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ASTRO 2023

Started by yesmaster
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dieABRdie said:
Any discussion of the ROCR?

Advocacy Radiation Oncology Case Rate Program - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

The ASTRO-proposed Radiation Oncology Case Rate (ROCR) program represents a bold initiative to reverse disastrous payment trends that are expected to continue.
www.astro.org www.astro.org
Click to expand...
They basically rehashed their existing stuff. Almost nothing worth mentioning (because it's already out there)...but they finally gave a timeline:

1696475513077.png


I would like to point out the last bullet point of Q4 2023: "Possible Bill Introduction"

We are currently in Q4 2023.

Really doing great with this ASTRO. Really working hard to garner support for your little project here.

I've put more effort into publishing case reports in a low-tier journal than this.
 
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First and foremost, the emphasis IMO needs to be on indexing anything we get reimbursed for to inflation.

Not unique to rad onc, but EVERY cost, from hardware to labor/salaries has risen substantially....but medicare reimbursement has not. Staff want higher salaries but where will it come from? See Kaiser strike today.

We're looking at 10 to 30 year treasury rates at nearly 5%+....which suggests inflation may be here to stay. We have GOT to index anything (be it ROCR) or fee for service to inflation or we're going to get crushed.

If we "lock in" with legislation some reimbursement rate....it could be a disaster in a persistent inflation environment.
 
elementaryschooleconomics said:
I've put more effort into publishing case reports in a low-tier journal than this.
Click to expand...
Time line is worrisome. They may in fact know what they are doing (which is worse).

It's all about who you know. Do community radiation oncologists without protons matter? Of course not. One advocate at MDACC is more significant than 4000 community radoncs not associated with prestige institutions.

Lame-duck session is the right target. Rich people love protons. Bipartisanship on something viewed as a rounding error to legislature (and our whole world to us) is very possible.

Edit: Please note that nothing in the timeline includes us, outside of second quarter 2023 solicitation of feedback. I believe SK did that right here!
 
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BobbyHeenan said:
First and foremost, the emphasis IMO needs to be on indexing anything we get reimbursed for to inflation.

Not unique to rad onc, but EVERY cost, from hardware to labor/salaries has risen substantially....but medicare reimbursement has not. Staff want higher salaries but where will it come from? See Kaiser strike today.

We're looking at 10 to 30 year treasury rates at nearly 5%+....which suggests inflation may be here to stay. We have GOT to index anything (be it ROCR) or fee for service to inflation or we're going to get crushed.

If we "lock in" with legislation some reimbursement rate....it could be a disaster in a persistent inflation environment.
Click to expand...

I wouldn't hold my breath: It's been pretty obvious over the last 15 years that radonc leadership has zero (0) understanding of the basic concepts of economics.
 
BobbyHeenan said:
First and foremost, the emphasis IMO needs to be on indexing anything we get reimbursed for to inflation.

Not unique to rad onc, but EVERY cost, from hardware to labor/salaries has risen substantially....but medicare reimbursement has not. Staff want higher salaries but where will it come from? See Kaiser strike today.

We're looking at 10 to 30 year treasury rates at nearly 5%+....which suggests inflation may be here to stay. We have GOT to index anything (be it ROCR) or fee for service to inflation or we're going to get crushed.

If we "lock in" with legislation some reimbursement rate....it could be a disaster in a persistent inflation environment.
Click to expand...

People are trying to pass versions of this kind of update right now (HR 2424 AMA Bill and HR 3674), the latter focusing specifically on free standing practices.

ASTRO has one of those links that allow you to easily email your rep for this bill. I linked a great letter that discusses the justification in the business forum (from USPA not ASTRO).

Become an Advocate - American Society for Radiation Oncology (ASTRO) - American Society for Radiation Oncology (ASTRO)

ASTRO has a new Advocacy Action Center! Check out our newest resource for making your voice heard in Washington. Send emails and tweet directly to your Senators and Representatives to make sure they act on the issues important to the radiation oncology community.
www.astro.org www.astro.org

Personally I am more supportive of both of these bills than ROCR.
 
CaesarRO said:
I'd argue unfair comparison.

You put more effort into nearly any SDN post you write....
Click to expand...
At this point it's a bizarre feedback loop.

ASTRO does something. I am confused. I try to fix my confusion.

Then I come on SDN like it's my LiveJournal in 2002 and detail how I tried to fix my confusion.

[Insert loop function Python script here]
 
OTN said:


I can't help but imagine that if there were an all-men's panel on breast cancer we would never hear the end of it.
Click to expand...


Here is a paper by a Rad Onc on this topic. It demonstrates the methods for these kinds of studies well. They are not elite studies. I would normally be kind of concerned but it's not like science publishing is high integrity these days.

FWIW this paper argues, at least at ASCO 2021, the proportion of manels and wanels versus mixed-gender panels were the same.

academic.oup.com

Recent trends of “manels”: gender representation among invited panelists at an international oncology conference

AbstractBackground. Gender disparities in academic medicine are a long-acknowledged concern, particularly at medical conferences. We investigated gender re
academic.oup.com academic.oup.com

There is also a conference paper that could not show gender discrimination at ASTRO.

Certainly there are many sexist folks hanging around medicine, but it seems like at least by these measures of conference presenting we are doing pretty good on equality.
 
elementaryschooleconomics said:
They basically rehashed their existing stuff. Almost nothing worth mentioning (because it's already out there)...but they finally gave a timeline:

View attachment 377394

I would like to point out the last bullet point of Q4 2023: "Possible Bill Introduction"

We are currently in Q4 2023.

Really doing great with this ASTRO. Really working hard to garner support for your little project here.

I've put more effort into publishing case reports in a low-tier journal than this.
Click to expand...
Here is more accurate version:

1696521795289.png
 
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TheWallnerus said:
Was this the worst ASTRO ever?

Will next year’s top it?

Let me “provide” you with some evidence


View attachment 377402
Click to expand...

You've got to be kidding me. The theme of the conference. Not a side lecture. The theme.

Mission creep at its finest, though usually this happens when the initial mission has been accomplished but the organization needs to move on to keep funding/motivation. instead we've just lost complete focus on the task at hand. Unreal.
 
Lol The asco themes for this and next year are ‘the art of oncology’ and ‘partnering with patients’

Themes are dumb/meaningless
 
If I were to do it again, I would’ve just registered for ASTRO 2023 exhibit hall admissions only, and saved a few hundred bucks. With everything recorded it’s a much better use of time to talk to your friends, colleagues, and vendors than to go to the talks.
 
ASCO 2025: This Is A Paid Endorsement

ASTRO 2025: Breadlines Are Here^

^A 15 min walk from the convention center and expect to pay $15-30 per loaf
 
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… A long, long time ago, I can still remember
How that MR-cobalt used to make me smile
And I knew if I had my chance
That I could watch those tumors dance
And maybe they'd be controlled for a while

… But October made me shiver
With the bankruptcy ever nearer
Bad news at the ASTRO
I couldn't take one more plenary
I can't remember if I cried
When I read the notice and sighed
But something touched me deep inside
The day the ViewRay died

… So, bye, bye, Linac-MRI
Simulated a cancer, but now I will transfer
And them good old execs ran off with all the revenue
Singin', "Elekta makes one too
Maybe they'll hire us too...


PS: That parody is dedicated to the sites (four?) that were in the process of installing or commissioning new ViewRay MRIdian systems as of last week. OOF
 
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At this point, we need to present @IonsAreOurFuture with a plaque at an award ceremony.

It sounds sarcastic but I'm dead serious.

Many people have come on SDN over the years to debate things, taking the unpopular side.

They last for maybe a week or two. Sometimes only a post or two. Reference: that Sameer guy.

But @IonsAreOurFuture IS STILL HERE.

I really apologize for the sarcastic tone of this post because I don't know how else to write this. But anyone who has regularly been on SDN knows what I'm saying is true. This is an anomaly.
 
elementaryschooleconomics said:
At this point, we need to present @IonsAreOurFuture with a plaque at an award ceremony.

It sounds sarcastic but I'm dead serious.

Many people have come on SDN over the years to debate things, taking the unpopular side.

They last for maybe a week or two. Sometimes only a post or two. Reference: that Sameer guy.

But @IonsAreOurFuture IS STILL HERE.

I really apologize for the sarcastic tone of this post because I don't know how else to write this. But anyone who has regularly been on SDN knows what I'm saying is true. This is an anomaly.
Click to expand...
Yes, could we please ban him or her? I come here for the echo chamber. I don't want to be right, I just want to be told I am.
 
Good Lord I just realized -

We're running a prospective trial here about prior hypotheses.

So the concerns SDN expressed had previously been dismissed as "miscreants" and/or "magical thinking".

If SDN opinions continue to become mainstream opinions:

The null hypothesis is nothing will change.

The miscreant hypothesis means we will take an opposing Viewpoint. Expansion was good, board certification process is flawless, etc.

Can we score a plenary session?
 
elementaryschooleconomics said:
At this point, we need to present @IonsAreOurFuture with a plaque at an award ceremony.

It sounds sarcastic but I'm dead serious.

Many people have come on SDN over the years to debate things, taking the unpopular side.

They last for maybe a week or two. Sometimes only a post or two. Reference: that Sameer guy.

But @IonsAreOurFuture IS STILL HERE.

I really apologize for the sarcastic tone of this post because I don't know how else to write this. But anyone who has regularly been on SDN knows what I'm saying is true. This is an anomaly.
Click to expand...

It has to be hard to be a serious proton physician or scientist in 2023. I know they are out there. I wish they would stand up to the riff raff and organize a serious plan to make clinical proton therapy rational and honest in the US.

@IonsAreOurFuture lead the way!
 
Ray D. Ayshun said:
it's nice to go to a conference in a good location with no reason to attend any part of the conference. I'm planning to be in DC next year to visit the museums on my boss's dime.
Click to expand...
samesies.

Though...this few weeks before the election gives me pause. DC is already a zoo.
 
NotMattSpraker said:
It has to be hard to be a serious proton physician or scientist in 2023. I know they are out there. I wish they would stand up to the riff raff and organize a serious plan to make clinical proton therapy rational and honest in the US.

@IonsAreOurFuture lead the way!
Click to expand...
Is it possible to work at one of these places and stand up to riff raff in your experience? with the poor job market people are afraid of being shown the door. The small nature of our field and inability for many people to leave jobs because they do not want to be separated from their families is a very powerful gun to your head. Essentially this stifles innovation, free thinking and free speech in our field.
 
RO28 said:
samesies.

Though...this few weeks before the election gives me pause. DC is already a zoo.
Click to expand...
Yes but all of the politicians will be outside of DC raising money for themselves or their colleagues. I daresay no federal politician will be anywhere near DC in October 2024
 
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thecarbonionangle said:
Is it possible to work at one of these places and stand up to riff raff in your experience? with the poor job market people are afraid of being shown the door. The small nature of our field and inability for many people to leave jobs because they do not want to be separated from their families is a very powerful gun to your head. Essentially this stifles innovation, free thinking and free speech in our field.
Click to expand...

I don’t know. I agree it can be very hard.

The one place I worked is a good steward of proton therapy so haven’t had to do it.
 
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