Frosty- That is a heavy "welcome to SDN" that seems like it has been waiting to be released! I appreciate the directness, and that means a lot that you believe I have helped millions of people around the world. That truly makes my day, and thank you for saying that.
You should have more confidence to speak up, and you may be surprised if you put yourself out there (with your real name) that you can make as big of an impact as you want (ASCO for example is looking for a community practice doc for their board). There are many very influential people in radonc that work in community practices (Chris Jones, first author on RTOG 9408; Frank Vicini is a world expert in breast cancer...very long list). I am a firm believer data is data, and there are many community docs that have a better synthesis of the data than some in the ivory towers who dont have to deal with the complete implications of various recommendations.
I think we all can agree that everyone has a voice, just as all of you have a very important voice here that I imagine many undergraduates, med students, residents and attendings read that help shape the perception of radonc. You also have an important voice in that you can use it to promote radonc, spread knowledge, etc, or use it to make assumptions and talk about people who you may or may not know personally. The fact that this thread started off with people sharing the OncCOVID app, it seems at first glance that people here are trying to disseminate knowledge to help our field and patients. This is awesome. As a quote that I have realized is spot on year after year...great minds discuss ideas. Average minds discuss events. Small minds discuss people. For you to be a radonc you all must have great minds
Humility is very important, and try to not over-interpret people (good or bad) based on limited data. To give you one example Frosty that you brought up, please dont think what happens on stage is not scripted or unrehearsed. Paul is a good friend of mine, a brilliant clinician, and is and will be a great leader in our field (will be an incredible Chair). I helped make Paul's slides with him and we went over what each of us would say. Although I delivered the talk, do you think my co-authors didnt edit/approve my slides (19 other experts in GU)? Do you think ASTRO leadership doesnt edit the final plenary slides? Paul did a perfect job in providing balance and that is the job of a discussant. My job is to present new data and draw conclusions. I am always happy to discuss limitations/problems with research, especially my own.
People on this forum, in practice, myself included, should be humble enough to know what they are and are not an expert in (hence why I have built a huge team with diverse expertise). Often quantifying the credibility of research and complex biostatistics is not something most people in medicine can say they are well-versed in. Thus, it is easy to dismiss something because of simple rules they read or heard about. Even biostatisticians are often not experts in balancing clinical and statistical significance and credibility; it is a retrospective study so its bad (that is how Gleason grade groups were created and the D'amico risk groups, which are practice changing), post-hoc from randomized data so it is not credible (why we dont give ADT to low risk men despite them being included in RTOG 9408), or people who even dismiss randomized data because of their own anecdotes or how they were trained (multiple trials showing no benefit in treating low risk PCa, but 20-50% of practices still do it) or those who believe all randomized data (PLCO PSA screening trial- US Task Force believed it). I can promise you that the more I read, the more collaborators I have, the more I learn in general....the more I realize how much I dont know and how insanely complex doing good research is. So many variables are out there that 99% of clinicians and academicians dont know are creating confounding, but want to draw conclusions anyways. There are so many complexities to even a published paper that never are shown given word limits.
Bottom line, I hope everyone keeps promoting our field, helping our patients, and trying to always learn more. Challenge dogma with data. The power of social media, journals, ASTRO, etc is that data is data. It doesnt matter if you are the president of ASTRO, a Chair, Professor, a thought leader, clinician, resident, or med student, data can prove any of these people wrong, but more importantly, can and should be used to help our patients.
I hope to pop in and out if there are questions. I sadly likely cant stay 100% on top of SDN, but that is why all of you are here to represent! Feel free to email with questions and I will do my best to keep up.
Best,
Dan
So on that note.
