Is there unspoken tension between RTs and Rad Oncs that I don’t know about?

[Anthodite]

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Your resident new grad RT here. Why do I feel like some rad oncs just don’t like RTs or think we’re glorified button pushers?

I’m not referring to obvious not getting along stuff at work from the rad onc doing add on sims at 4:30pm or the radiation therapist purposely not following exact orders. That’s valid coworker hatred. I can’t say the same for the following:

- I mean like this rad onc feeling the need to try to pimp one of my freshmen students like she hasn’t learnt half of the stuff we’re doing at school, why embarrass her in front of a patient?

-I recently applied to a rad onc lab(because I’m premed and rather get into research I like) and the website mentioned “oncology experts” it listed EVERYONE in the department from med physics/dosimetry to like child life care& counselors. Like no mention of a radiation therapist anywhere not even in the patients “what to expect” section which I find weird. What do you mean: “you get a CT simulation, rad onc reviews, dosimetry plans, physics confirms, radiation is received with check ups from nursing every week”. It feels like it was purposely left out I don’t know. Maybe I’m overthinking because the author of the website is also the person who rejected me from the lab.

I would mention the fact so many patients would be scared that RTs give the radiation but I’m going to give the benefit of the doubt it’s not exactly something to remember telling the patient every time.

Be honest were you ever taught during residency or something that RTs were button pushers or something? If so, god I wish that’s all it took to pass the registry. I had one rad onc tell me that my program was a mini residency minus the other aspects of oncology and actually prescribing/verifying things.

P.S. I don’t hate rad oncs I actually wanna become one because of the ones I loved. And disclaimer: I used paraphrased quotes to give the center anonymity but if you recognize this random famous website please let’s not state the name of the center okay.

 

[brushbeamscanning]

I think it's really culture dependent but I would say most rad oncs really appreciate radiation therapists; they're super important to delivery of care and especially for CT simulations. Good, well trained RTs make your clinic run efficiently, they catch things too sometimes and help with IGRT etc.

 

[thecarbonionangle]

Generally no issues with them. There are some who can be quite bad, arrogant and ignore physician orders,lazy. Some of the culture in the RT run departments with admins who were RTs, can have very anti physician policies. i don’t think there is general animosity. It is person specific.

 

[thesauce]

I don’t think I can cover all the specific examples but will address at least one.

On the whole, it has been my experience that no one complains as much in the department as RTTs. They complain about hours, they complain about pay, they complain about introducing new technology, and they complain about the number of patients. The latter is ironic because that is a conflict of interest. Fewer patients mean less work for the RTT and an easier schedule, but less revenue for the department, but the RTTs still want more $.

While radoncs have seen a massive decrease in their salary against inflation, RTTs have gone up tremendously and it is NEVER enough. They are always looking around for a better deal and threatening to walk.

A specific point you brought up:

- I mean like this rad onc feeling the need to try to pimp one of my freshmen students like she hasn’t learnt half of the stuff we’re doing at school, why embarrass her in front of a patient?

This is how we learn in much of med school and residency. Some people (maybe most) hate it. I loved it - when I was put on the spot, I remembered the answer FOREVER. He/she is trying to teach in a way they think is effective and I’d encourage you not to take it personally.

 

[RickyScott]

Very department dependent. Many hospitals seem more concerned with keeping tech/staff happy than docs to the point where the doc is almost subordinate to them. With igrt, I do think the importance of the tech has increased vs when I was in training. Good for them if they can increase their salaries. That’s how a market should work. Long term, there will be less fractions and techs don’t have a great future.

 

[RickyScott]

Very department dependent. Many hospitals seem more concerned with keep tech/staff happy than docs to the point where the doc is almlst subordinate to them. Oversupply of radoncs directly impacts power dynamics.

With igrt, I do think the importance of the tech has increased vs when I was in training. Good for them if they can increase their salaries. Long term there will be less fractions and I wouldn’t want to be a tech in 20 years

 

[Anthodite]

I think it's really culture dependent but I would say most rad oncs really appreciate radiation therapists; they're super important to delivery of care and especially for CT simulations. Good, well trained RTs make your clinic run efficiently, they catch things too sometimes and help with IGRT etc.

^Generally this has been most of the vibe I’ve got, like you can tell when a department has a good team relationship like that and I think most do.

Generally no issues with them. There are some who can be quite bad, arrogant and ignore physician orders,lazy. Some of the culture in the RT run departments with admins who were RTs, can have very anti physician policies. i don’t think there is general animosity. It is person specific.

Yeah the RTs that I’ve met who don’t get along with the doctor are also the ones that don’t get along with most of their other coworkers.

Very department dependent. Many hospitals seem more concerned with keeping tech/staff happy than docs to the point where the doc is almost subordinate to them. With igrt, I do think the importance of the tech has increased vs when I was in training. Good for them if they can increase their salaries. That’s how a market should work. Long term, there will be less fractions and techs don’t have a great future.

Does this have anything to do with therapists usually being understaffed? Now I know this varies region to region, but like where I’m from if a center is well staffed for a consistent time with non travelers it’s ONLY a because they pay a fair wage. Also this is my first time hearing fractionation related to the job market for us. In terms of grim RT prospects it’s always that new varian linac that’s tripping everyone up. But haha… three years of school down the drain ig 😭

 

[RickyScott]

^Generally this has been most of the vibe I’ve got, like you can tell when a department has a good team relationship like that and I think most do.

Yeah the RTs that I’ve met who don’t get along with the doctor are also the ones that don’t get along with most of their other coworkers.

Does this have anything to do with therapists usually being understaffed? Now I know this varies region to region, but like where I’m from if a center is well staffed for a consistent time with non travelers it’s ONLY a because they pay a fair wage. Also this is my first time hearing fractionation related to the job market for us. In terms of grim RT prospects it’s always that new varian linac that’s tripping everyone up. But haha… three years of school down the drain ig 😭

almost by definition if department is understaffed, it is because they are not paying market salaries. Sometimes, they may need to pay in the 80-90% because they have particularly nasty cultures/admins or bad locations, but so be it. Techs will be more affected by hypofrac than anyone else in the dept. episode based payments would cut my dept operating hrs by more than 1/2. Earn as much as you can in next 5 yrs.

 

[Anthodite]

On the whole, it has been my experience that no one complains as much in the department as RTTs. They complain about hours, they complain about pay, they complain about introducing new technology, and they complain about the number of patients. The latter is ironic because that is a conflict of interest. Fewer patients mean less work for the RTT and an easier schedule, but less revenue for the department, but the RTTs still want more $.

While radoncs have seen a massive decrease in their salary against inflation, RTTs have gone up tremendously and it is NEVER enough. They are always looking around for a better deal and threatening to walk.

A specific point you brought up:

This is how we learn in much of med school and residency. Some people (maybe most) hate it. I loved it - when I was put on the spot, I remembered the answer FOREVER. He/she is trying to teach in a way they think is effective and I’d encourage you not to take it personally.

Woah I’ve never thought about it from this POV. All I know is centers are recommended to have 2 therapists for every 25 patients being treated but most don’t.

A lot of centers I’ve rotated through don’t have enough radiation therapists to the point I was asked to fill in as a student. Yes, you heard that right I did everything alone but beam on when I was a student. Great learning experience but my 15 min lunch breaks and the feeling like I doing two-three peoples job for free was draining.

It sucks you guys aren’t being fairly compensated and I really want the best for you all. But understanding when most therapists are window shopping for jobs it’s likely because they’re being overworked.

I won’t lie I’ve met some RTs who hate their career for many reasons and some seasoned ones that refuse to acknowledge SGRT actually being useful. I can get why you wouldn’t like working with these people, I surely don’t.

-oh god you guys had to go through that kinda questioning during training? I’m not a fan of that style of learning, it’s borderline if not actually traumatizing. My student spent the rest of her day not being able to focus during clinicals and I wasn’t sure how to help as a new grad besides tell her it was okay to not know something.

 

[Anthodite]

almost by definition if department is understaffed, it is because they are not paying market salaries. Sometimes, they may need to pay in the 80-90% because they have particularly nasty cultures/admins or bad locations, but so be it. Techs will be more affected by hypofrac than anyone else in the dept. episode based payments would cut my dept operating hrs by more than 1/2. Earn as much as you can in next 5 yrs.

You’re so right, this very famous place I rotated at paid like $5-10 an hour with a HEFTY sign on bonus more than every other center. They consistently rely on new grads staying for their minimum 1 year and travelers to keep it functional. You could not pay me an attending rad oncs salary to work there. At that center I experienced more forms of discrimination and bullying than I knew existed. Those extra $5-10 would go to the psychiatrist I relied on to get through my required time there.

You’re making me want to go into superficial radiation therapy or get my CT credentials now. I’ve only noticed hypofrac be popular for breast(APBI) and lung(SBRT) patients, not quite as much for everyone else like all the palliative cases I see. Is this changing too?

 

[pikachu]

Woah I’ve never thought about it from this POV. All I know is centers are recommended to have 2 therapists for every 25 patients being treated but most don’t.

A lot of centers I’ve rotated through don’t have enough radiation therapists to the point I was asked to fill in as a student. Yes, you heard that right I did everything alone but beam on when I was a student. Great learning experience but my 15 min lunch breaks and the feeling like I doing two-three peoples job for free was draining.

It sucks you guys aren’t being fairly compensated and I really want the best for you all. But understanding when most therapists are window shopping for jobs it’s likely because they’re being overworked.

I won’t lie I’ve met some RTs who hate their career for many reasons and some seasoned ones that refuse to acknowledge SGRT actually being useful. I can get why you wouldn’t like working with these people, I surely don’t.

-oh god you guys had to go through that kinda questioning during training? I’m not a fan of that style of learning, it’s borderline if not actually traumatizing. My student spent the rest of her day not being able to focus during clinicals and I wasn’t sure how to help as a new grad besides tell her it was okay to not know something.

People who want to go to medical school should acclimate themselves to the socratic method “tout de suite” as they say. If you think a couple questions meant to teach are “traumatizing” you may want to rethink your career choices.

 

[RickyScott]

You’re so right, this very famous place I rotated at paid like $5-10 an hour with a HEFTY sign on bonus more than every other center. They consistently rely on new grads staying for their minimum 1 year and travelers to keep it functional. You could not pay me an attending rad oncs salary to work there. At that center I experienced more forms of discrimination and bullying than I knew existed. Those extra $5-10 would go to the psychiatrist I relied on to get through my required time there.

You’re making me want to go into superficial radiation therapy or get my CT credentials now. I’ve only noticed hypofrac be popular for breast(APBI) and lung(SBRT) patients, not quite as much for everyone else like all the palliative cases I see. Is this changing too?

Once 300x10 pays the same as 800 x1/2, palliative will shift massively.

 

[Anthodite]

People who want to go to medical school should acclimate themselves to the socratic method “tout de suite” as they say. If you think a couple questions meant to teach are “traumatizing” you may want to rethink your career choices.

It’s one thing to ask questions for a learning opportunity, it’s another to do so in a way meant to embarrass the student to the point her eyes turned red in front of a patient. The Socratic method doesn’t include laughing at the students response and then proceeding to explain how ridiculous their answer was. If the pathway to being a doctor is filled with teachers who enjoy breaking down their students, then yes I will reconsider.

 

[CaesarRO]

It’s one thing to ask questions for a learning opportunity, it’s another to do so in a way meant to embarrass the student to the point her eyes turned red in front of a patient. The Socratic method doesn’t include laughing at the students response and then proceeding to explain how ridiculous their answer was. If the pathway to being a doctor is filled with teachers who enjoy breaking down their students, then yes I will reconsider.

Definitely depends where you go, but it's quite common. Whether it's less common or core part of training, you'll definitely encounter it more than once along the path to becoming a doctor

 

[ramsesthenice]

I buy their affection with donuts, pizza, or other goodies a couple times per month. I also know all 24 of their names and general family/social situations so I can talk about how they are doing at the machines. I don’t get half the pushback some of my colleagues do. The little relationship things that work elsewhere in life work pretty good here too.

My mom was a nurse and would go out of her way to take as long as possible and ask as many stupid questions as she could to the docs who she didn’t like. I see plenty of that dynamic around me now and want no part of it.

 

[RickyScott]

I buy their affection with donuts, pizza, or other goodies a couple times per month. I also know all 24 of their names and general family/social situations so I can talk about how they are doing at the machines. I don’t get half the pushback some of my colleagues do. The little relationship things that work elsewhere in life work pretty good here too.

My mom was a nurse and would go out of her way to take as long as possible and ask as many stupid questions as she could to the docs who she didn’t like. I see plenty of that dynamic around me now and want no part of it.

Yup. Be kind and reasonable with staff. Large systems are dehumanizing employers at every level. Last thing you need is staff going out of their way to make your life difficult. Totally lucked out w/present group of techs, but have been in some awful situatuons in the past with staff trying to stab me in the back w/zero reason. That sort of dynamic will inevitably happen at some point in a large system without you inviting it upon yourself.

 

[Reaganite]

Your resident new grad RT here. Why do I feel like some rad oncs just don’t like RTs or think we’re glorified button pushers?

I’m not referring to obvious not getting along stuff at work from the rad onc doing add on sims at 4:30pm or the radiation therapist purposely not following exact orders. That’s valid coworker hatred. I can’t say the same for the following:

- I mean like this rad onc feeling the need to try to pimp one of my freshmen students like she hasn’t learnt half of the stuff we’re doing at school, why embarrass her in front of a patient?

-I recently applied to a rad onc lab(because I’m premed and rather get into research I like) and the website mentioned “oncology experts” it listed EVERYONE in the department from med physics/dosimetry to like child life care& counselors. Like no mention of a radiation therapist anywhere not even in the patients “what to expect” section which I find weird. What do you mean: “you get a CT simulation, rad onc reviews, dosimetry plans, physics confirms, radiation is received with check ups from nursing every week”. It feels like it was purposely left out I don’t know. Maybe I’m overthinking because the author of the website is also the person who rejected me from the lab.

I would mention the fact so many patients would be scared that RTs give the radiation but I’m going to give the benefit of the doubt it’s not exactly something to remember telling the patient every time.

Be honest were you ever taught during residency or something that RTs were button pushers or something? If so, god I wish that’s all it took to pass the registry. I had one rad onc tell me that my program was a mini residency minus the other aspects of oncology and actually prescribing/verifying things.

P.S. I don’t hate rad oncs I actually wanna become one because of the ones I loved. And disclaimer: I used paraphrased quotes to give the center anonymity but if you recognize this random famous website please let’s not state the name of the center okay.

Ive worked with many great RTTs. Several have become close personal friends. That being said, if someone asked me to predict the problem employee in any RT department, I'm going with an RTT. Every department has that one RTT that is absolutely obsessed with the schedule, desperate to get out of clinic by 2PM, will schedule a patient at 6AM any opportunity they get, etc. In the heyday of supervision rules, these guys were Satan incarnate as far as I was concerned. Be reasonable with the schedule, and you'll get along just fine with most rad oncs.

 

[ramsesthenice]

Ive worked with many great RTTs. Several have become close personal friends. That being said, if someone asked me to predict the problem employee in any RT department, I'm going with an RTT. Every department has that one RTT that is absolutely obsessed with the schedule, desperate to get out of clinic by 2PM, will schedule a patient at 6AM any opportunity they get, etc. In the heyday of supervision rules, these guys were Satan incarnate as far as I was concerned. Be reasonable with the schedule, and you'll get along just fine with most rad oncs.

I agree with everything but the problem employee comment. In the past, I would have agreed, but the way big systems work now, hands down, its the department admin. Though recently, I've rather enjoyed their attempt at a tongue lashing. Last week, they started in on me for screwing up management of a patient seen at one site and treated at another. I calmly took it all in and when they came up for air, asked them if I even had the administrative rights to do everything I would have had to do without involving their staff (knowing full damn well I don't). I was then able to turn the tables further and pull up the email thread I would have happily shared at the beginning had someone simply asked. To be fair, I actually really do like our admin and we usually have a great relationship. Which makes situations like this all the more frustrating. If we could start with professional courtesy and questions rather than accusations, it would have been a pleasant 2 min conversation.

 

[deleted1180461]

Agree with all of the above.

The department manager is the position that has the greatest potential to make your life hell.

The biggest issue I have with RTT is their complete inability to accept normal working hours (9 to 5). They have somehow shifted expectations that the work day ends at 5 to 4. Now they are upset if there’s anything past 3, and they’d really like to get it to 2. It is completely bizzare to me that they all think this way. If getting out at 2 meant starting at 5AM, 99% of them would do it. Is it something about the job that attracts people who like to go to bed at 8 PM? I don’t get it.

If you asked them what normal working hours are I’d put a large amount of money you would get a response of 7 to 3. 9 to 5? Never heard of such a crazy thing.

That said, I am lucky to have good managers and RTT now but have dealt with all these problems in the past.

 

[ramsesthenice]

Agree with all of the above.

The department manager is the position that has the greatest potential to make your life hell.

The biggest issue I have with RTT is their complete inability to accept normal working hours (9 to 5). They have somehow shifted expectations that the work day ends at 5 to 4. Now they are upset if there’s anything past 3, and they’d really like to get it to 2. It is completely bizzare to me that they all think this way. If getting out at 2 meant starting at 5AM, 99% of them would do it. Is it something about the job that attracts people who like to go to bed at 8 PM? I don’t get it.

If you asked them what normal working hours are I’d put a large amount of money you would get a response of 7 to 3. 9 to 5? Never heard of such a crazy thing.

That said, I am lucky to have good managers and RTT now but have dealt with all these problems in the past.

I can't speak to smaller or community practices but the role of the admin in an academic setting has to be viewed in context. There is so much waste and having someone ruthless keeping tabs can end up meaning a better bottom line when you want departmental support for academic research. This stuff is critical for junior faculty. I doubt anyone here would be shocked, but the proportion of academic rad oncs who leave easy money on the table by doing things like not checking CBs, writing LONs, or attending P2Ps can be disheartening. In many situations, it is a necessary evil brought on by ourselves.

Let me be clear, I am not talking about the police-state BS you guys have mentioned previously like trying to have you stay until 5:00 regardless of the treatment schedule etc. There is no context in which that crap is warranted or beneficial to anyone.

 

[deleted1180461]

I can't speak to smaller or community practices but the role of the admin in an academic setting has to be viewed in context. There is so much waste and having someone ruthless keeping tabs can end up meaning a better bottom line when you want departmental support for academic research. This stuff is critical for junior faculty. I doubt anyone here would be shocked, but the proportion of academic rad oncs who leave easy money on the table by doing things like not checking CBs, writing LONs, or attending P2Ps can be disheartening. In many situations, it is a necessary evil brought on by ourselves.

Let me be clear, I am not talking about the police-state BS you guys have mentioned previously like trying to have you stay until 5:00 regardless of the treatment schedule etc. There is no context in which that crap is warranted or beneficial to anyone.

If you paid each doctor per RVU rather than paying a salary and pooling the RVUs up and dividing the excess as the chair sees fit, then you wouldn’t have the problem of rad oncs not checking daily images. Nobody is going to leave 0.85 wRVU x 20 on the table more than a couple times a year, if that.

 

[TheWallnerus]

If you paid each doctor per RVU rather than paying a salary and pooling the RVUs up and dividing the excess as the chair sees fit, then you wouldn’t have the problem of rad oncs not checking daily images. Nobody is going to leave 0.85 wRVU x 20 on the table more than a couple times a year, if that.

Economics is not really the study of economies so much as it is the study of human behavior

 

[ramsesthenice]

If you paid each doctor per RVU rather than paying a salary and pooling the RVUs up and dividing the excess as the chair sees fit, then you wouldn’t have the problem of rad oncs not checking daily images. Nobody is going to leave 0.85 wRVU x 20 on the table more than a couple times a year, if that.

You would think that. If you have any food or drink in your mouth please stop reading now and finish whatever you are doing before continuing. I don't want to debate bonus/pay structure in academics and how much should be RVU based. Our department uses a formula which weights publications, grants, RVUs, department citizenship etc based on clinical vs tenure status. Basically, if you spend 30 minutes filling out the departmental form, you will get somewhere between 85 and 100% of your max bonus (which is 15% of your base). Its not huge, but we do it biannually and we are talking 35-50K for most of us twice a year. In multiple cycles over the last 2 years, at least one person has failed to submit the form and forfeited what is essentially a guaranteed bonus.

 

[thecarbonionangle]

Agree with all of the above.

The department manager is the position that has the greatest potential to make your life hell.

The biggest issue I have with RTT is their complete inability to accept normal working hours (9 to 5). They have somehow shifted expectations that the work day ends at 5 to 4. Now they are upset if there’s anything past 3, and they’d really like to get it to 2. It is completely bizzare to me that they all think this way. If getting out at 2 meant starting at 5AM, 99% of them would do it. Is it something about the job that attracts people who like to go to bed at 8 PM? I don’t get it.

If you asked them what normal working hours are I’d put a large amount of money you would get a response of 7 to 3. 9 to 5? Never heard of such a crazy thing.

That said, I am lucky to have good managers and RTT now but have dealt with all these problems in the past.

This is what i was alluding to. I have seen it multiple times. Usually the admin is also an RT and is totally on board. Schedule patients at 7 am block check. Sbrt during lunch, anything to be out by 3. The animosity ramps up rather quickly in these places.

 

[deleted1180461]

This is what i was alluding to. I have seen it multiple times. Usually the admin is also an RT and is totally on board. Schedule patients at 7 am block check. Sbrt during lunch, anything to be out by 3. The animosity ramps up rather quickly in these places.

It’s completely insane how this has become normal. Clinic starts at 9. 8-9 is tumor board and admin time. The day is over at 5. As a rule. Sometimes it can go to 6.

As an intern I remember being told to go home at 11pm. I’m sorry, but that doesn’t breed sympathy when someone gets pissy they have to stay past THREE PM.

 

[NotMattSpraker]

Like no mention of a radiation therapist anywhere not even in the patients “what to expect” section which I find weird.

Good discussion overall, thanks for your post.

I think this aspect is real. In my limited experience, therapists are often overlooked in comparison to all the other clinic workers. Im sure its not true everywhere.

Ill even admit I often make special mention of the "team they dont see" (dosi, physics) but do not make special mention of the therapists. It is totally unintentional, I love my therapists.

The patients do get to know them well and recognize their importance by showing them a lot of love... lots of gifts and cards. But certainly can introduce their importance earlier.

 

[OTN]

This is what i was alluding to. I have seen it multiple times. Usually the admin is also an RT and is totally on board. Schedule patients at 7 am block check. Sbrt during lunch, anything to be out by 3. The animosity ramps up rather quickly in these places.

Out by 3 pm. Lol. LMAO, even.

 

[Lamount]

Any tension that I see is the age-old conflict between ego and expectation. MDs think the ground should shake when we talk... and RTs expect to get home to their family, which is reasonable given that they make <20% what we do. In my department when there is an issue between RT and another doc, it's usually the doc trying to be a bully, and I end up siding with the RT.

 

[Tigerstang]

This is typically the sign of a toxic department and often linked to academics. Outside of my training institution, I have seldom seen these types of issues.

 

[OTN]

I am fiercely protective of our RTs and get emotional when I think about what they do for our patients. Our RTs are uniformly excellent, communicate very well with all of us, and I get countless great comments from patients. I've made it my personal goal to work with any and all RTs who want to advance their career in any way, and it is a huge source of pride for me that I've been able to make that happen for more than one of our therapists.

If you are a doctor who thinks you are "above" an RT, bully a therapist, or treat your therapists badly in any way you are doing radiation oncology wrong.

 

[deleted1180461]

I am fiercely protective of our RTs and get emotional when I think about what they do for our patients. Our RTs are uniformly excellent, communicate very well with all of us, and I get countless great comments from patients. I've made it my personal goal to work with any and all RTs who want to advance their career in any way, and it is a huge source of pride for me that I've been able to make that happen for more than one of our therapists.

If you are a doctor who thinks you are "above" an RT, bully a therapist, or treat your therapists badly in any way you are doing radiation oncology wrong.

There is a line between being a toxic boss that makes people stay until 5 with nothing to do (or forces people to go home early when they hit OT and make the rest operate short staffed) and letting the inmates run the asylum. “Above” may not be the appropriate word if it’s meant to convey status, but there is a chain of command in any functional organization. If I say there is an emergent ad on, there’s an emergent ad on. I don’t need to explain myself further.

I have seen RTTs take out doctors they don’t like. It’s amazing the power they can obtain in some dysfunctional systems.

 

[randomname2018]

I doubt anyone here would be shocked, but the proportion of academic rad oncs who leave easy money on the table by doing things like not checking CBs, writing LONs, or attending P2Ps can be disheartening.

As someone with knowledge of this in a large academic setting, the annual loss is staggering. Over a million in lost charges year over year.

 

[Gfunk6]

As someone with knowledge of this in a large academic setting, the annual loss is staggering. Over a million in lost charges year over year.

What a waste, that money could have been used to pay for five clinical instructors!

 

[thecarbonionangle]

There is a line between being a toxic boss that makes people stay until 5 with nothing to do (or forces people to go home early when they hit OT and make the rest operate short staffed) and letting the inmates run the asylum. “Above” may not be the appropriate word if it’s meant to convey status, but there is a chain of command in any functional organization. If I say there is an emergent ad on, there’s an emergent ad on. I don’t need to explain myself further.

I have seen RTTs take out doctors they don’t like. It’s amazing the power they can obtain in some dysfunctional systems.

Other things i have seen: therapist questioning the need for when the patient is starting. Therapist questioning the need for an immobilization device. Therapist questioning the need for new technology which is good for the patient because it “slows them down” (literally everything slows them down). Therapists questioning the need for the amount of arcs in a plan because it also “slows them down”. Therapist questioning the need to bill something as SBRT (multiple sites) because they do not want to treat multiple on one day so it is within 5fx, advocate to bill as IMRT. I could go on and on the things i have heard and seen over the years.

I’m sorry but they are not my equal. There is a chain of command. We didn’t go to school for so long to deal with this BS. And sorry you are not the only one who has to get home to their family.
This is one of those things that is almost impossible to pick up about a department unless you locum there for months.

 

[deleted1180461]

Other things i have seen: therapist questioning the need for when the patient is starting. Therapist questioning the need for an immobilization device. Therapist questioning the need for new technology which is good for the patient because it “slows them down” (literally everything slows them down). Therapists questioning the need for the amount of arcs in a plan because it also “slows them down”. Therapist questioning the need to bill something as SBRT (multiple sites) because they do not want to treat multiple on one day so it is within 5fx, advocate to bill as IMRT. I could go on and on the things i have heard and seen over the years.

I’m sorry but they are not my equal. There is a chain of command. We didn’t go to school for so long to deal with this BS. And sorry you are not the only one who has to get home to their family.
This is one of those things that is almost impossible to pick up about a department unless you locum there for months.

This is what happens when doctors become employees.

 

[thecarbonionangle]

This is what happens when doctors become employees.

The reality of the majority of the people in this board, the future the “leaders” wanted and got

 

[Reaganite]

There is a line between being a toxic boss that makes people stay until 5 with nothing to do (or forces people to go home early when they hit OT and make the rest operate short staffed) and letting the inmates run the asylum. “Above” may not be the appropriate word if it’s meant to convey status, but there is a chain of command in any functional organization. If I say there is an emergent ad on, there’s an emergent ad on. I don’t need to explain myself further.

I have seen RTTs take out doctors they don’t like. It’s amazing the power they can obtain in some dysfunctional systems.

This was my experience in a hospital setting and why I became so anti direct supervision. Shifted the power structure too heavily towards ancillary staff. "We're treating that patient at 6AM, and I'm not doing that emergent add on until tomorrow. Remember that time you left for tumor board and I treated that Medicare patient?" Needless to say I've been non-hospital based ever since, and my therapists are some of the best people I know.

 

[deleted1180461]

This was my experience in a hospital setting and why I became so anti direct supervision. Shifted the power structure too heavily towards ancillary staff. "We're treating that patient at 6AM, and I'm not doing that emergent add on until tomorrow. Remember that time you left for tumor board and I treated that Medicare patient?" Needless to say I've been non-hospital based ever since, and my therapists are some of the best people I know.

A return to direct supervision is completely unacceptable (and remember CMS just kicked the can down the road another year. The threat isn’t gone). Anybody here who continues to fund Astro has some explaining to do. Especially with the whole RW cancels TS for making a joke fiasco. Nothing exemplifies the whole big rad onc vs little rad onc conflict so precisely.

 

[Reaganite]

So rw was behind that??

 

[Lamount]

Other things i have seen: therapist questioning the need for when the patient is starting. Therapist questioning the need for an immobilization device. Therapist questioning the need for new technology which is good for the patient because it “slows them down” (literally everything slows them down). Therapists questioning the need for the amount of arcs in a plan because it also “slows them down”. Therapist questioning the need to bill something as SBRT (multiple sites) because they do not want to treat multiple on one day so it is within 5fx, advocate to bill as IMRT. I could go on and on the things i have heard and seen over the years.

I’m sorry but they are not my equal. There is a chain of command. We didn’t go to school for so long to deal with this BS. And sorry you are not the only one who has to get home to their family.
This is one of those things that is almost impossible to pick up about a department unless you locum there for months.

Just explain the need. Either 1) they will learn something 2) you will learn something or 3) you still get pushback… but you will seem much more reasonable pulling rank (and will probably earn the respect of the quiet therapist next to the one who is arguing).

At this point, I have therapists explaining to other therapists why I like things a certain way.

 

[CurbYourExpectations]

No, Ralph was not behind anything (as far as I know), that was a joke made by someone.
Todd does not deserve getting subpoenaed by anyone (if that happened). Todd has dealt with enough unnecessary bs and he seems like a good person. Jokes and nonmaleficence are not accountable by almost any laws.

My thoughts personally did not change at all based on Todd's tweet, I don't think any rational person would change a thought that would harm ASTRO based off of that tweet.

 

[deleted1180461]

So rw was behind that??

I have no idea. That what was claimed here. I have better things to do than get sued.

 

[Mandelin Rain]

Is there unspoken tension between RTs and Rad Oncs that I don’t know about?​

Not sure about all that, but I’ve worked in many clinics through my years and have witnessed plenty of unspoken (and spoken) sexual tension betwixt RTTs and Rad Oncs.

 

[drowsy12]

Is there unspoken tension between RTs and Rad Oncs that I don’t know about?​

Not sure about all that, but I’ve worked in many clinics through my years and have witnessed plenty of unspoken (and spoken) sexual tension betwixt RTTs and Rad Oncs.

Mostly spoken in my experience

 

[ramsesthenice]

Is there unspoken tension between RTs and Rad Oncs that I don’t know about?​

Not sure about all that, but I’ve worked in many clinics through my years and have witnessed plenty of unspoken (and spoken) sexual tension betwixt RTTs and Rad Oncs.

I was going to make a physics joke here but I don't want to get cancelled and well...it pretty much makes its self 😉

 

[TheWallnerus]

Mostly spoken in my experience

I was going to make a physics joke here but I don't want to get cancelled and well...it pretty much makes its self 😉

Definitely have known some physicists to have accelerated some particles into some RTTs
know what I’m sayin

 

[thecarbonionangle]

Definitely have known some physicists to have accelerated some particles into some RTTs
know what I’m sayin

Ive heard this more so in the often married MD to RT direction