My guess is we'll see more diversity in terms of country of medical school attended among future graduates.
I'm guessing that's not the kind of diversity they have in mind.
I'm guessing that's not the kind of diversity they have in mind.
-
CycleTrack and SDN are teaming up to make medical school admissions more transparent and accessible! Read the announcement to learn how we’re supporting the future of CycleTrack’s free application-tracking tools .
Dare you to reply!
Started by RadOncMegatron
Get help with your application
Use all the free resources available to you from SDN: articles, guides, expert advising, forums discussions, and school research.
If you truly care about disadvantaged minorities, should you really be encouraging them to enter this field, given the threatening job situation? or better yet, fix the problem, so they can flourish.
Last edited:
OMG - NEJM HAS GONE TOO FAR WITH THIS STUFF:
Racist Like Me — A Call to Self-Reflection and Action for White Physicians
I hate having to write on this topic (sorta), but man this is going too far ...
Hey white doctors (not me) - you are racist NEJM says so!
Greatest hits from this article:
Can other white people here please confirm to us other minorities your racism please. Please submit to the Red Journal and let everyone know about your white supremacy thanks. I also would like to hear examples of how you blatantly mistreat people based on race b/c of course you are white and must be racist. Our patients definitely need to know, but oh wait - are the white patient's racist too?!?!?
***To be super clear I am being sarcastic here. Of course not all white people are racist and imbedded with the "subtle tendrils of white supremacy." Sad that I actually have to say it these days.***
Racist Like Me — A Call to Self-Reflection and Action for White Physicians
I hate having to write on this topic (sorta), but man this is going too far ...
Hey white doctors (not me) - you are racist NEJM says so!
Greatest hits from this article:
"I am racist. I would love to believe otherwise... And yet I am racist, shaped by the sometimes subtle tendrils of white supremacy deeply embedded in our culture." 
"The other day, I noticed myself sitting farther than usual from a black patient in her hospital bed. I once mistook one black resident for another resident who is also black."👎
"Though implicit bias is unconscious by definition, it is a treatable condition. As I become more aware of my biases, they begin to loosen their grip. When I realized I was sitting farther than usual from my hospitalized patient, I moved closer"
"The other day, I noticed myself sitting farther than usual from a black patient in her hospital bed. I once mistook one black resident for another resident who is also black."👎
"Though implicit bias is unconscious by definition, it is a treatable condition. As I become more aware of my biases, they begin to loosen their grip. When I realized I was sitting farther than usual from my hospitalized patient, I moved closer"
Can other white people here please confirm to us other minorities your racism please. Please submit to the Red Journal and let everyone know about your white supremacy thanks. I also would like to hear examples of how you blatantly mistreat people based on race b/c of course you are white and must be racist. Our patients definitely need to know, but oh wait - are the white patient's racist too?!?!?
***To be super clear I am being sarcastic here. Of course not all white people are racist and imbedded with the "subtle tendrils of white supremacy." Sad that I actually have to say it these days.***
That's what medicine used to say about being gay...
Can't say I blame nejm completely, considering the current political climate and the environment engendered by the sitting president.
Hate group count hits 20-year high amid rise in white supremacy, report says
'A racist act': Rashida Tlaib comments spark debate on racism during Michael Cohen hearing
Worries grow about white nationalism in the ranks
Hate group count hits 20-year high amid rise in white supremacy, report says
'A racist act': Rashida Tlaib comments spark debate on racism during Michael Cohen hearing
Worries grow about white nationalism in the ranks
Last edited:
I agree the country is in turmoil, but all that aside, what I fear is that this will negatively affect the doctor-patient relationship. Purely based on race, patients will shop around not for opioids, but for doctor's who match their skin color, creed, nationality, orientation, gender, etc. Once you say all white doctors are racists, well then are all white patients racist? Are Black, Asian, Latino doctors racist? Are Black, Asian, Latino patients racist?
The crazy thing is I say "no," but Dr. Deborah Cohan (who wrote this article) in weird of act simultaneous elitism (publication in the NEJM) and self-immolation by frankly admitting she is racist, has committed racist acts toward her patients, and affirms being affected by white supremacy would say "yes." Would it be ok now for black patients to not want to see her for this confession? No really...? According to her logic, the best thing would be for her to refer her black patients to a black physician (recall this is what our rad onc colleague Dr. Winkfield is pushing for with her ASCO quota agenda). Not good I say... Not good...
It seem in radiation oncology, there are several Indian women docs who have reappropriated their own darker skin tone to annoint themselves as advocates on this issue and engage the rest of us with constant microaggressions.. Ironically, if you truly care about women and disadvantaged minorities, you would tell them stay the hell out of radiation. They dont need to be taken advantage of with fellowships, or exploitative jobs.
Last edited:
similar article that was retracted about our sexual biases. Apparently we are all sexist because we are permissive when a male dogs trys to mount female dogs and that does not elicit condementation, but male on male causes the owner to strenuously object
A Study Researched Rape Culture and Dog Parks
By KATHERINE TIMPF
June 11, 2018 7:16 PM
(Pixabay)
Helen Wilson insists that her dog-park study may have found some helpful answers for how we handle rape culture among humans.
Apaper written by Portland Ungendering Research Initiative’s Helen Wilson claims that dog parks are actually very sexual places where we can learn things about rape culture and “queer performativity.”
Yes — seriously.
Wilson explains the whole thing in her paper, titled “Human reactions to rape culture and queer performativity at urban dog parks in Portland, Oregon.”
the paper’s abstract. “The purpose of this research is to uncover emerging themes in human and canine interactive behavioral patterns in urban dog parks to better understand human a-/moral decision-making in public spaces and uncover bias and emergent assumptions around gender, race, and sexuality.”
According to the abstract, the paper asks the questions “What issues surround queer performativity and human reaction to homosexual sex between and among dogs?” and “Do dogs suffer oppression based upon (perceived) gender?”
College Fix, Wilson’s paper claims that dog parks are “petri dishes for canine rape culture.”
“They offer a very public view into the ways human companions foster and perpetuate masculinist systems of communal oppression across species and in public spaces,” the paper states. “The cultural norms operating within and upon these spaces form microcultures where acceptable and unacceptable behavior in human communities may be reflected in the way human companions construct their interactions with dogs, particularly in regard to rape culture and queering, and a-/moral interpretations of such behaviors and their human analogues under the assumptions of rape culture.”
“In essence,” Wilson states, dogs parks “become rape-condoning spaces in which human rape culture plays out by the moral permissiveness we extend to animals.”
Reason’s Robby Soave notes, Wilson was at least up-front about the limitations of her study. For example: She admits she has no way of knowing whether or not any given instance of dog-humping actually constituted rape:
“It is difficult if not impossible to ascertain when canine sexual advances are un/wanted, or when they are rapes rather than performances of canine dominance, which introduces considerable unavoidable ambiguity in my interpretations of this variable,” she writes.
No kidding.
Still, Wilson insists that her study may have found some helpful answers for how we handle rape culture among humans in our human society:
By publicly or otherwise openly and suddenly yelling (NB: which was also effective at stopping dog rape/humping incidents) at males when they begin to make sexual advances on females (and other males in certain non-homosocial contexts), and by making firm and repeated stands against rape culture in society, activism, and media, human males may be metaphorically “shocked” out of regarding sexual violence, sexual harassment, and rape culture as normative, which may decrease rape rates and disrupt rape culture and emancipate rape-condoning spaces.
As I explained earlier, humans generally behave much differently than dogs.
3
In other words: Wilson believes that we may be able to “shock” men out of perpetuating rape culture the same way a yelling owner can “shock” his or her dog out of humping another canine. Unfortunately, however, I must say that I don’t believe humans can train each other the same way that an owner can train a dog. For one thing, adult humans don’t really have “owners.” Sure, we have bosses, but we don’t have one single person in our lives whom we rely on for everything from food to being able to use the bathroom. In adult life, there’s absolutely no relationship that comes even close to the dog–owner relationship, because, as I explained earlier, humans generally behave much differently than dogs.
The bottom line: Although it is certainly impressive that Wilson spent 100 hours watching dogs in parks for this study, I really don’t think that her work did anything to advance us as a societ
A Study Researched Rape Culture and Dog Parks
By KATHERINE TIMPF
June 11, 2018 7:16 PM
(Pixabay)
Helen Wilson insists that her dog-park study may have found some helpful answers for how we handle rape culture among humans.
Apaper written by Portland Ungendering Research Initiative’s Helen Wilson claims that dog parks are actually very sexual places where we can learn things about rape culture and “queer performativity.”
Yes — seriously.
Wilson explains the whole thing in her paper, titled “Human reactions to rape culture and queer performativity at urban dog parks in Portland, Oregon.”
the paper’s abstract. “The purpose of this research is to uncover emerging themes in human and canine interactive behavioral patterns in urban dog parks to better understand human a-/moral decision-making in public spaces and uncover bias and emergent assumptions around gender, race, and sexuality.”
According to the abstract, the paper asks the questions “What issues surround queer performativity and human reaction to homosexual sex between and among dogs?” and “Do dogs suffer oppression based upon (perceived) gender?”
College Fix, Wilson’s paper claims that dog parks are “petri dishes for canine rape culture.”
“They offer a very public view into the ways human companions foster and perpetuate masculinist systems of communal oppression across species and in public spaces,” the paper states. “The cultural norms operating within and upon these spaces form microcultures where acceptable and unacceptable behavior in human communities may be reflected in the way human companions construct their interactions with dogs, particularly in regard to rape culture and queering, and a-/moral interpretations of such behaviors and their human analogues under the assumptions of rape culture.”
“In essence,” Wilson states, dogs parks “become rape-condoning spaces in which human rape culture plays out by the moral permissiveness we extend to animals.”
Reason’s Robby Soave notes, Wilson was at least up-front about the limitations of her study. For example: She admits she has no way of knowing whether or not any given instance of dog-humping actually constituted rape:
“It is difficult if not impossible to ascertain when canine sexual advances are un/wanted, or when they are rapes rather than performances of canine dominance, which introduces considerable unavoidable ambiguity in my interpretations of this variable,” she writes.
No kidding.
Still, Wilson insists that her study may have found some helpful answers for how we handle rape culture among humans in our human society:
By publicly or otherwise openly and suddenly yelling (NB: which was also effective at stopping dog rape/humping incidents) at males when they begin to make sexual advances on females (and other males in certain non-homosocial contexts), and by making firm and repeated stands against rape culture in society, activism, and media, human males may be metaphorically “shocked” out of regarding sexual violence, sexual harassment, and rape culture as normative, which may decrease rape rates and disrupt rape culture and emancipate rape-condoning spaces.
As I explained earlier, humans generally behave much differently than dogs.
3
In other words: Wilson believes that we may be able to “shock” men out of perpetuating rape culture the same way a yelling owner can “shock” his or her dog out of humping another canine. Unfortunately, however, I must say that I don’t believe humans can train each other the same way that an owner can train a dog. For one thing, adult humans don’t really have “owners.” Sure, we have bosses, but we don’t have one single person in our lives whom we rely on for everything from food to being able to use the bathroom. In adult life, there’s absolutely no relationship that comes even close to the dog–owner relationship, because, as I explained earlier, humans generally behave much differently than dogs.
The bottom line: Although it is certainly impressive that Wilson spent 100 hours watching dogs in parks for this study, I really don’t think that her work did anything to advance us as a societ
Last edited:
This part of the Sokol part 2 hoax papers. What is revealing is that the study passed through peer review and was actually given accolades as very important research.
Remember our field to has a bunch of these types of paper, though not as pernicious as the above, that came out this month in the Red Journal
Differences in Physician Compensation Between Men and Women at United States Public Academic Radiation Oncology Department
The paper even admits that "Our analysis could not account for personal decisions or factors for which there was not a public marker" and used publicly available database data. They did not include hours worked, take into consideration subsite specialization, or new hires for their analysis.
How this biased and low caliber research could make it to our most prestigious journal and the aforementioned "racism" article makes it into the NEJM is a terrible harbringer, as I said before, of this stuff coming down to effect the patient - doctor relationship, as these people are in charge of our field.
100% right my friend.
I personally saw recently in academic rad onc where a woman and a man were hired at the same time for the same job and the woman was paid less. Both were similarly qualified with the same title and job expectations.
I used to think this stuff was fluff. I used to want to believe that everything was equal.
But, over the years I've seen so much shadiness and people getting taken advantage of both in academics in the private world.
The only leverage we have as MDs is to negotiate better terms or walk away from abusive positions. In rad onc, they got us. If you're looking at a bad job or stuck in a bad job, where are you going to go? There are no jobs. Since they know they got us, they stuff our salaries downwards as much as possible so senior partners and chairs can pocket the technicals while the rest of us fight for part of the professionals.
Men still more commonly have some ability to go anywhere in the country and have some ability for hard ball negotiating. I know several women who ended up exploited or unemployed because they couldn't leave specific metro areas.
The whole thing makes me ill.
Gender bias aside (I think it's real), these are pretty lowly salary numbers. I guess that's where the field as a whole is heading.
Ah well. I hate to derail a thread but this is a little germane. In March GQ there's a piece about Chef Tunde Wey. In the article I learned that the chef learned "white people will never give anything up." I coulda told him that.
Looks like much of the numbers difference could be largely explained by the number of chairmen vs chairwomen, and likely experience. Interesting that table 1 went with mean averages for everything (salary) but years of experience where they went median. Women in rad onc (and to a much smaller degree medicine at large) is a more recent development. The really high earners are likely the dinosaurs who have been around forever. And those dinosaurs tend to be men. This may even out in the coming decades, or not?
Would be interesting to look at an analysis with median salary and/or salary numbers excluding chairpeople. My guess is they'd be more similar.
Not saying that this discrimination does not exist, just that looking at this data doesn't necessarily prove it.
This hurts because it's true. I'm on the low side of those numbers. I had no better offers when I graduated residency. I'm several years out now and and have been trying for a year now to find something better. No interviews.
Where I work they're trying to bring the salaries down even more. I see no opportunity for significant growth. Unless something opens up for me, I'm not sure I'll ever make an MGMA average rad onc salary in my entire career.
What is disturbing is that for spousal reasons, women are less likely to take rural jobs and thus subject to more exploitative urban positions and fellowships. The same mf's encouraging residency expansion are ironically complaining that women are stuck in lower paying urban positions and fellowships, yet actually encourage more women/minorities to enter the field, despite the fact that women as a whole are more geographically restricted.. It so wrong. We need to start calling these people out at sexist.
Last edited:
This is what happens when you create a society where everything involving women involves sexism, everything involving blacks involves racism, everything involving muslims or immigrants involves xenophobia, everything involving gays is homophobic, etc.
If you question the validity of a story about racism or sexism, whether or not it should be published, whether its points are valid, scientifically accurate, etc, then you will be accused of racism, sexism, whatever. It should come as no surprise that the NEJM published this.
The societal shift has allowed anybody to push any issue, no matter how absurd, by creating a bully pulpit that shuts down any criticism by calling all dissent racist, sexist, etc. The irony is that people will appropriate skin color, sex, etc. to legitimize and push their political agenda and further their careers, and that appropriation is in and of itself extremely racist, sexist, etc.
It's comforting to see that at least some of my colleagues can identify the absurdity in all of this, and I think most of us are reasonable and understand that this stuff is being crammed down our throats by people who know that if anybody objects they can just point a finger and scream sexism or racism and literally nobody is going to object because nobody wants to have their name and professional reputation dragged through the mud with allegations like that on social media.
This is Obama's legacy. He had the opportunity to bring the country together and unite everyone. Instead he decided to fan the flames of racial tensions at every possible juncture. Ferguson, Trayvon Martin, Henry Gates, etc. Pushing this narrative regardless of what the truth was that straight white men everywhere are systematically oppressing everyone else. And look at where that got us.
You are absolutely right to be concerned about the breakdown of the doctor-patient relationship. The current political climate that has led to ridiculous articles like this has pushed a false narrative that may cause minorities to think I am prejudiced against them and will provide inferior care, either consciously or subconsciously. That doesn't engender trust, it's a shame, and it's only going to get worse.
If you question the validity of a story about racism or sexism, whether or not it should be published, whether its points are valid, scientifically accurate, etc, then you will be accused of racism, sexism, whatever. It should come as no surprise that the NEJM published this.
The societal shift has allowed anybody to push any issue, no matter how absurd, by creating a bully pulpit that shuts down any criticism by calling all dissent racist, sexist, etc. The irony is that people will appropriate skin color, sex, etc. to legitimize and push their political agenda and further their careers, and that appropriation is in and of itself extremely racist, sexist, etc.
It's comforting to see that at least some of my colleagues can identify the absurdity in all of this, and I think most of us are reasonable and understand that this stuff is being crammed down our throats by people who know that if anybody objects they can just point a finger and scream sexism or racism and literally nobody is going to object because nobody wants to have their name and professional reputation dragged through the mud with allegations like that on social media.
This is Obama's legacy. He had the opportunity to bring the country together and unite everyone. Instead he decided to fan the flames of racial tensions at every possible juncture. Ferguson, Trayvon Martin, Henry Gates, etc. Pushing this narrative regardless of what the truth was that straight white men everywhere are systematically oppressing everyone else. And look at where that got us.
You are absolutely right to be concerned about the breakdown of the doctor-patient relationship. The current political climate that has led to ridiculous articles like this has pushed a false narrative that may cause minorities to think I am prejudiced against them and will provide inferior care, either consciously or subconsciously. That doesn't engender trust, it's a shame, and it's only going to get worse.
Gotta be provacative to get an editorial published in NEJM. Glad this physician decided her personal integrity was not above groveling and self-flagellation to land herself a NEJM publication.
Cool that she thinks all black residents are the same and that she prefers to sit farther away from black patients, and maybe she actually is a racist if she does that. But how dare her to project that to all white physicians.
This was one of the most disturbing parts of the article for me as well.
I have literally never done anything like what she described (subconsciously sit farther away from black patients). And the fact that she thinks she has the voice to proclaim that all white people are subconsciously racist like her and she is somehow morally superior because she can identify it. What in the actual F.
The author KNEW that a topic like this would result in a publication because the NEJM doesn't want to be accused of racism. So let me get this straight. She wrote an article where she self-identified as a racist, somehow twisted that self-realization into a virtue signal, made inappropriate racial generalizations, and used the topic of racism to generate an NEJM publication to buff up her CV. Sounds about right.
However, I have witnessed it. I have witnessed some physicians give preferential treatment given to wealthy VIPs and basically ignore poor or less educated patients. It's always been a status thing and not a skin color thing that I've noticed, although I'm sure bread and butter racism by doctors still does happen it just seems to be very rare. And the offending doctors are of various skin colors, sex, etc. Definitely not just old white guys. It makes me sick.
Like I said, Obama's legacy. Overcorrecting followed by even more overcorrecting. We now have the pendulum swinging wildly from one stop to the other flying right over any sense of reason in the middle and slamming against the rails and eventually the whole thing is going to smash itself apart. I pass a prepper supply store on the way to work every day that is looking more and more appealing (j/k...mostly).
What a weird strange thread this is. There are other places to rant about this stuff. Lets talk about the job market and the ABR.
I mean there are like 15 threads to talk about the job market and ABR. I don't think having a thread dedicated to this is super unreasonable.
Easy to say on an anonymous internet forum. But would you really?
She is in academia in one of the most liberal cities in America.
If you called for her resignation, you would be called a racist and/or sexist and risk losing your job.
Meanwhile, she will get promoted.
You know this is true.
Is white privilege not the same now a days?
To be very honest- when I was offered a research fellowship by my chair many years ago, I felt that it was so beneath american grads, particularly WASP ones.
Last edited:
ever present homophobiasimilar article that was retracted about our sexual biases. Apparently we are all sexist because we are permissive when a male dogs trys to mount female dogs and that does not elicit condementation, but male on male causes the owner to strenuously object
A Study Researched Rape Culture and Dog Parks
By KATHERINE TIMPF
June 11, 2018 7:16 PM
(Pixabay)
Helen Wilson insists that her dog-park study may have found some helpful answers for how we handle rape culture among humans.
Apaper written by Portland Ungendering Research Initiative’s Helen Wilson claims that dog parks are actually very sexual places where we can learn things about rape culture and “queer performativity.”
Yes — seriously.
Wilson explains the whole thing in her paper, titled “Human reactions to rape culture and queer performativity at urban dog parks in Portland, Oregon.”
the paper’s abstract. “The purpose of this research is to uncover emerging themes in human and canine interactive behavioral patterns in urban dog parks to better understand human a-/moral decision-making in public spaces and uncover bias and emergent assumptions around gender, race, and sexuality.”
According to the abstract, the paper asks the questions “What issues surround queer performativity and human reaction to homosexual sex between and among dogs?” and “Do dogs suffer oppression based upon (perceived) gender?”
College Fix, Wilson’s paper claims that dog parks are “petri dishes for canine rape culture.”
“They offer a very public view into the ways human companions foster and perpetuate masculinist systems of communal oppression across species and in public spaces,” the paper states. “The cultural norms operating within and upon these spaces form microcultures where acceptable and unacceptable behavior in human communities may be reflected in the way human companions construct their interactions with dogs, particularly in regard to rape culture and queering, and a-/moral interpretations of such behaviors and their human analogues under the assumptions of rape culture.”
“In essence,” Wilson states, dogs parks “become rape-condoning spaces in which human rape culture plays out by the moral permissiveness we extend to animals.”
Reason’s Robby Soave notes, Wilson was at least up-front about the limitations of her study. For example: She admits she has no way of knowing whether or not any given instance of dog-humping actually constituted rape:
“It is difficult if not impossible to ascertain when canine sexual advances are un/wanted, or when they are rapes rather than performances of canine dominance, which introduces considerable unavoidable ambiguity in my interpretations of this variable,” she writes.
No kidding.
Still, Wilson insists that her study may have found some helpful answers for how we handle rape culture among humans in our human society:
By publicly or otherwise openly and suddenly yelling (NB: which was also effective at stopping dog rape/humping incidents) at males when they begin to make sexual advances on females (and other males in certain non-homosocial contexts), and by making firm and repeated stands against rape culture in society, activism, and media, human males may be metaphorically “shocked” out of regarding sexual violence, sexual harassment, and rape culture as normative, which may decrease rape rates and disrupt rape culture and emancipate rape-condoning spaces.
As I explained earlier, humans generally behave much differently than dogs.
3
In other words: Wilson believes that we may be able to “shock” men out of perpetuating rape culture the same way a yelling owner can “shock” his or her dog out of humping another canine. Unfortunately, however, I must say that I don’t believe humans can train each other the same way that an owner can train a dog. For one thing, adult humans don’t really have “owners.” Sure, we have bosses, but we don’t have one single person in our lives whom we rely on for everything from food to being able to use the bathroom. In adult life, there’s absolutely no relationship that comes even close to the dog–owner relationship, because, as I explained earlier, humans generally behave much differently than dogs.
The bottom line: Although it is certainly impressive that Wilson spent 100 hours watching dogs in parks for this study, I really don’t think that her work did anything to advance us as a societ
'Dog Park Debbie' calls the police on man whose puppy mounted her dog: 'That's inappropriate'
This is a GREAT thread. Keep it up you guys! following.
Assessment of Differences in Clinical Activity and Medicare Payments Among Female and Male Radiation Oncologists
I really just wanted to get that Troll's face off as the most recent post on this thread, but there is an interesting article above that just came out in JAMA Network Open.
Main point "Our findings suggest that female radiation oncologists submit fewer charges and collect less Medicare reimbursement than do male radiation oncologists in all practice settings... The gap in Medicare collections may be driven in part by fewer charges submitted by female radiation oncologists"
Good Points:
+ "A flexible work schedule and opportunities for part-time employment have been shown to be attractive options for female radiation oncologists"
+ "It is also possible that women prioritize time spent with a given patient vs number of patients seen, and that extra time spent counseling patients is not reflected in HCPCS code volume."
+ " It is possible that female radiation oncologists may include in their practice a greater proportion of less well-reimbursed technologies such as 3-dimensional conformal therapies (typically used for treating breast cancer), while foregoing more favorably reimbursed technologies such as intensity modulated radiation therapy(typically used for treating genitourinary malignant neoplasms"
+"Quantifying these differences has allowed us to show that women consistently billed for less remunerative services, which is neither expected nor rational. In comparable studies examining similarly productive subspecialists in other fields such as orthopedic surgery, sex-based differences in Medicare collections were not apparent,so further study is required to determine the factors unique to radiation oncology that result in women submitting more poorly remunerated procedure codes at the same time that men aggregate more favorably remunerated codes."
Biased / Unsubstantiated Rationale:
-" An alternative possibility is that the reduced clinical activity of female practitioners is not associated with the intentional practice choices women make and instead is due to factors outside of their control. Overt discrimination has yet to be eliminated from the profession of medicine"
-"These sex-based distinctions in subspecialization may develop because men are more attuned to the possibility of differences in revenue generation, or because radiation oncology subspecialties that women choose (or are encouraged to choose) involve less revenue-generating [good up to here - women may be more interested in breast and Gyn cancer with less IMRT use and men GU] “communal” attributes rather than more favorably reimbursed “agentic” attributes" [why go there?]
-"Our study illustrates a gap between the sexes in Medicare charges and collections for radiation oncologists, the latter of which is possibly attributable to female physicians consistently submitting fewer charges and charging for services that are less well reimbursed [This part is a good point]. The source of this variation is unknown but warrants further study, as it may have implications for addressing value as well as sex-based barriers for economic advancement within the specialty of radiation oncology and beyond [This part not so much]."
I hate the rationale just above because it is highly unnecessary to insert "overt discrimination" and "sex based barriers" unless there are men in charge who tell women to bill less b/c they are female???
All the other points are excellent and I agree that we do need to talk about breast cancer treatments using 3DCRT making significantly less than prostate cancer using IMRT. These are real talking points and places we can improve. If it is true female radiation oncologists are submitting fewer charges we can deal with that as well. It appears to me the gender bias / discrimination arguments are highly unnecessary for this article, but doubt it would've been published in JAMA without tipping your hat in that direction.
I really just wanted to get that Troll's face off as the most recent post on this thread, but there is an interesting article above that just came out in JAMA Network Open.
Main point "Our findings suggest that female radiation oncologists submit fewer charges and collect less Medicare reimbursement than do male radiation oncologists in all practice settings... The gap in Medicare collections may be driven in part by fewer charges submitted by female radiation oncologists"
Good Points:
+ "A flexible work schedule and opportunities for part-time employment have been shown to be attractive options for female radiation oncologists"
+ "It is also possible that women prioritize time spent with a given patient vs number of patients seen, and that extra time spent counseling patients is not reflected in HCPCS code volume."
+ " It is possible that female radiation oncologists may include in their practice a greater proportion of less well-reimbursed technologies such as 3-dimensional conformal therapies (typically used for treating breast cancer), while foregoing more favorably reimbursed technologies such as intensity modulated radiation therapy(typically used for treating genitourinary malignant neoplasms"
+"Quantifying these differences has allowed us to show that women consistently billed for less remunerative services, which is neither expected nor rational. In comparable studies examining similarly productive subspecialists in other fields such as orthopedic surgery, sex-based differences in Medicare collections were not apparent,so further study is required to determine the factors unique to radiation oncology that result in women submitting more poorly remunerated procedure codes at the same time that men aggregate more favorably remunerated codes."
Biased / Unsubstantiated Rationale:
-" An alternative possibility is that the reduced clinical activity of female practitioners is not associated with the intentional practice choices women make and instead is due to factors outside of their control. Overt discrimination has yet to be eliminated from the profession of medicine"
-"These sex-based distinctions in subspecialization may develop because men are more attuned to the possibility of differences in revenue generation, or because radiation oncology subspecialties that women choose (or are encouraged to choose) involve less revenue-generating [good up to here - women may be more interested in breast and Gyn cancer with less IMRT use and men GU] “communal” attributes rather than more favorably reimbursed “agentic” attributes" [why go there?]
-"Our study illustrates a gap between the sexes in Medicare charges and collections for radiation oncologists, the latter of which is possibly attributable to female physicians consistently submitting fewer charges and charging for services that are less well reimbursed [This part is a good point]. The source of this variation is unknown but warrants further study, as it may have implications for addressing value as well as sex-based barriers for economic advancement within the specialty of radiation oncology and beyond [This part not so much]."
I hate the rationale just above because it is highly unnecessary to insert "overt discrimination" and "sex based barriers" unless there are men in charge who tell women to bill less b/c they are female???
All the other points are excellent and I agree that we do need to talk about breast cancer treatments using 3DCRT making significantly less than prostate cancer using IMRT. These are real talking points and places we can improve. If it is true female radiation oncologists are submitting fewer charges we can deal with that as well. It appears to me the gender bias / discrimination arguments are highly unnecessary for this article, but doubt it would've been published in JAMA without tipping your hat in that direction.
But I thought one of the points being pushed for (at some point in all this) was that it was best for women to see women doctors because they will be able to relate to them better, so breast cancer will go to female rad oncs.... and thus prostate cancer should (since we've shooting for equality here, right?) go to male rad oncs?
Can't have your cake and eat it too.
Agree with the results, disagree with the discussion. Seems like a clear case of taking the (objective) data and trying to make (subjective) opinions.
Regardless, lord knows who has $3000 to publish this in an open access journal.
Can't have your cake and eat it too.
Agree with the results, disagree with the discussion. Seems like a clear case of taking the (objective) data and trying to make (subjective) opinions.
Regardless, lord knows who has $3000 to publish this in an open access journal.
Towards a standard of care in oncology for transgender patients - Burns et al. Lancet Oncology, 2019
I find it interesting that many of our colleagues in radiation oncology are in lead positions when it comes to these diversity initiatives. In this paper from Lancet Oncology, 3/5 authors are radiation oncologists.
I feel much sympathy for our gender dysphoric and transgender patients. I agree that they need specialized care and sympathy. This population has a 41% suicide attempt rate, as seen on a study from the American Foundation for Suicide Prevention. Upmost respect and care is needed.
There are good points in this article, but it is sad to see exclusion (from those promoting "inclusivity") of the wide range of opinions on this topic. I am here to tell the authors the following points:
-We should not be forced / compelled to use gender pronouns against the threat of professional condemnation
-We should not give up "the binary sex-based approach to cancer (male patients get prostate cancer; female patients get ovarian cancer)" for this population
-We should not have political groups (from either side) to help decide oncology treatment standards
- Article quote: "Third, transgender community leaders, organisations, and patients must be involved in the development of treatment standards "
-We should not promote the idea that minority groups are better served by those in their minority groups, as we have talked about much here
- Article quote: ."Minority patients report better doctor–patient relationships, health-care access, and outcomes when they are treated by doctors of their minority group." Do you really think this is going to favor transgender doctors? The NEJM had an article written before entitled Dealing with Racist Patients. Patient's will have a pass to ask for non-transgender doctors, which would be wrong.
Likely, these groups do not represent everyone in the transgender community (popular transgender individuals such as Blair White or Deirdre McCloskey would disagree with many aspects of this article). Many transgender patients probably just want the best cancer care they can get by the time they see us and most of us would treat them with respect, kindness, and give them that care without ideologues telling us how to do so.
I find it interesting that many of our colleagues in radiation oncology are in lead positions when it comes to these diversity initiatives. In this paper from Lancet Oncology, 3/5 authors are radiation oncologists.
I feel much sympathy for our gender dysphoric and transgender patients. I agree that they need specialized care and sympathy. This population has a 41% suicide attempt rate, as seen on a study from the American Foundation for Suicide Prevention. Upmost respect and care is needed.
There are good points in this article, but it is sad to see exclusion (from those promoting "inclusivity") of the wide range of opinions on this topic. I am here to tell the authors the following points:
-We should not be forced / compelled to use gender pronouns against the threat of professional condemnation
-We should not give up "the binary sex-based approach to cancer (male patients get prostate cancer; female patients get ovarian cancer)" for this population
-We should not have political groups (from either side) to help decide oncology treatment standards
- Article quote: "Third, transgender community leaders, organisations, and patients must be involved in the development of treatment standards "
-We should not promote the idea that minority groups are better served by those in their minority groups, as we have talked about much here
- Article quote: ."Minority patients report better doctor–patient relationships, health-care access, and outcomes when they are treated by doctors of their minority group." Do you really think this is going to favor transgender doctors? The NEJM had an article written before entitled Dealing with Racist Patients. Patient's will have a pass to ask for non-transgender doctors, which would be wrong.
Likely, these groups do not represent everyone in the transgender community (popular transgender individuals such as Blair White or Deirdre McCloskey would disagree with many aspects of this article). Many transgender patients probably just want the best cancer care they can get by the time they see us and most of us would treat them with respect, kindness, and give them that care without ideologues telling us how to do so.
Unplugging the Pipeline — A Call for Term Limits in Academic Medicine
Considering what I've seen with some of the sept and octagenarians in the field in terms of skill/competence in this field, I can't disagree, irrespective of race or gender. Far more compelling reason to get rid of them for that reason rather than dragging the race/gender issue into it
Disgusting.
This public virtue signalling race to see who can play the biggest victim and cast wide stereotypes is not going to end well.
It's all superficial identity politics, dividing people based on appearances and lumping them in groups.
That this nonsensical noxious zeitgeist has become so pervasive in academia speaks volumes to what it produces and to what its current value has been reduced.
You'd think we'd be better than this kneejerk intersectionality.
White, male, christian, straight, over represented minority = bad
Black, brown, female, gay, non-christian = good
All the former are trying to suppress all the latter. And any differences in things like employment or income must automatically be due to this completely fictional ghost in the machine, right?
#WOMENWHOCURIE. What's this supposed to mean? Are you implying that there are so many males in our field that don't think women can do this job that we need to make this special event for it? Are you saying that you don't trust me not to automatically assume you are inferior or unqualified? It is actually quite insulting and personally deeply disturbing to be made to feel like I must be so inherently prejudiced.
Equality of opportunity has existed for quite a while now, friends. There are exceptions, but if you want to claim this vast conspiracy with all the old white and ORM males sitting around in secret societies trying to figure out how to underpay and under-employ female professionals, you're going to have to provide evidence, you know, something we pride ourselves on doing. Because I'm just not seeing it on a systemic scale. In fact, I'm seeing the opposite, with efforts to preferentially recruit people based on sex (female) and skin color (non-white, non-east Asian).
So, so sick of this, and people riding this politically correct wave of cultural toxicity, and outright racism and sexism, to further their careers. And the whole "look at how woke I am" culture Twitter has promoted. Twitter. Tweeting. Hunting for praise and likes. Public recognition. C.V. boosting. Affirmation of character through public shaming. Aren't we better than that?
Last edited:
So how do you really feel?
Get the old PEOPLE out. Idgaf how.
KHE damn.
KHE damn.
Its funny how some of these absolutely pitiful “leaders” are women minorities who have actually hurt everyone including the people they claim to care about with their sorry excuse for leadership. Never mind that two white guys are only people who stood up speaking truth to LK and PW.
i dont care who is a leader, what pronouns they like, their origin, who they go home to at night, i just want a good leader.
The cabal of WASPS is nowhere to be found. We need entrenched bad leaders out whoever they are!!
i dont care who is a leader, what pronouns they like, their origin, who they go home to at night, i just want a good leader.
The cabal of WASPS is nowhere to be found. We need entrenched bad leaders out whoever they are!!
I'm all for removing those who are unable to perform clinically from the field. I don't care what race or gender they are. Bring back competency exams for folks over 70 the way we ask old people to confirm they can still drive safely. What's more dangerous in an old, unsafe person's hands? A car or a linear accelerator?
I am pretty sure the answer is a car. I get your point, but this is probably not a good analogy.
The car only kills and gets totaled once typically.... The 70 y/o can keep screwing patients up with the same linac.
I kid (sort of). I've seen a few folks who dual certified in rads and RO in the early 1970s. Very scary to see their transition from using China pencils on film to contouring for imrt
Last edited:
Fair. Was the only thing that easily came to mind when I thought about what we ensure old people can continue to do when they are old.
‘Imagine how it would feel to be a white male chair or dean and knowing that you just got called a rotting old drain clog in the NEJM...’
Omg poor them.
Wait - am I taking crazy pills? Those chairs get Called that and worse daily in this sub-forum.
Omg poor them.
Wait - am I taking crazy pills? Those chairs get Called that and worse daily in this sub-forum.
#1 is important. Calling someone out for their actions and the ramifications on the field or for their inability to independently provide modern radiotherapeutic treatment is far different than calling them out solely because of their race and sex.
Probably car. Young therapists/dosimetrists/physicists are an old rad onc's chauffeurs.
A couple of things
1) I can't wait until Reshma Jagsi has to point out actual real life people, not imaginary "white men" to bring down. She needs to WALK THE WALK in her own dept. before trying to clean up the rest of the world. FIRE YOUR OWN WHITE MALE CHAIR WHO HAS BEEN THERE A LONG TIME. Oh btw, see some other “random who cares b/c they are white males” under Theodore Lawrence as well on their website
2) Dr. Jagsi keeps harping about URMs - UNDER represented minorities. SHE IS ASIAN/INDIAN = OVER REPRESENTED minority. Be consistent and apply your own rules to YOURSELF. Bonus How long have you kept your deputy chair position? Isn't time for you to move over for a true URM.
Mind you there are only 2-3% Jews in the population and 6-7% Asians, but I believe these groups make up 10-15% and 20-25% of physicians respectively. Dr. Jagsi tell us how much is too much? Perhaps you can just ask your alma mater / Harvard for advice.
3) I have been saying here for a while, this is eventually going to spill over into the patient doctor relationship. I am not looking forward to the day when patient's ask for a white, black, Asian, Hispanic, Muslim, Jewish, etc. doctor that best matches their own identity. Following on the heals of this will be those who will want to ask on ideological basis. Politics is destroying everything why should the patient-doctor relationship be spared?
Last edited:
