s tenure at ASTRO, membership grew by over 50% to its current level of more than 10,500 physicians, biologists, physicists, radiation therapists, dosimetrists and other health care professionals."

"It has been my privilege to work on behalf of our ASTRO members these past 22 years. "
 
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Ray D. Ayshun said:
Explicit

"Today, ASTRO announced that our CEO, Laura Thevenot, plans to retire at the end of this year after leading the organization since 2002. During Laura’s tenure at ASTRO, membership grew by over 50% to its current level of more than 10,500 physicians, biologists, physicists, radiation therapists, dosimetrists and other health care professionals."

"It has been my privilege to work on behalf of our ASTRO members these past 22 years. "
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That's fairly hilarious actually.

Yesterday, January 8th: "We doubled the number of RadOncs, huzzah"
Today, January 9th: "We built this pretend coalition because of payment cuts"

We can mark January 2024 as the time when ASTRO acknowledged double the docs for significantly less reimbursement.

Really strong work, guys.
 
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elementaryschooleconomics said:
Yesterday, January 8th: "We doubled the number of RadOncs, huzzah"
Today, January 9th: "We built this pretend coalition because of payment cuts"

We can mark January 2024 as the time when ASTRO acknowledged double the docs for significantly less reimbursement.
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med students might be wet behind the ears, but no ones doubted their ability to do basic math
 
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RealSimulD said:
I don't know whether shifting $$ from ASTRO to ACRO changes anything. I am uncertain that these organizations do a whole lot of valuable things. Maybe some successful lobbying to protect us at times, but I don't know. ASTRO is acting against our best interests many times. ACRO is neutral at best - I don't see what they've accomplished since IGRT lobbying (which did help us immensely).

Time will tell.

I'm a member of neither at moment.
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One is bad and the other is potentially not bad. I will take the latter.
 
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drowsy12 said:
I would agree. I generally caution against falling into the trap that ACRO is some special group. They’re just like any other group. They exist to earn more money than they spend, that’s it. People at the top of ACRO have many of the same biases and relationships as those involved with Astro. Act accordingly.
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Nothing I've seen policy or proposal wise from ACRO has been remotely as anti community/PP as the crap ASTRO and ASTRO PAC has been pushing for nearly 2 decades.

Was acro anti urorads or anti physician ownership of linacs (via trying to the eliminate the IOAE stark exemption)? ASTRO PAC was.

Was acro fraction-shaming and IMRT-shaming us with BS "choosing wisely" edicts while giving proton centers carte blanche with no prospective Randomized data to support their treatment? ASTRO did

Overtraining too many residents with too many unnecessary/low-quality training programs and then embracing nonsense igrt/physician supervision policies to help artificially prop up the job market? ASTRO again!
 
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Fair enough, I don't know enough about ACRO's history to know about their public statements on UroRads or residency training. I do know there are many people in academic leadership who attend and speak at the conferences.
 
drowsy12 said:
Fair enough, I don't know enough about ACRO's history to know about their public statements on UroRads or residency training. I do know there are many people in academic leadership who attend and speak at the conferences.
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Not doing anything I've listed above is good enough in my book. As @RealSimulD has pointed out, ASTRO is never going to let a community person go anywhere in that organization, too much academic rot, best to support an organization that at least pretends to be about those practicing out in the community
 
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Any input regarding ARS? All I know is that they have the best locations in regards to their meetings.
 
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I see zero reason for any community rad onc to be involved with ASTRO at this point. They don't represent me from a professional standpoint and definitely not from a sociopolitical standpoint (which they shouldn't even be involved with in the first place).
 
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MidwestRadOnc said:
I see zero reason for any community rad onc to be involved with ASTRO at this point. They don't represent me from a professional standpoint and definitely not from a sociopolitical standpoint (which they shouldn't even be involved with in the first place).
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And their annual fees are crazy expensive! Even though I have a generous amount of CME/Professional society reimbursement funding… I can’t support that product!
 
5000 physicians paying 1000_$ year = 5 mill. Decent percentage of physician dues going to ceo salary?
 
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NotMattSpraker said:
Im not sure if you know this, but consultants are expensive. So.
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There's McKinsey's consulting model, which is questionable enough.
And then there are DEI/anti-racist "consultants"

The mafia figured this out a long time ago. This "if you want to continue to exist, pay us" racket. Oh yeah, and we got a couple of guys you're gonna hire,, Vinnie and Fredo, they're good guys. Real good guys, don't like any trouble, they're uh, gonna hang around your shop now and make sure everything runs smoothly. Make sure everyone gets along real nice, you know.

Yeah, you can charge more under that model.
 
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MidwestRadOnc said:
There's McKinsey's consulting model, which is questionable enough.
And then there are DEI/anti-racist "consultants"

The mafia figured this out a long time ago. This "if you want to continue to exist, pay us" racket. Oh yeah, and we got a couple of guys you're gonna hire,, Vinnie and Fredo, they're good guys. Real good guys, don't like any trouble, they're uh, gonna hang around your shop now and make sure everything runs smoothly. Make sure everyone gets along real nice, you know.

Yeah, you can charge more under that model.
Click to expand...

The workforce consultant has to be the most embarrassing example of all.

They paid a lot of money, tried to spin the results, then buried the real discussion. From a practical perspective like... what did we learn from this consulting? For all intents, the workforce study never happened. The best discussion about the results and how they can impact our field was literally erased, it never happened. In the absence of an explanation, I just have to assume someone on the board or elsewhere in the organization didnt like it.

Im sure they still had to pay the bill though. And now membership dues are higher.

Even if you assume the best intents, this is a complete fumble and failure to execute the goal. Administrative malpractice basically, and life just goes on.

That alone, Im holding on to my money and giving it to more effective people.
 
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Don't forget they buried the presentation. That still warms my heart.
 
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thesauce said:
It is. It just doesn’t help anybody or our field as a whole.
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Oh interesting. People have said this to me, but I don't see why paying a membership fee to anything intrinsically helps "the field". Can you expand on that?

I feel like I help people and the field the same pre and post ASTRO membership. Im just $700 richer and no one calls me names on Twitter. Well maybe less people call me names.
 
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NotMattSpraker said:
Oh interesting. People have said this to me, but I don't see why paying a membership fee to anything intrinsically helps "the field". Can you expand on that?

I feel like I help people and the field the same pre and post ASTRO membership. Im just $700 richer and no one calls me names on Twitter. Well maybe less people call me names.
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Astro yes. Because they suck.

Acro - I don’t know. But assuming they fight cuts, residency expansion, etc. they need money to lobby. That’s how your money helps.
 
thesauce said:
Astro yes. Because they suck.

Acro - I don’t know. But assuming they fight cuts, residency expansion, etc. they need money to lobby. That’s how your money helps.
Click to expand...

Yea, I just think reframing this discussion with the question "what does a society do for me?" is a lot healthier. We have to figure out a way to get physicians to believe in their own power and importance.

If you're interested in policy and you believe the US is pay to play, it's worth knowing that the AMA is the only society doing lobby spending near the other "stakeholders" (pharma, hospitals). They seem like they will deliver on some MPFS pay improvements in 2024.

The story of why we will likely never have legislation to fix The Match is fascinating and kind of sad. Carmody has a great write up: The Match, Part 5: The Lawsuit
 
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RickyScott said:
They erased the workforce presentation from the online virtual meeting?
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Correct.

The reason you don't know this is because they did it secretly.

It was recorded, like normal, during the 2023 conference.

It was uploaded, like normal, with the rest of the sessions from that day.

It was available, like normal, for 1-2 weeks after the conference.

One morning, someone attempted to go watch the Workforce Taskforce panel presentation. Only to discover it was not available.

Glossing over salacious details (such as ASTRO officials choosing to respond only to specific people inquiring what happened), the claim was put forth that it was "being taken down for review after a small compliance issue was identified".

They pretended, perhaps for a day or so, that it would go back online.

It will never go back online.

They have never discussed what happened. Nor will they ever.

Without question, it benefits RadOnc to NOT be a member of ASTRO. With the current structure of that organization, funding ASTRO is actively harming the field.

However, they can change, and I will happily go back to being a dues-paying member should the organization rediscover rational thought.
 
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1704980814364.png


(this X post is still public, I just redacted names because this person doesn't need to get dragged into these shenanigans)
 
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elementaryschooleconomics said:
Correct.

The reason you don't know this is because they did it secretly.

It was recorded, like normal, during the 2023 conference.

It was uploaded, like normal, with the rest of the sessions from that day.

It was available, like normal, for 1-2 weeks after the conference.

One morning, someone attempted to go watch the Workforce Taskforce panel presentation. Only to discover it was not available.

Glossing over salacious details (such as ASTRO officials choosing to respond only to specific people inquiring what happened), the claim was put forth that it was "being taken down for review after a small compliance issue was identified".

They pretended, perhaps for a day or so, that it would go back online.

It will never go back online.

They have never discussed what happened. Nor will they ever.

Without question, it benefits RadOnc to NOT be a member of ASTRO. With the current structure of that organization, funding ASTRO is actively harming the field.

However, they can change, and I will happily go back to being a dues-paying member should the organization rediscover rational thought.
Click to expand...
#DefundASTRO
 
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elementaryschooleconomics said:
View attachment 380850

(this X post is still public, I just redacted names because this person doesn't need to get dragged into these shenanigans)
Click to expand...

This is likely why I will never be a member of ASTRO, regardless of leadership change. They would have to come out and acknowledge their trash culture in the past and how they will fix it for me to even consider it.

They did the same exact thing of white lies and internet editing with the SCAROP survey when I tried to buy it, which by the way, they have not released and continue to conduct.
 
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Minor Compliance Issue. GREAT murky term.

next time I want to skip my wife's work Christmas party, I'll blame a minor compliance issue. no questions asked!
 
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Can somebody explain this conspiracy theory in detail to someone who hasn't followed anything ASTRO related in years? Very slowly please.
 
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Okay, so if you can tolerate me yelling about protons just a little more. This is a very interesting editorial in JAMA Onc out recently from some authors that are almost certainly part of the "proton lobby". I don't mean that totally pejoratively, Steven Frank has done a lot for the field of particle therapy and has been a very vocal advocate and executive director of NAPT. Hes in the club.

The editorial is very interesting and we could have some great trial design convo, but here is the key paragraph.

So the foundational point of their argument is not that RCTs show benefit of protons for HN, it's that ASTROs policy says its necessary. He wrote the policy and as we all know, support for HN proton therapy is retrospective or dosimetric, RCTs are pending.

As an aside, they seem to also argue that PFS is the same for photons and protons. But just a few years ago Frank wrote a narrative implying that "stakeholders" forced a PFS primary end point for the US randomized trial.

Im not sure if he thinks PFS is different or is not different! (I can guess what he thinks)

If you go back in the literature, this debate has been ongoing for like 25 years. Have the anti-RCT folks won through regulatory capture?

Lame if so.

jamanetwork.com

The Case for Allowing Proton Beam Therapy on Head and Neck Cooperative Group Studies

This Viewpoint present the case for revisiting the proscription of proton beam therapy in trials of patients with de novo, nonmetastatic head and neck cancer.
jamanetwork.com jamanetwork.com

1704991425238.png
 
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RickyScott said:
is proton radionecrosis mentioned?
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No but I think that would be outside scope of the article. The main argument is that ongoing trials in the HN space should be amended to allow for proton therapy. In some settings this is a reasonable argument. In others it is not. They give 3 examples where the protocols are already being amended. I think adding it to HN001 that is testing a biomarker strategy is very reasonable. On the other hand, adding it to RTOG 1008, which is testing whether chemo should be added to salivary gland treatments... thats seems nuts (assuming you believe protons improve HN radiation toxicity).

I understand the frustration he is dealing with day to day and my guess is that is what is driving this editorial. It is really hard to enroll patients to proton trials. But in my experience the main reason is because they hear ads about how it is so much better!

Stopping the ads seems a way better strategy than whatever this editorial is supposed to be (in my opinion).
 
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MidwestRadOnc said:
Can somebody explain this conspiracy theory in detail to someone who hasn't followed anything ASTRO related in years? Very slowly please.
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Which part? The Workforce thing?

There's really nothing more to tell. I'm not kidding, from the outsider perspective, that's the sum total of what happened.

Panel presentation took place, was recorder, was available online. 1-2 weeks later taken down without notice. Accidentally discovered by someone trying to watch it. ASTRO contacted, response as above ("compliance"), no additional clarifications have ever been offered, panel presentation deleted forever.

Now, if you want to talk about Grassy Knoll theories....
 
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