ASTRO Position Statement on the U.S. Radiation Oncology Workforce

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GapCalc

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ASTRO Position Statement on the U.S. Radiation Oncology Workforce from https://www.astro.org/Blog/January-2021/The-Future-of-our-Field/

Radiation oncology has long been a critical component of multidisciplinary cancer management, driven by clinical and scientific innovation. Recent advances in technology and our understanding of cancer biology have allowed radiation oncologists to offer more accurate and effective therapies, often in fewer total treatments than before, resulting in improved patient care. ASTRO has observed growth in residency training positions over the past two decades. With more efficient treatment delivery, fewer radiation oncologists may be needed in the coming years. Residency training positions should be reserved for those who are enthusiastic about the field and should reflect the anticipated societal need for radiation therapy services. As we prepare the next generation of radiation oncologists for independent practice, we encourage stakeholders to carefully consider these aspects affecting our specialty as they review the size and scope of their training programs.

Additionally, ASTRO acknowledges the continued need to grow and nurture diversity within the next generation of our workforce. We serve diverse peoples, and our trainees and faculty should reflect that diversity. We are committed to addressing all aspects of bias as we seek to ensure equity and inclusion within our specialty and to improve health outcomes for all our patients.


At least it's a start, ~8 years after Blood Bath in Red Journal ....
 
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thecarbonionangle

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Incoming ASTRO president chair of no good WV program is new “leader”. this will dictate the policy. Let’s just say she ain’t closing down her program.
 
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radonc17

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ASTRO Position Statement on the U.S. Radiation Oncology Workforce from https://www.astro.org/Blog/January-2021/The-Future-of-our-Field/

Radiation oncology has long been a critical component of multidisciplinary cancer management, driven by clinical and scientific innovation. Recent advances in technology and our understanding of cancer biology have allowed radiation oncologists to offer more accurate and effective therapies, often in fewer total treatments than before, resulting in improved patient care. ASTRO has observed growth in residency training positions over the past two decades. With more efficient treatment delivery, fewer radiation oncologists may be needed in the coming years. Residency training positions should be reserved for those who are enthusiastic about the field and should reflect the anticipated societal need for radiation therapy services. As we prepare the next generation of radiation oncologists for independent practice, we encourage stakeholders to carefully consider these aspects affecting our specialty as they review the size and scope of their training programs.
Additionally, ASTRO acknowledges the continued need to grow and nurture diversity within the next generation of our workforce. We serve diverse peoples, and our trainees and faculty should reflect that diversity. We are committed to addressing all aspects of bias as we seek to ensure equity and inclusion within our specialty and to improve health outcomes for all our patients.


At least it's a start, ~8 years after Blood Bath in Red Journal ....

Literally feels like blood sweat tears

grateful for the role SDN and others played
 
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RadOncDoc21

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ASTRO Position Statement on the U.S. Radiation Oncology Workforce from https://www.astro.org/Blog/January-2021/The-Future-of-our-Field/

Radiation oncology has long been a critical component of multidisciplinary cancer management, driven by clinical and scientific innovation. Recent advances in technology and our understanding of cancer biology have allowed radiation oncologists to offer more accurate and effective therapies, often in fewer total treatments than before, resulting in improved patient care. ASTRO has observed growth in residency training positions over the past two decades. With more efficient treatment delivery, fewer radiation oncologists may be needed in the coming years. Residency training positions should be reserved for those who are enthusiastic about the field and should reflect the anticipated societal need for radiation therapy services. As we prepare the next generation of radiation oncologists for independent practice, we encourage stakeholders to carefully consider these aspects affecting our specialty as they review the size and scope of their training programs.
Additionally, ASTRO acknowledges the continued need to grow and nurture diversity within the next generation of our workforce. We serve diverse peoples, and our trainees and faculty should reflect that diversity. We are committed to addressing all aspects of bias as we seek to ensure equity and inclusion within our specialty and to improve health outcomes for all our patients.


At least it's a start, ~8 years after Blood Bath in Red Journal ....
I read the full posting, they also indicated growth in the field in regards to radiopharmaceuticals and theranostics. Last I checked, nuc med/radiologists won’t even let me sniff that stuff.
 
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Gfunk6

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By Thomas Eichler, MD, FASTRO, ASTRO Chair

After more than a decade of enjoying the prestige of being one of the most highly sought-after specialties in the medical student match process, there have been troubling signs in the past few years that something was amiss. In 2019, the number of medical students who initially matched into radiation oncology declined with multiple slots unfilled. At the time, there was speculation about whether this was an anomaly or the beginning of a trend that had been forecast years before. In 2020, the field saw a larger decline in the number of medical students who matched, coupled with an increase in the number of people who then entered the field through the Supplemental Offer and Acceptance Program (SOAP) process. In fact, radiation oncology had the highest percentage of spots filled through the SOAP of any medical specialty.

From a treatment perspective, many factors, including the decreased use of radiation for some disease sites and an increased use of hypofractionation, bring into question the long-term viability of our specialty. Despite the many positive aspects of radiation oncology, there are growing concerns about the future of the workforce. There has been an increase in the number of available trainee positions despite the apparent decline in medical student interest and concern regarding patient volume projections. These issues contribute to forecasts of declining income streams and anxieties about the future given the recently proposed ― and now delayed ― radiation oncology alternative payment model. The worrisome trend in the SOAP percentages for radiation oncology underscores some of these negative perceptions about the field among students and residency applicants, which are in turn amplified on social media platforms. Not surprisingly, many students are confused about what career path to choose and may be discouraged to pursue radiation oncology before they even truly explore it.

ASTRO leaders have sought to be forthright with our members about challenges in the field (see previous blog posts below) and ASTRO’s role in addressing them. While there are strict anti-trust principles ASTRO must abide by, the Board of Directors felt compelled to issue a definitive statement so that there is no ambiguity about our position.

ASTRO Position Statement on the U.S. Radiation Oncology Workforce

  • Radiation oncology has long been a critical component of multidisciplinary cancer management, driven by clinical and scientific innovation. Recent advances in technology and our understanding of cancer biology have allowed radiation oncologists to offer more accurate and effective therapies, often in fewer total treatments than before, resulting in improved patient care. ASTRO has observed growth in residency training positions over the past two decades. With more efficient treatment delivery, fewer radiation oncologists may be needed in the coming years. Residency training positions should be reserved for those who are enthusiastic about the field and should reflect the anticipated societal need for radiation therapy services. As we prepare the next generation of radiation oncologists for independent practice, we encourage stakeholders to carefully consider these aspects affecting our specialty as they review the size and scope of their training programs.

    Additionally, ASTRO acknowledges the continued need to grow and nurture diversity within the next generation of our workforce. We serve diverse peoples, and our trainees and faculty should reflect that diversity. We are committed to addressing all aspects of bias as we seek to ensure equity and inclusion within our specialty and to improve health outcomes for all our patients.

While we acknowledge that this statement will not magically solve the issues impacting the field, we do want to be clear with our current and future members about ASTRO’s stance on this critical issue. We also strive to keep the lines of communication open with all members, including our residents. We listen to and appreciate the insights and perspectives from Association of Residents in Radiation Oncology (ARRO) to better understand their perceptions and experiences. Results from a survey of the class of 2020 found that residents had an average of five job interviews, received at least two job offers and, perhaps most significantly, 99% of residents were satisfied with the offers they received. While there are some vocal naysayers on social media, the direct response from residents gives us confidence and hope about the current realities in the field.

Radiation oncology has always sought the best and the brightest minds for our field because we know it is a truly rewarding area of cancer treatment. That will not change. We have deeply meaningful interactions with our patients, curing many of their cancers, alleviating suffering and extending life. Technology continues to play a large role in the field with novel and groundbreaking synergies between radiation and systemic agents, including immunotherapeutics, and many contemporary research questions are emerging, ripe for exploration and clinical trials. The field is also expanding due to innovations in radiopharmaceuticals and theranostics, offering radiation oncologists exciting new ways in which to help patients. While the future is unpredictable, we unequivocally believe in the continued impact and relevance of our specialty going forward, and perhaps more importantly, have unshakeable faith in the dedicated professionals who have made radiation oncology fundamental in the fight against cancer.

TLDR version

Although we have denied that there was a workload/workforce imbalance for years, we can no longer ignore the obvious. The increase in resident complement, the challenges with reduced applicant numbers and the reduced fractions for radiation courses all point us to the conclusion that we have a resident oversupply problem.

ASTRO is asking all Chairs and Program Directors to pretty please with sugar on top to reduce your resident numbers voluntarily and pretty please with sugar on top don't SOAP in residents who fail to match in other fields who do not show a dedicated interest in Rad Onc.

Also, like climate change denialists point out that the weather outside today is cold so man-made greenhouse warming is clearly a hoax - we make an analogous argument that the job market was awesome in 2020 so please ignore all the naysayers.

Thank you and please don't forget to pay your ASTRO dues.
 
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medgator

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TLDR version

Although we have denied that there was a workload/workforce imbalance for years, we can no longer ignore the obvious. The increase in resident complement, the challenges with reduced applicant numbers and the reduced fractions for radiation courses all point us to the conclusion that we have a resident oversupply problem.

ASTRO is asking all Chairs and Program Directors to pretty please with sugar on top to reduce your resident numbers voluntarily and pretty please with sugar on top don't SOAP in residents who fail to match in other fields who do not show a dedicated interest in Rad Onc.

Also, like climate change denialists point out that the weather outside today is cold so man-made greenhouse warming is clearly a hoax - we make an analogous argument that the job market was awesome in 2020 so please ignore all the naysayers.

Thank you and please don't forget to pay your ASTRO dues.
My sdn anonymous response to that article since i don't have an astro login anymore:

"platitudes from the highest members of Astro a few years in is a good start"
 
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thecarbonionangle

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As i said in another post. I believe we should pay our ASTRO pues early and often. donate early and often. If everyone leaves ASTRO, they will leave behind nothing but the swamp. New voices need to assume leadership to get us out of this hole.

This does not mean i don’t criticize ASTRO. The way they run ROHUB banning dissenting posts is despicable while allowing clearly racist threads which attack URMs to stand as Kosher. Very telling of good ole boy culture, vituperative cabal of old white men like Steinberg, Randall, Wallner, Hallahan, nepotism Harari and any other clown who “leads” this field. We need to put these people out to pasture before the new beginning can start
 
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scarbrtj

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Sometimes in church I feel like the pastor is looking my way when he speaks. "Your fancy silver sports car, Omega watch, and Yeezy coat won't save you!" And it'll make me squirm for a sec. Like when Eichler repeats the phrase "a few vocal naysayers on social media" over and over. You talkin' to me?! "Most significantly," he continues, "99% of residents were satisfied with the offers they received." Most significantly? MOST significantly? OK. The frog in a slowly warming pot of water is 99% satisfied with the temperature all the way up to 100 Celsius.

But. In all seriousness. "With more efficient treatment delivery, fewer radiation oncologists may be needed in the coming years." This is all "they" ever had to say. Too much energy and gaslighting was wasted saying that reality was just the opposite.
 
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Mandelin Rain

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Well ASTRO, prepare to hear from the anti-trust lawyers I've had on retainer waiting for this moment.
 
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RickyScott

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Not sure they can really do anything constructive. Again, even with shutting down all residencies for next 10 years, we would still have a problem. Moreover, it clear that only buffet from unemployment is the huge prices charged at academic centers allowing them to overhire. When the balloon, is popped watch out!
 
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RadOncDoc21

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Sometimes in church I feel like the pastor is looking my way when he speaks. "Your fancy silver sports car, Omega watch, and Yeezy coat won't save you!" And it'll make me squirm for a sec. Like when Eichler repeats the phrase "a few vocal naysayers on social media" over and over. You talkin' to me?! "Most significantly," he continues, "99% of residents were satisfied with the offers they received." Most significantly? MOST significantly? OK. The frog in a slowly warming pot of water is 99% satisfied with the temperature all the way up to 100 Celsius.

But. In all seriousness. "With more efficient treatment delivery, fewer radiation oncologists may be needed in the coming years." This is all "they" ever had to say. Too much energy and gaslighting was wasted saying that reality was just the opposite.
You’re THAT guy!
 

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At least the problem is finally acknowledged from atop the Ivory towers. At a minimum, this signals to all the academic departments that it is the view of Astro that expansion and starting up a new programs will be viewed negatively. This maybe gives some room for faculty at places like Duke and Columbia to speak up against residency expansion and official Astro position can now be cited. Will Tulane and Penn State and god only knows who else stop with their plans for opening up new training programs given this? Will programs contract? Will hell pit programs actually close? Time will tell. The statement leaves plenty of wiggle room to just ignore it so long as things are carefully considered.
 
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scarbrtj

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Not sure they can really do anything constructive. Again, even with shutting down all residencies for next 10 years, we would still have a problem. Moreover, it clear that only buffet from unemployment is the huge prices charged at academic centers allowing them to overhire. When the balloon, is popped watch out!
The skeptic in me thinks APM caused ASTRO’s come to Jesus moment.
 
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People are quite generous in their praise on #radonc. Fellatial in their praise, even. If you read the actual words, he doesn't say anything people don't know and then he takes shots at us all. Is this praiseworthy?
 
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People are quite generous in their praise on #radonc. Fellatial in their praise, even. If you read the actual words, he doesn't say anything people don't know and then he takes shots at us all. Is this praiseworthy?

I stand corrected. Two shots.

Results from a survey of the class of 2020 found that residents had an average of five job interviews, received at least two job offers and, perhaps most significantly, 89% of residents were satisfied with the offers they received. While there are some vocal naysayers on social media, the direct response from residents gives us confidence and hope about the current realities in the field.

The worrisome trend in the SOAP percentages for radiation oncology underscores some of these negative perceptions about the field among students and residency applicants, which are in turn amplified on social media platforms. Not surprisingly, many students are confused about what career path to choose and may be discouraged to pursue radiation oncology before they even truly explore it.
 
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Gfunk6

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“Vocal media naysayers”
We ought to be careful what we say. The last thing we want is a bunch of disgruntled Radiation Oncologists trying to storm the ABR office to prevent certification of board exam results.
 
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scarbrtj

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"Most significantly," he continues, "99% of residents were satisfied with the offers they received."
Because I'm lazy, and because I'm *99%* certain I CTRL-C/CTRL-V'd this, I think Eichler initially wrote "99%" instead of 89%. He must've corrected it later.
 
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“Vocal media naysayers”
Yeah...it's a double shot. Please consider sharing this statement with colleagues outside of SDN. Other than a few privileged training programs the larger trends in health care will make it much more costly to run a program and hopefully some will decide it is not worth it
 
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Chartreuse Wombat

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Because I'm lazy, and because I'm *99%* certain I CTRL-C/CTRL-V'd this, I think Eichler initially wrote "99%" instead of 89%. He must've corrected it later.
I would like to see the data. Does the average graduate get two offers? How about the bottom quartile? 89% of those with offers...what about not getting an offer? Averages are bad metrics for these types of endpoints. Cue the joke "Bill Gates walks into a bar..."
 
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RadOncDoc21

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We ought to be careful what we say. The last thing we want is a bunch of disgruntled Radiation Oncologists trying to storm the ABR office to prevent certification of board exam results.
Stop the count!!
 
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Even in regards to this relatively tame blogpost...Ralph gonna Ralph:

View attachment 326696
Ralph being Ralph.
To be honest I would prefer the specialty society that I pay dues to (for the time being) to be "inward looking" and "self-interested". Ralph is immune to any economic consequences and many variables that normal people deal with on a daily basis. Completely detached from the reality of everyday RO
 
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RadsWFA1900

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Ralph being Ralph.
To be honest I would prefer the specialty society that I pay dues to (for the time being) to be "inward looking" and "self-interested". Ralph is immune to any economic consequences and many variables that normal people deal with on a daily basis. Completely detached from the reality of everyday RO
Exactly. Thats pretty much what we need. Specialty sociaties dont adavance the science (although they may make you aware of it) thats what grants and academic centers do. Specialty societies protect the viability and intrgrity of the profession. Just focusing on the science is nie but the reality is you have to fight tooth and nail from those who would tear you down.
 
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Chartreuse Wombat

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Exactly. Thats pretty much what we need. Specialty sociaties dont adavance the science (although they may make you aware of it) thats what grants and academic centers do. Specialty societies protect the viability and intrgrity of the profession. Just focusing on the science is nie but the reality is you have to fight tooth and nail from those who would tear you down.
I am old enough (>30 years in the business) to harken back to the days when specialty societies were only about science and education. This was the case at ASTRO in the late 1980's early 1990s. Now as they make clear in their councils there are other two additional missions-government relations and health policy. These two "new" councils dominate ASTRO's attention. I may not like it but that is where we are at the moment.
 
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RickyScott

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I am old enough (>30 years in the business) to harken back to the days when specialty societies were only about science and education. This was the case at ASTRO in the late 1980's early 1990s. Now as they make clear in their councils there are other two additional missions-government relations and health policy. These two "new" councils dominate ASTRO's attention. I may not like it but that is where we are at the moment.
The money here is so extraordinary (if UPENN's negotiated rates are representative of mskcc/mdacc tier hospitals) that all other concerns fly out the window. The numbers they are posted are so ridiculous, its going to take a while to sink in what is truly going on in this specialty.
 
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The money here is so extraordinary (if UPENN's negotiated rates are representative of mskcc/mdacc tier hospitals) that all other concerns fly out the window. The numbers they are posted are so ridiculous, its going to take a while to sink in what is truly going on in this specialty.
do you have a link for this?
 

RickyScott

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do you have a link for this?
Upenn actually complied with the 2021 mandate- the actual dollars they recover from select insurance companies, plus the average reimbursement per code






STEREOTACTIC BODY RADIATION DELIVERY
77373
$56,291.27
avg
$1,870.32
cms
$7,411.73
aetna hmo
$1,982.54
aetna medicare
$51,490.00
ibc hmo
$51,490.00
ibc ppo
$1,870.32
ibc medicare
$19,139.03
cigna
$1,926.43$1,012.40$2,019.95$1,860.00$1,982.54$1,850.00$15,761.56$25,331.07$1,870.32$27,582.72$1,982.54

77338CHG MLC IMRT DESIGN & CONSTRUCTION PER IMRT PLAN$8,843.90
avg
$354.46
cms
$2,942.29$375.73$549.80$549.80$354.46$3,006.93$365.10$150.80$382.82$4,421.95$375.73$400.01$2,476.29$3,979.75$354.46$4,333.51$375.73

772953-D RADIOTHERAPY PLAN DOSE-VOLUME HISTOGRAMS$27,877.30
avg
$1,317.07
cms
$2,841.95$1,396.10$12,414.79$12,414.79$1,317.07$9,478.28$1,356.59$545.42$1,422.44$597.92$1,396.10$594.70$7,805.64$12,544.79$1,317.07$13,659.88$1,396.10

77386CHG INTENSITY MODULATED RADIATION TX DLVR COMPLEX$14,416.11
avg
$569.87
cms
$2,399.87$604.06$3,113.00$3,113.00$569.87$4,901.48$586.96$309.74$615.46$529.15$604.06$526.31$4,036.51$6,487.25$569.87$7,063.89$604.06

77385CHG INTENSITY MODULATED RADIATION TX DLVR SIMPLE$14,404.39
avg
$569.87
cms
$2,392.34$604.06$3,113.00$3,113.00$569.87$4,897.49$586.96$309.74$615.46$499.97$604.06$497.28$4,033.23$6,481.98$569.87$7,058.15$604.06

77523PROTON TX DELIVERY \INTERMEDIATE$21,866.80
avg
$1,318.57
cms
$13,678.26$1,397.69$3,115.00$3,115.00$1,318.57$7,434.71$1,358.13$1,149.64$1,424.06$548.25$1,397.69$1,488.01$6,122.70$9,840.06$1,318.57$10,714.73$1,397.69
77336CONTINUING MEDICAL PHYSICS CONSLTJ PR WK$1,583.54
avg
$133.89
cms
$443.80$141.92$240.29$240.29$133.89$538.40$137.90$61.53$144.60$91.14$141.92$90.65$443.39$712.59$133.89$775.94$141.92
77334TX DEVICES DESIGN & CONSTRUCTION COMPLEX$3,464.35
avg
$354.46
cms
$881.26$375.73$1,212.87$1,212.87$354.46$1,177.88$365.10$114.46$382.82$102.30$375.73$101.75$970.02$1,558.96$354.46$1,697.53$375.73
77280THER RAD SIMULAJ-AIDED FIELD SETTING SIMPLE$2,893.81
avg
$133.89
cms
$1,602.17$141.92$1,373.06$1,373.06$133.89$983.90$137.90$61.53$144.60$67.89$141.92$67.53$810.27$1,302.21$133.89$1,417.97$141.92
77470SPECIAL TREATMENT PROCEDURE$9,598.61
avg
$569.87
cms
$903.26$604.06$4,851.49$4,851.49$569.87$3,263.53$586.96$225.66$615.46$39.99$604.06$39.78$2,687.61$4,319.37$569.87$4,703.32$604.06
77301NTSTY MODUL RADTHX PLN DOSE-VOL HISTOS$17,078.16
avg
$1,317.07
cms
$11,554.66$1,396.10$12,414.79$12,414.79$1,317.07$5,806.57$1,356.59$545.42$1,422.44$1,316.56
 
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Mandelin Rain

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This type of price gouging is why everyone sees their insurance premiums increase 10-15% every year.

It is literally injuring everyone in the United States.

Insurance companies happily go along simply because (as noted) the more they pay out in claims, the more they can keep in profit (in the ACA mandated 80:20 ratio). The hospitals enrich themselves. And normal people get boned. It's perverse.
 
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thecarbonionangle

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This type of price gouging is why everyone sees their insurance premiums increase 10-15% every year.

It is literally injuring everyone in the United States.

Insurance companies happily go along simply because (as noted) the more they pay out in claims, the more they can keep in profit (in the ACA mandated 80:20 ratio). The hospitals enrich themselves. And normal people get boned. It's perverse.
You say boned like thats a bad thing
 
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scarbrtj

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This type of price gouging is why everyone sees their insurance premiums increase 10-15% every year.

It is literally injuring everyone in the United States.

Insurance companies happily go along simply because (as noted) the more they pay out in claims, the more they can keep in profit (in the ACA mandated 80:20 ratio). The hospitals enrich themselves. And normal people get boned. It's perverse.

Our specialty is getting boned too because it’s causing/allowing a classic economic bubble to play out of, you guessed it, residency expansion and rad onc oversupply. True Tulip Mania.
 
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thecarbonionangle

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Our specialty is getting boned too because it’s causing/allowing a classic economic bubble to play out of, you guessed it, residency expansion and rad onc oversupply. True Tulip Mania.
Tulip mania is a really fascinating. Just like Tesla or Bitcoin. Rad onc was a beautiful tulip. It could only go up now look at us. Now people use it to light a fire to stay warm, just like Zimbabwe money
 
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scarbrtj

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Tulip mania is a really fascinating. Just like Tesla or Bitcoin. Rad onc was a beautiful tulip. It could only go up now look at us. Now people use it to light a fire to stay warm, just like Zimbabwe money
When a price for a something gets COMPLETELY divorced from reality, it’s tulip mania. Look at these rad onc prices. History repeats itself! But a tulip mania is a kind of folie a deux. You need a “stupid” buyer as well as the irrationally predatory seller. Buyers don’t stay stupid forever.

EDIT: in this scenario I’m calling payors buyers. But other buyers of rad onc include students, current residents, and grads looking for jobs. They need to “purchase” some rad onc too.
 
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evilbooyaa

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I would like to see the data. Does the average graduate get two offers? How about the bottom quartile? 89% of those with offers...what about not getting an offer? Averages are bad metrics for these types of endpoints. Cue the joke "Bill Gates walks into a bar..."

Think the 89% of satisfaction was an edit based on the following tweet about presentation of resident job prospects from the class of 2020 survey by Chelain and ARRO:


Which led to the edit per ASTRO Guy:

 
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scarbrtj

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Think the 89% of satisfaction was an edit based on the following tweet about presentation of resident job prospects from the class of 2020 survey by Chelain and ARRO:


Which led to the edit per ASTRO Guy:

Ha good documentation.

And just like that the dissatisfaction rate went up ten-fold. And it’s still OK everything’s OK we are fine.
 

RickyScott

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When a price for a something gets COMPLETELY divorced from reality, it’s tulip mania. Look at these rad onc prices. History repeats itself! But a tulip mania is a kind of folie a deux. You need a “stupid” buyer as well as the irrationally predatory seller. Buyers don’t stay stupid forever.

EDIT: in this scenario I’m calling payors buyers. But other buyers of rad onc include students, current residents, and grads looking for jobs. They need to “purchase” some rad onc too.
Waiting for CMS to force MDACC and MSKCC to release their prices by raising the daily fine. If this holds true, should we expect a statement from ASTRO about predatory evil in their midst?
 
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Neuronix

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For those of us in academics, they don't disclose true reimbursements to us. So all we can do is cost-effectiveness analyses based on published medicare allowable rates. When the actual reimbursements are completely out of line with medicare allowable, it makes the cost-effectiveness analyses inaccurate.

Now that the real data is out there I bet we'll have a new wave of cost-effectiveness analyses.
 
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RickyScott

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For those of us in academics, they don't disclose true reimbursements to us. So all we can do is cost-effectiveness analyses based on published medicare allowable rates. When the actual reimbursements are completely out of line with medicare allowable, it makes the cost-effectiveness analyses inaccurate.

Now that the real data is out there I bet we'll have a new wave of cost-effectiveness analyses.
Seems abundantly clear that such analyses need to focus on cost effectiveness not fractionation. May need to bring psychologists into this as well- does hypofravctionation allow the doc to feel good about himself/justify these kind of charges.
 
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Mandelin Rain

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For those of us in academics, they don't disclose true reimbursements to us. So all we can do is cost-effectiveness analyses based on published medicare allowable rates. When the actual reimbursements are completely out of line with medicare allowable, it makes the cost-effectiveness analyses inaccurate.

Now that the real data is out there I bet we'll have a new wave of cost-effectiveness analyses.
The issue is no one knows what the contracted reimbursement/adjustment is. But even if they get (about) 25% billed rate, Penn is probably getting (around) 400-500% Medicare which is probably (in the range of) 2.5-5x what the private practice down the street is getting.

So when our dear RickyScott warns of academic centers getting 3-5x what he does for the same service and you call him "crazy" or some other such word. Well... he ain't.
 
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