Rad Onc Twitter

[Mandelin Rain]

If I really think a guy should have XRT, I will drop "diaper" a few times in the consult visit. I usually try to play it fairly straight though.

I don't play that Gillette song in the background, though. And I'm not talking about the razors.

---

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[medgator]

Definitely highlight the incontinence risk when pt is deciding on tx.. also discuss the need for viagra/cialis with xrt vs needing caverject or a penis pump (Austin powers reference here) with RP if things go south in terms of EF

 

[Dan Spratt]

Resident urologist weighing in. First off, let me say I agree that another retrospective NCDB review showing improved OS with surgery over radiation is neither novel nor informative, as it does not address any of the glaring issues of selection bias from the other 5,000 NCDB reviews that have been done. It also lacks face validity (50% OS improvement makes no logical sense, or I need to start offering RP to patients as a life extending treatment for all indications).

That being said, the uproar caused in rad-onc caused by a bad article in a low rent urology journal is pretty appalling. Chairman of a program calling a paper that some resident wrote "tabloid trash" on social media is unprofessional IMO, and I usually like what Dr. Spratt writes. Even worse is the chairman below, calling for people to write letters to promotion committees to effectively end people's careers. Be better.





View attachment 336173

DoctwoB-
I appreciate you weighing in. Great to hear the perspective of a urology resident. I was very disappointed in how my posts were interpreted and have personally apologized to the medical student who was first author of the paper and offered to personally mentor or help him.

I know all too well that social media posts can be misinterpreted given the tiny character limit and often minimal context of dozens of tweets. However, I want SDN to understand one thing- My post in no way was intended to be personal against anyone, especially not a medical student. My posts never are meant to be personal, but are to focus on data and to speak directly. My post was in regards to a publication that blatantly is propagating misinformation in the public domain, in a scientific journal, and in the journal that represents the SUO. This paper harms patients, period. People must accept that if you put your work in the public domain it is open to criticism and calling it tabloid trash is gentle to what it should be called and what patients would call it who feel they have been lied to by physicians and have been harmed by them.

It just so happens that papers have authors, and there is a first author of that paper, and that first author happened to be a medical student. That is why I blame in part the mentors (and their lack of training on understanding the problem with the paper) and was very clear that in no way is the medical student responsible. He was trusting their mentors, who work at Harvard and naturally should be trusted to guide them well. I also hold the editors, reviewers, and journal responsible, just as the NY Times and other non-biomedical journals would be...even tabloids have standards. Those journals get sued even for misinformation.

Thus, my criticism is directed at a flawed paper and not a personal attack on a student. I have stated this clearly on social media and personally to the student, and here as well. I have mentored >40 students, dozens of urology residents and fellows and faculty, and my comments in no way were meant to be anti urology (as I stated clearly). Radonc has put out similar trash and I have written high profile papers in JCO about brachy, papers about protons, carbon, etc and work hard as an editor and reviewer for >30 journals to not allow this type of garbage through, even when it shows RP is worse. I publicly have stated when I was a resident I was the first author of a paper showing brachy was better than EBRT, and I now publicly use my own paper as an example of the problems and harms of that type of research.

So to those fueling the fire that this had anything to do with a student, this is misguided and spinning something that is not true. A paper with a misleading title and conclusions that is impossible (which most urologists know) is unethical to publish and deserves to be called out. The mentors should have not done this and the journal should have not published it.

We should not take criticism of our work as personal. Trying to insult my professionalism (which I was not a Chair when I made the posts) is personal. Patients deserve us to not accept misinformation that can harm them. I am disheartened that so many would rather see patients harmed by these lies and stick up for their buddies/specialty instead. Reminds me of politics. I have received hundreds of messages thanking me for calling out this garbage from both urologists, radoncs, medoncs, and most importantly, patient advocacy groups.

Remember, while we type and have these dialogues patients are dying of cancer or developing serious side effects from our treatment. These are the real problems we should be focused on.

Keep up the great work everyone and remember that you will always end up on top when you are fighting for patients.

Best,
Dan

 

[OTN]

DoctwoB-
I appreciate you weighing in. Great to hear the perspective of a urology resident. I was very disappointed in how my posts were interpreted and have personally apologized to the medical student who was first author of the paper and offered to personally mentor or help him.

I know all too well that social media posts can be misinterpreted given the tiny character limit and often minimal context of dozens of tweets. However, I want SDN to understand one thing- My post in no way was intended to be personal against anyone, especially not a medical student. My posts never are meant to be personal, but are to focus on data and to speak directly. My post was in regards to a publication that blatantly is propagating misinformation in the public domain, in a scientific journal, and in the journal that represents the SUO. This paper harms patients, period. People must accept that if you put your work in the public domain it is open to criticism and calling it tabloid trash is gentle to what it should be called and what patients would call it who feel they have been lied to by physicians and have been harmed by them.

It just so happens that papers have authors, and there is a first author of that paper, and that first author happened to be a medical student. That is why I blame in part the mentors (and their lack of training on understanding the problem with the paper) and was very clear that in no way is the medical student responsible. He was trusting their mentors, who work at Harvard and naturally should be trusted to guide them well. I also hold the editors, reviewers, and journal responsible, just as the NY Times and other non-biomedical journals would be...even tabloids have standards. Those journals get sued even for misinformation.

Thus, my criticism is directed at a flawed paper and not a personal attack on a student. I have stated this clearly on social media and personally to the student, and here as well. I have mentored >40 students, dozens of urology residents and fellows and faculty, and my comments in no way were meant to be anti urology (as I stated clearly). Radonc has put out similar trash and I have written high profile papers in JCO about brachy, papers about protons, carbon, etc and work hard as an editor and reviewer for >30 journals to not allow this type of garbage through, even when it shows RP is worse. I publicly have stated when I was a resident I was the first author of a paper showing brachy was better than EBRT, and I now publicly use my own paper as an example of the problems and harms of that type of research.

So to those fueling the fire that this had anything to do with a student, this is misguided and spinning something that is not true. A paper with a misleading title and conclusions that is impossible (which most urologists know) is unethical to publish and deserves to be called out. The mentors should have not done this and the journal should have not published it.

We should not take criticism of our work as personal. Trying to insult my professionalism (which I was not a Chair when I made the posts) is personal. Patients deserve us to not accept misinformation that can harm them. I am disheartened that so many would rather see patients harmed by these lies and stick up for their buddies/specialty instead. Reminds me of politics. I have received hundreds of messages thanking me for calling out this garbage from both urologists, radoncs, medoncs, and most importantly, patient advocacy groups.

Remember, while we type and have these dialogues patients are dying of cancer or developing serious side effects from our treatment. These are the real problems we should be focused on.

Keep up the great work everyone and remember that you will always end up on top when you are fighting for patients.

Best,
Dan

Not as much trash talked about radiation around these parts by urology, after they bought their own machine and own radonc. Funny how that works out.

If I were on Twitter rather than SDN, I wouldn't be able to call out hiding behind a medical student while you publish a study with "controversial" (at best) conclusions for exactly what it is: cowardice.

Glad you're there, though, Dan. Keep up the good fight.

 

[RickyScott]

Not as much trash talked about radiation around these parts by urology, after they bought their own machine and own radonc. Funny how that works out.

If I were on Twitter rather than SDN, I wouldn't be able to call out hiding behind a medical student while you publish a study with "controversial" (at best) conclusions for exactly what it is: cowardice.

Glad you're there, though, Dan. Keep up the good fight.

Yip, also true for cryo or the latest purple laser.

 

[thesauce]

DoctwoB-
I appreciate you weighing in. Great to hear the perspective of a urology resident. I was very disappointed in how my posts were interpreted and have personally apologized to the medical student who was first author of the paper and offered to personally mentor or help him.

I know all too well that social media posts can be misinterpreted given the tiny character limit and often minimal context of dozens of tweets. However, I want SDN to understand one thing- My post in no way was intended to be personal against anyone, especially not a medical student. My posts never are meant to be personal, but are to focus on data and to speak directly. My post was in regards to a publication that blatantly is propagating misinformation in the public domain, in a scientific journal, and in the journal that represents the SUO. This paper harms patients, period. People must accept that if you put your work in the public domain it is open to criticism and calling it tabloid trash is gentle to what it should be called and what patients would call it who feel they have been lied to by physicians and have been harmed by them.

It just so happens that papers have authors, and there is a first author of that paper, and that first author happened to be a medical student. That is why I blame in part the mentors (and their lack of training on understanding the problem with the paper) and was very clear that in no way is the medical student responsible. He was trusting their mentors, who work at Harvard and naturally should be trusted to guide them well. I also hold the editors, reviewers, and journal responsible, just as the NY Times and other non-biomedical journals would be...even tabloids have standards. Those journals get sued even for misinformation.

Thus, my criticism is directed at a flawed paper and not a personal attack on a student. I have stated this clearly on social media and personally to the student, and here as well. I have mentored >40 students, dozens of urology residents and fellows and faculty, and my comments in no way were meant to be anti urology (as I stated clearly). Radonc has put out similar trash and I have written high profile papers in JCO about brachy, papers about protons, carbon, etc and work hard as an editor and reviewer for >30 journals to not allow this type of garbage through, even when it shows RP is worse. I publicly have stated when I was a resident I was the first author of a paper showing brachy was better than EBRT, and I now publicly use my own paper as an example of the problems and harms of that type of research.

So to those fueling the fire that this had anything to do with a student, this is misguided and spinning something that is not true. A paper with a misleading title and conclusions that is impossible (which most urologists know) is unethical to publish and deserves to be called out. The mentors should have not done this and the journal should have not published it.

We should not take criticism of our work as personal. Trying to insult my professionalism (which I was not a Chair when I made the posts) is personal. Patients deserve us to not accept misinformation that can harm them. I am disheartened that so many would rather see patients harmed by these lies and stick up for their buddies/specialty instead. Reminds me of politics. I have received hundreds of messages thanking me for calling out this garbage from both urologists, radoncs, medoncs, and most importantly, patient advocacy groups.

Remember, while we type and have these dialogues patients are dying of cancer or developing serious side effects from our treatment. These are the real problems we should be focused on.

Keep up the great work everyone and remember that you will always end up on top when you are fighting for patients.

Best,
Dan

I don’t know, Dan. You have nothing to be sorry for IMO. A fake randomized trial? Give me a break. It had to be addressed head-on. Serious issues with that journal’s editorial board...

You are a strong leader and a solid advocate for our profession. Carry on...but help us to contract residencies for the love of God

 

[fiji128]

So I went through the actual paper that Dr. Spratt and others are outraged about. Below is the link as it hasn't posted on here yet.

Radical prostatectomy versus external beam radiation therapy for high-grade, clinically localized prostate cancer: Emulation of a target clinical trial - PubMed

In observational analyses designed to emulate a target clinical trial of men with high-grade, clinically localized prostate cancer, RP was associated with improved OS compared with EBRT+ADT.

pubmed.ncbi.nlm.nih.gov

Yup, a total garbage study brought to you by a group of Harvard urologist. I wonder if it would've even been published if it came from lets say a mid tier state medical school. Surprised to see Anthony D'Amico name attached to this.

"This is the first study, to our knowledge, to specifically emulate a hypothetical target trial comparing definitive local therapies for prostate cancer. Given the difficulty of conducting randomized clinical trials in clinically-localized prostate cancer, carefully conducted observational analyses designed to emulate a hypothetical target trial may therefore provide the best source of evidence."

"Despite utilizing a rigorous framework to emulate a hypothetical target trial, this study has a number of limitations. Most importantly, it is non-randomized and subject to unmeasured confounding given a limited set of pre-treatment covariates available in the NCDB. Furthermore, the NCDB only captures OS, and thus we are unable to examine other meaningful oncologic outcomes such as development of metastatic disease or cancer-specific mortality." -lol

 

[Chartreuse Wombat]

Lower tier journal to be sure

InCites Journal Citation Reports

InCites Journal Citation Reports

journalprofile.clarivate.com

 

[RadOncMegatron]

DoctwoB-
I appreciate you weighing in. Great to hear the perspective of a urology resident. I was very disappointed in how my posts were interpreted and have personally apologized to the medical student who was first author of the paper and offered to personally mentor or help him.

I know all too well that social media posts can be misinterpreted given the tiny character limit and often minimal context of dozens of tweets. However, I want SDN to understand one thing- My post in no way was intended to be personal against anyone, especially not a medical student. My posts never are meant to be personal, but are to focus on data and to speak directly. My post was in regards to a publication that blatantly is propagating misinformation in the public domain, in a scientific journal, and in the journal that represents the SUO. This paper harms patients, period. People must accept that if you put your work in the public domain it is open to criticism and calling it tabloid trash is gentle to what it should be called and what patients would call it who feel they have been lied to by physicians and have been harmed by them.

It just so happens that papers have authors, and there is a first author of that paper, and that first author happened to be a medical student. That is why I blame in part the mentors (and their lack of training on understanding the problem with the paper) and was very clear that in no way is the medical student responsible. He was trusting their mentors, who work at Harvard and naturally should be trusted to guide them well. I also hold the editors, reviewers, and journal responsible, just as the NY Times and other non-biomedical journals would be...even tabloids have standards. Those journals get sued even for misinformation.

Thus, my criticism is directed at a flawed paper and not a personal attack on a student. I have stated this clearly on social media and personally to the student, and here as well. I have mentored >40 students, dozens of urology residents and fellows and faculty, and my comments in no way were meant to be anti urology (as I stated clearly). Radonc has put out similar trash and I have written high profile papers in JCO about brachy, papers about protons, carbon, etc and work hard as an editor and reviewer for >30 journals to not allow this type of garbage through, even when it shows RP is worse. I publicly have stated when I was a resident I was the first author of a paper showing brachy was better than EBRT, and I now publicly use my own paper as an example of the problems and harms of that type of research.

So to those fueling the fire that this had anything to do with a student, this is misguided and spinning something that is not true. A paper with a misleading title and conclusions that is impossible (which most urologists know) is unethical to publish and deserves to be called out. The mentors should have not done this and the journal should have not published it.

We should not take criticism of our work as personal. Trying to insult my professionalism (which I was not a Chair when I made the posts) is personal. Patients deserve us to not accept misinformation that can harm them. I am disheartened that so many would rather see patients harmed by these lies and stick up for their buddies/specialty instead. Reminds me of politics. I have received hundreds of messages thanking me for calling out this garbage from both urologists, radoncs, medoncs, and most importantly, patient advocacy groups.

Remember, while we type and have these dialogues patients are dying of cancer or developing serious side effects from our treatment. These are the real problems we should be focused on.

Keep up the great work everyone and remember that you will always end up on top when you are fighting for patients.

Best,
Dan

If I write a crap database paper can you mentor me too?

On a serious note, you have nothing to apologize for and have overwhelming support. Please don’t take your foot off the gas on this topic!

 

[deleted969641]

I stand by my assertion that it's academic dishonestly almost on the level of falsifying data. Abstracts are available to the general public (and the lay press who screams at the scientifically illiterate public to "trust the experts"), and I guarantee you somewhere out there today a urologist is telling a patient that new data just came out that shows that RP has a much better chance of curing your high risk prostate cancer than RT. Authors/journal should retract and apologize or else be prepared for this to affect their academic careers.

 

[Mandelin Rain]

I stand by my assertion that it's academic dishonestly almost on the level of falsifying data. Abstracts are available to the general public (and the lay press who screams at the scientifically illiterate public to "trust the experts"), and I guarantee you somewhere out there today a urologist is telling a patient that new data just came out that shows that RP has a much better chance of curing your high risk prostate cancer than RT. Authors/journal should retract and apologize or else be prepared for this to affect their academic careers.

I agree with this.

It is academically dishonest. It will be misinterpreted. It will justify poor care for patients.

Retraction or repercussions are appropriate.

 

[TheWallnerus]

and I guarantee you somewhere out there today a urologist is telling a patient that new data just came out that shows that RP has a much better chance of curing your high risk prostate cancer than RT.

It is academically dishonest. It will be misinterpreted. I will justify poor care for patients.

"You can guarantee it" because you are correct. Just look at all the times the article has been re-tweeted by urologists at this point with "RP improves survival versus radiation" bylines attached. I won't post the re-tweets here lest I be called... *gasp* unprofessional *gasp*

 

[TheWallnerus]

That is why I blame in part the mentors (and their lack of training on understanding the problem with the paper) and was very clear that in no way is the medical student responsible. He was trusting their mentors, who work at Harvard and naturally should be trusted to guide them well.

Yup, a total garbage study brought to you by a group of Harvard urologist.

Harvard

 

[seper]

we are at peak large database analysis

 

[Mandelin Rain]

Randomized Starbucks Gift Cards: Emulating a Prospective Clinic Trial through Emailed Pattern of Care Analysis.

 

[ROforbetterorworse]

Boris Gershman, MD - DF/HCC

- DF/HCC

www.dfhcc.harvard.edu

 

[seper]

When SEER studies (esp. linked to Medicare claims data) started coming out 15 years ago, its was very fun to read/do. Makes it extra sad to read this garbage now

 

[Doctorer]

This gives me an idea for a study.

Step 1: Find a bunch of SEER/NCDB papers comparing treatment modalities.
Step 2: Find the first author's specialty
Step 3: Find the correlation between a "positive" study and author specialty.

I'll settle for being middle author.

 

[MegaVoltagePhoton]

This gives me an idea for a study.

Step 1: Find a bunch of SEER/NCDB papers comparing treatment modalities.
Step 2: Find the first author's specialty
Step 3: Find the correlation between a "positive" study and author specialty.

I'll settle for being middle author.

What if there is a middle author of a different specialty? Maybe you could do propensity weighting based on author order?

 

[Doctorer]

What if there is a middle author of a different specialty? Maybe you could do propensity weighting based on author order?

That's why I'd limit the analysis to either first author or last author specialties. Although I like your spirit: we can save the IPW analysis for the second paper.

 

[Lamount]

Cap'n Crunch cures alzheimers (assertions based on simulated clinical trial constructed from facebook survey)

 

[ROforbetterorworse]

This gives me an idea for a study.

Step 1: Find a bunch of SEER/NCDB papers comparing treatment modalities.
Step 2: Find the first author's specialty
Step 3: Find the correlation between a "positive" study and author specialty.

I'll settle for being middle author.

Over/under of 6 months that this will be in print within next 6 months

$20

Radonc vs the field (all other specialties) on who will complete the project

$20

DM me for parlay 🤣

 

[Doctorer]

Over/under of 6 months that this will be in print within next 6 months

$20

Radonc vs the field (all other specialties) on who will complete the project

$20

DM me for parlay 🤣

That's why I want middle author credits! Please DM me for my contact info.

 

[radiation]

This gives me an idea for a study.

Step 1: Find a bunch of SEER/NCDB papers comparing treatment modalities.
Step 2: Find the first author's specialty
Step 3: Find the correlation between a "positive" study and author specialty.

I'll settle for being middle author.

Stereotactic Ablative Radiation Therapy Versus Surgery in Early Lung Cancer: A Meta-analysis of Propensity Score Studies - PubMed

For patients with early-stage non-small cell lung cancer who are eligible for either treatment, better overall survival was seen after surgery compared with SABR. However, lung cancer-specific survival was similar for both treatments. Prospective clinical trials are preferred to propensity...

pubmed.ncbi.nlm.nih.gov

Underrated paper

 

[beamotherapy]

I couldn't help but think of the current state of affairs in Rad Onc when I read this NYT article about polarization and in-grouping. About the motivations for posting on Twitter and SDN, and how both groups accuse each other of misinformation.

‘Belonging Is Stronger Than Facts’: The Age of Misinformation (Published 2021)

Social and psychological forces are combining to make the sharing and believing of misinformation an endemic problem with no easy solution.

www.nytimes.com

 

[RickyScott]

I couldn't help but think of the current state of affairs in Rad Onc when I read this NYT article about polarization and in-grouping. About the motivations for posting on Twitter and SDN, and how both groups accuse each other of misinformation.

‘Belonging Is Stronger Than Facts’: The Age of Misinformation (Published 2021)

Social and psychological forces are combining to make the sharing and believing of misinformation an endemic problem with no easy solution.

www.nytimes.com

While there is increasing polarization, at the end of the day, it is undeniable that resident numbers have doubled, while pt numbers have not, and that hypofractionation is increasing. This is just not in dispute by anyone. One side believes medstudents should just ignore these facts because we don’t have level 1 “evidence” of widespread unemployment. I very much doubt medstudents are making career choices based on the rantings of anonymous internet posters.

 

[OTN]

While there is increasing polarization, at the end of the day, it is undeniable that resident numbers have doubled, while pt numbers have not, and that hypofractionation is increasing. This is just not in dispute.

I would think, in addition, the anonymous nature of SDN would blunt some of the social benefit aspects of social media posting. To characterize what's been posted here as misinformation would be incorrect.

 

[elementaryschooleconomics]

While there is increasing polarization, at the end of the day, it is undeniable that resident numbers have doubled, while pt numbers have not, and that hypofractionation is increasing. This is just not in dispute by anyone. One side believes medstudents should just ignore these facts because we don’t have level 1 “evidence” of widespread unemployment. I very much doubt medstudents are making career choices based on the rantings of anonymous internet posters.

I love this.

SDN Guidelines: The rapid expansion of residency programs is causing oversupply which has a negative effect on the job market (Level 1)

Twitter Guidelines: The expansion of residency programs could theoretically make finding the ideal job slightly more difficult (Category 2B)

 

[beamotherapy]

While there is increasing polarization, at the end of the day, it is undeniable that resident numbers have doubled, while pt numbers have not, and that hypofractionation is increasing. This is just not in dispute by anyone. One side believes medstudents should just ignore these facts because we don’t have level 1 “evidence” of widespread unemployment. I very much doubt medstudents are making career choices based on the rantings of anonymous internet posters.

These are good points. I was also thinking of opinions about where our specialty is heading in general. On the one hand you have #radoncrocks encouraging med students to match in Rad Onc; on the other you have predictions on SDN of declining use of radiotherapy, breadlines etc.

I don't know, I think SDN does influence med student career choices. There have been several who have posted about it on this board.

 

[beamotherapy]

I would think, in addition, the anonymous nature of SDN would blunt some of the social benefit aspects of social media posting. To characterize what's been posted here as misinformation would be incorrect.

You are right, residency expansion is certainly a fact. The twitter crowd also has their "alternative facts" about how great things are in our specialty, and seems to think SDN is misinforming about the state of our specialty in general. I think there is a community on SDN or hive mind that reinforces negativity about our specialty and mocks dissenters and outsiders. I give credit to the academicians that try to come on here and bring their perspective, and likewise to SDN members who try to engage on twitter.

 

[Ray D. Ayshun]

This thread has sort of become a catch all. In any case, being as I took a dump on the rj publishing that covid paper last week, I can say I like the question this paper is asking, SEER analysis and all:

DEFINE_ME

oh, and I like the answer too.

 

[Mandelin Rain]

This thread has sort of become a catch all. In any case, being as I took a dump on the rj publishing that covid paper last week, I can say I like the question this paper is asking, SEER analysis and all:

DEFINE_ME

oh, and I like the answer too.

"Further study of the omission of endocrine therapy in this patient population is warranted."

 

[medgator]

Oh Ralphie...

 

[evilbooyaa]

Somebody take Grandpa's keyboard away again....

 

[OTN]

Somebody take Grandpa's keyboard away again....

Glad this was brought up. I was going to post it. Dr. RW decided to end the conversation when it was apparent he was getting wrecked. He is a big part of the generation who has failed the rest of us. His lack of ability to look in the mirror is telling.

 

[TheWallnerus]

I really wanted to refute Ralph on Twitter. You know, use logic and data and what not. And then I realized... why. Not refuting him is SO more effective than responding.

 

[deleted941485]

Glad this was brought up. I was going to post it. Dr. RW decided to end the conversation when it was apparent he was getting wrecked. He is a big part of the generation who has failed the rest of us. His lack of ability to look in the mirror is telling.

Retraining in a new specialty is like getting a divorce its messy, financially ruinous, and downright soul sucking but sometimes you're just forced to do it.

 

[Baws]

Glad this was brought up. I was going to post it. Dr. RW decided to end the conversation when it was apparent he was getting wrecked. He is a big part of the generation who has failed the rest of us. His lack of ability to look in the mirror is telling.

Hibiscus Island Mansion sells for $8M

A Hibiscus Island waterfront mansion sold for $7.8 million.

therealdeal.com

Sold the specialty for their own gains...

 

[RickyScott]

Hibiscus Island Mansion sells for $8M

A Hibiscus Island waterfront mansion sold for $7.8 million.

therealdeal.com

Sold the specialty for their own gains...

Property tax 2% in Florida is 140k a year

 

[Baws]

Property tax 2% in Florida is 140k a year

"Trends in the quality of residents accepted for training have been drifting slightly downward.”

These "leaders" like Wallner, DO and Ralph Weasel are so full of ****

 

[RadOncDoc21]

Hibiscus Island Mansion sells for $8M

A Hibiscus Island waterfront mansion sold for $7.8 million.

therealdeal.com

Sold the specialty for their own gains...

Wow!

 

[RickyScott]

"Trends in the quality of residents accepted for training have been drifting slightly downward.”

These "leaders" like Wallner, DO and Ralph Weasel are so full of ****

View attachment 337351

Let’s not leave out million dollar Mikey Steinberg who sold multiple practices for tens of millions and now encourages suckers and minorities to come to his department. Or 2 million dollar Lou “shame on us if medical students have better knowledge of the job market”

 

[deleted969641]

The audacity and/or tone-deafness to imply residents are selfishly motivated to care about how they are financially compensated for their labor after residency is stunning especially coming from figures in the field who are so old and senior that they have surely amassed high 7 figures if not 8 figure net worths (or else they have done something spectacularly wrong in their financial planning) having lived through a long career where radiation oncologists were able to keep most of the income they generated with fewer middlemen to siphon it off.

It's really easy to point your finger and call aspiring rad oncs improperly motivated for caring about jobs (money) when you've got 10 million in the bank, likely offshore or in other investments to somehow avoid taxes. Meanwhile the new crop of rad oncs is selfish to complain about having worries about our prospects of becoming W2 employees for the organizations these people control, making a fraction of what they did in their heyday, and not having any good way to shelter it from being chopped in half off the bat before reaching our pockets and paying our bills and debt obligations (which are proportionally far higher than whatever they were in 1970 because of academic bloat and the student loan scam).

Capitalism drives innovation, Ralph. All those companies making the products that we use in clinic and fund our studies? That wasn't the result of benevolent socialist-minded physicians and scientists working only to better society and happily accepting low salaries and volunteering nights and weekends for their passion for research while maintaining full clinics without protected time and having a good junk of the professional component scalped off by higher ups. Of course you know that, but it's insulting that you think you can deceive others into believing it. The COVID vaccine did not magically appear in record time from a few well-meaning post-docs slaving away in a university lab. It appeared because private pharma was heavily incentivized to make it happen. If you drive down salaries in rad onc to the bottom of the field, you are not going to get the best and the brightest. There will be some, but not a lot. This should not be surprising, nor should it be something you should lament. Using this as a criticism is deeply insincere.

As the saying has always been, those who can't do teach. And as such academia will ironically reap what it has sewn, and become filled with practitioners that any remaining private practices won't touch who pump out the bare minimum inconsequential research as a checkbox to keep their job and "teach" residents what the important trial data to memorize is so as to be a competent practitioner one day and not discuss anything that actually involves getting compensated for your time or preparing students to go out and work independently (which used to be the point of education) as that would be improper and contrary to the mission of making the majority of us permaresidents at satellites.

 

[TheWallnerus]

Hibiscus Island Mansion sells for $8M

A Hibiscus Island waterfront mansion sold for $7.8 million.

therealdeal.com

Sold the specialty for their own gains...

Everyone here is invited for dinner. Lamb pairs well with the blood of newborns.

 

[Baws]

Everyone here is invited for dinner. Lamb pairs well with the blood of newborns.

Lisa Kachnic does a phenomenal job I've heard

 

[thecarbonionangle]

I heard when Wallner sharts, money actually comes out.

 

[Baws]

The audacity and/or tone-deafness to imply residents are selfishly motivated to care about how they are financially compensated for their labor after residency is stunning especially coming from figures in the field who are so old and senior that they have surely amassed high 7 figures if not 8 figure net worths (or else they have done something spectacularly wrong in their financial planning) having lived through a long career where radiation oncologists were able to keep most of the income they generated with fewer middlemen to siphon it off.

It's really easy to point your finger and call aspiring rad oncs improperly motivated for caring about jobs (money) when you've got 10 million in the bank, likely offshore or in other investments to somehow avoid taxes. Meanwhile the new crop of rad oncs is selfish to complain about having worries about our prospects of becoming W2 employees for the organizations these people control, making a fraction of what they did in their heyday, and not having any good way to shelter it from being chopped in half off the bat before reaching our pockets and paying our bills and debt obligations (which are proportionally far higher than whatever they were in 1970 because of academic bloat and the student loan scam).

Capitalism drives innovation, Ralph. All those companies making the products that we use in clinic and fund our studies? That wasn't the result of benevolent socialist-minded physicians and scientists working only to better society and happily accepting low salaries and volunteering nights and weekends for their passion for research while maintaining full clinics without protected time and having a good junk of the professional component scalped off by higher ups. Of course you know that, but it's insulting that you think you can deceive others into believing it. The COVID vaccine did not magically appear in record time from a few well-meaning post-docs slaving away in a university lab. It appeared because private pharma was heavily incentivized to make it happen. If you drive down salaries in rad onc to the bottom of the field, you are not going to get the best and the brightest. There will be some, but not a lot. This should not be surprising, nor should it be something you should lament. Using this as a criticism is deeply insincere.

As the saying has always been, those who can't do teach. And as such academia will ironically reap what it has sewn, and become filled with practitioners that any remaining private practices won't touch who pump out the bare minimum inconsequential research as a checkbox to keep their job.

With the current stock market, I pity the boomer radonc with a 7 figure net worth

 

[elementaryschooleconomics]

As the saying has always been, those who can't do teach. And as such academia will ironically reap what it has sewn, and become filled with practitioners that any remaining private practices won't touch who pump out the bare minimum inconsequential research as a checkbox to keep their job and "teach" residents what the important trial data to memorize is so as to be a competent practitioner one day and not discuss anything that actually involves getting compensated for your time or preparing students to go out and work independently (which used to be the point of education) as that would be improper and contrary to the mission of making the majority of us permaresidents at satellites.

I love this description.

Hiring new grads for satellite permaresident positions! Not entirely clear what a VSIM is, but knows every single reported result from the CROSS trial to two significant digits, and ensures that all OARs fall within the institutionally-mandated constraints (though not sure what to do other than ask Dosimetry to "try harder" if the constraints aren't met).

 

[medgator]

Honestly, i hope they never take away his Twitter account...

 

[elementaryschooleconomics]

Honestly, i hope they never take away his Twitter account...

"New to Twitter"? I hope he's making a joke there...but perhaps he feels like Twitter, similar to RadOnc, requires a full 5 years of training before you can independently practice it?