Rad Onc Twitter

  • Thread starter Thread starter deleted1002574
  • Start date Start date
This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.
Members don't see this ad.
fiji128 said:
Absolutely crazy that the cash cow that is UPenn rad onc is now offering a $280,000 salary. A place that is building community proton centers and purposed a certified palliative care network. Also note one of their vice chairs is also chair of the rad onc RRC.

In 10 years that offer is likely to be $225,000 if nothing changes.
Click to expand...

I have it from a reputable source that the reason the VA does not cover protons for prostate cancer - period - is that Steve Hahn while at UPenn was trying to charge the VA 400k/patient-course.
 
Speaking of trumpian crony Steve Hahn, anybody know what he is up to? my guess is he turns up somewhere. Maybe OHSU will hire him?
 
emt409 said:
I have it from a reputable source that the reason the VA does not cover protons for prostate cancer - period - is that Steve Hahn while at UPenn was trying to charge the VA 400k/patient-course.
Click to expand...
Says it right on the va authorization they don't cover protons without prior approval for every diagnosis I've treated... Everything else is good to go. Really as nice as seeing a straight Medicare pt honestly when it comes to authorization
 
Last edited:
emt409 said:
I have it from a reputable source that the reason the VA does not cover protons for prostate cancer - period - is that Steve Hahn while at UPenn was trying to charge the VA 400k/patient-course.
Click to expand...
I am sure he got away with similar sht at MDACC and why there is a less than zero chance they will disclose prices despite the Texas law. These centers are basically engaged in racketeering.
Edit: In fairness, he was probably knocking off 100k from the list price because he felt bad about those prostate implants at the philadelphia va.
www.nytimes.com

At V.A. Hospital, a Rogue Cancer Unit (Published 2009)

A unit in Philadelphia operating with virtually no outside scrutiny botched 92 of 116 prostate cancer treatments over a span of more than six years.
www.nytimes.com www.nytimes.com
 
Last edited:
emt409 said:
I have it from a reputable source that the reason the VA does not cover protons for prostate cancer - period - is that Steve Hahn while at UPenn was trying to charge the VA 400k/patient-course.
Click to expand...

I too heard this from a reputable source. It wasn’t specific to prostate but I heard the VA at one time authorized a proton course at UPenn and got hit with a > 300k bill.

Obviously this is hearsay, but this narrative you’re posting is in line with what I heard too from someone on the business side of protons that I’ve known to be accurate and truthful.
 
emt409 said:
I have it from a reputable source that the reason the VA does not cover protons for prostate cancer - period - is that Steve Hahn while at UPenn was trying to charge the VA 400k/patient-course.
Click to expand...

BobbyHeenan said:
I too heard this from a reputable source. It wasn’t specific to prostate but I heard the VA at one time authorized a proton course at UPenn and got hit with a > 300k bill.

Obviously this is hearsay, but this narrative you’re posting is in line with what I heard too from someone on the business side of protons that I’ve known to be accurate and truthful.
Click to expand...
The price transparency guy showed top insurances can pay out close to $500,000 per patient per proton course.

In Canada, they are used to paying American proton centers that get their out of country referrals "at a cost often exceeding $250,000 per patient."

So Steve charging in the 300-400K range (per patient) is 'bout average.

Remember when Steve called protons the next disruptive innovation in healthcare?
 
1623415976176.png
 
Mandelin Rain said:
Burying the lede a bit. 8,300+ providers billing rad onc codes?
Click to expand...
Wait wait what.

This is a HUGE problem in our specialty btw: lack of accurate workforce numbers (how many ROs are there really). Like for instance if one person says there's 5500 rad oncs and another 4500, a 1000 difference is not much in large specialties but obviously it's a big % difference and has all those workforce ramifications... 4500 is OK... 5500 is not great... 8300 is the bill collector's at the door and your shirttails are on fire.

Start looking through any of the recent literature like from Trevor Royce or Mudhit C or James Bates e.g. The number of U.S. ROs they proffer/estimate differ wildly. It's not subtle. There are 9000+ RO NPI numbers registered in the U.S. FWIW.
 
TheWallnerus said:
Wait wait what.

This is a HUGE problem in our specialty btw: lack of accurate workforce numbers (how many ROs are there really). Like for instance if one person says there's 5500 rad oncs and another 4500, a 1000 difference is not much in large specialties but obviously it's a big % difference and has all those workforce ramifications... 4500 is OK... 5500 is not great... 8300 is the bill collector's at the door and your shirttails are on fire.

Start looking through any of the recent literature like from Trevor Royce or Mudhit C or James Bates e.g. The number of U.S. ROs they proffer/estimate differ wildly. It's not subtle. There are 9000+ RO NPI numbers registered in the U.S. FWIW.
Click to expand...
For a specialty so obsessed with the memorization of minutiae and not so much as breathing on a patient without at least Phase II trial data to back it up, there sure are a lot of strong opinions that the "job market is fine" in the absence of any reliable numbers...
 
What is the source and where do they get there data? The fact that multiple parts of this infographic appear to be outliers, I would approach this with some healthy skepticism.
 
Palex80 said:
Click to expand...

All for the low, low price of $139.99.

Contents:

"This book offers comprehensive career development advice for professionals in radiation oncology. While numerous texts have been published to advise medical students on entry into the specialty, and to guide residents and junior faculty with exam preparation, there remains a need for a comprehensive resource that covers topics pertinent to a successful career within radiation oncology. This text has been edited and written by leading experts in the field, and offers multiple unique vantage points.

This work is divided into five sections covering career planning, applying to faculty positions, early career development, mid and senior career considerations, and contextual issues. Throughout the text, authors balance “nuts and bolts” (e.g., preparing your CV and evaluating a contract) with big picture considerations. Each chapter is written concisely, yet comprehensively, from the vantage point of a mentor advising a mentee; questions to review with local mentors and additional reading suggestions are also provided. Issues of workforce disparities, conscious and unconscious bias, work-life equilibrium, and interpersonal conflict, and how these may impact one’s career path, are also closely addressed. While the work is primarily targeted to those pursuing career paths within academic medicine, there is also distinct value and tailored content for trainees and radiation oncologists practicing in hospital-based, hybrid or community settings.

In a period of rapid change in the healthcare sector and cancer care more specifically, this book will serve as the premier reference for those pursuing an independent career in radiation oncology."
 
Lamount said:
What is the source and where do they get there data? The fact that multiple parts of this infographic appear to be outliers, I would approach this with some healthy skepticism.
Click to expand...
I called upJordan Johnson and would encourage connecting with him on linked in or twitter. He is able to run data searches on millions of claims and open to research collaboration.
 
seper said:
Silly idea to sell that book
Click to expand...
Wow, what an absolutely niche book to write, sell, and promote on Twitter.

$140 eh? Alright, I'm going to go take the notebook I keep in my bag which I handwrite my favorite factoids in, type it up, title it "First Aid for Radiation Oncology", and charge $95 for it. I need to get in on this game!

I might get sued if I use the "First Aid" thing so...maybe like, "Knowledge OTVs: checkups on facts"

I dunno, I'll work on the title.
 
Also, just because I feel like the internet has moved on from this, an update:

1623469698826.png


www.corvallisadvocate.com

Lawmakers Step Up for University Sex Victims - The Corvallis Advocate

In the aftermath of a high-profile lawsuit accusing Oregon Health & Science University of fostering a culture permissive toward sexual abusers while punishing victims, on May 10 Senate Joint Resolution 30 was introduced by Sen. Kim Thatcher, R-Keizer. In the lawsuit against OHSU, settled in...
www.corvallisadvocate.com www.corvallisadvocate.com
 
elementaryschooleconomics said:
Wow, what an absolutely niche book to write, sell, and promote on Twitter.

$140 eh? Alright, I'm going to go take the notebook I keep in my bag which I handwrite my favorite factoids in, type it up, title it "First Aid for Radiation Oncology", and charge $95 for it. I need to get in on this game!

I might get sued if I use the "First Aid" thing so...maybe like, "Knowledge OTVs: checkups on facts"

I dunno, I'll work on the title.
Click to expand...

I’m going to get in on this too

Self published memoir:

“What not to do: how I learned to be a competent radiation oncologist by NOT emulating my garbage attendings”
 
FrostyHammer said:
Career development in academic radonc can be summed up in 3 simple steps:

1) STFU and do what you're told
2) Kiss as much a$$ as possible
3) Partake in the circle jerk

Oh and BTW, the cost of the above SDN message is $140 cheaper than that book.
Click to expand...

lmao what I don’t understand is why non-authors of this book are promoting it?
 
elementaryschooleconomics said:
Also, just because I feel like the internet has moved on from this, an update:

View attachment 338682

www.corvallisadvocate.com

Lawmakers Step Up for University Sex Victims - The Corvallis Advocate

In the aftermath of a high-profile lawsuit accusing Oregon Health & Science University of fostering a culture permissive toward sexual abusers while punishing victims, on May 10 Senate Joint Resolution 30 was introduced by Sen. Kim Thatcher, R-Keizer. In the lawsuit against OHSU, settled in...
www.corvallisadvocate.com www.corvallisadvocate.com
Click to expand...
Interesting, there is no mention of Time Up Healthcare, the controversy or a decision to resign on Jagsi's wikipedia entry. At least we know she had perfect SATs.
 
lyltothend said:
Interesting, there is no mention of Time Up Healthcare, the controversy or a decision to resign on Jagsi's wikipedia entry. At least we know she had perfect SATs.
Click to expand...
Hmmm...how surprising.

That's why I think it's important we don't forget this. They're going to sweep this under the rug if they can.

It's frustrating when Esther et al build careers off this "champion of the downtrodden and disadvantaged" narrative, and then when the rubber meets the road - when a woman experiencing sexual harassment from a male physician went directly to Esther asking for help - she did nothing. We can speculate till we're blue in the face as to why, but I believe it's no coincidence that Esther's hypocrisy stems from the perpetrator being someone with social media clout who ran in similar circles with her.

Notably, the allegations from the victim seem highly credible: the resident who harassed her (and others) was...transferred...to a different program across the country, and OHSU settled this case for over half a million dollars rather than risk going to trial.

Twitter just continues to demonstrate how it's one of the most dangerous tools ever invented. It doesn't matter what specialty you are and what image you're trying to craft, whether you're an Emergency Doc pretending to stand up for women, or a RadOnc Doc who is trying to downplay market issues to entice naïve medical students into the field, people are creating these myths and narratives about themselves for their own ambitions...while harming others in the process.

Sort of seems antithetical to what it means to be a physician, yes?
 
thecarbonionangle said:
When someone graduates from a hellpit just unlearn all you know and read a book and learn from your coworkers. Refer to hellpit list. You know who you are.
Click to expand...
Have heard some upper mid/upper programs have the same problem in the other direction... Fox chase? PA on every service helping it run without you.

Anderson? Mdacc has their own way of doing things outside the mainstream and supposedly clinical load is on the lighter side considering how many attendings they have per site.

I think places like CCF, Wisconsin, etc are probably going to be the best of both worlds in terms of workload, education, balanced approach to cases etc
 
Last edited:
medgator said:
Have heard some upper mid/upper programs have the same problem in the other direction... Fox chase? PA on every service helping it run without you.

Anderson? Mdacc has their own way of doing things and supposedly clinical load is on the lighter side considering how many attendings they have per site.

I think places like CCF, Wisconsin, etc are probably going to be the best of both worlds in terms of workload, education etc
Click to expand...
Totally agree - the balance of education to workload seems incredibly difficult to strike, and it's easy to tip in either direction without careful and deliberate planning/action.

Unfortunately, many departments seem to just "wing it" and assume appropriate learning is happening. This 1:1 (or 2:1 or whatever) apprenticeship model somewhat unique to our specialty is...problematic, to put it mildly, unless departmental leadership is actively curating it.
 
seper said:
Counts towards 4 required publications at my employer, in order to get promoted. Base comp goes up 5% 🙂
Click to expand...
This is why the pile ons against the crappy database/retrospective studies is pointless. Until the incentive structure is changed people will continue to pump out volume and lines on a CV at the expense of quality.

There should be a system where running an RCT is required for promotion. Of course then you’d have a million under accrued RCTs, so would have to allow participation as a primary author in a co-op group to suffice.
 
DoctwoB said:
So would have to allow participation as a primary author in a co-op group to suffice.
Click to expand...

This is completely unrealistic. Cooperative group trial leadership or authorship on one is impossible for most attendings. Also, having funding and patients to run an RCT to completion is the realm of few attendings.
 
DoctwoB said:
This is why the pile ons against the crappy database/retrospective studies is pointless. Until the incentive structure is changed people will continue to pump out volume and lines on a CV at the expense of quality.

There should be a system where running an RCT is required for promotion. Of course then you’d have a million under accrued RCTs, so would have to allow participation as a primary author in a co-op group to suffice.
Click to expand...

I can see it now. 60 authors on one paper and in the fine print:

*AB, CD, EF, GH, IJ, KL, MN, OP, QR, ST, UV, WX, and YZ all contributed equally to this paper.
 
seper said:
90% of assistant / associate professors in Radonc have nothing to do with science. Myself included
Click to expand...

Yet most of them still need to publish. This is the problem. Pay or rank should not be tied to papers in a mostly clinical position. Yet this is how it works at most academic shops.
 
Neuronix said:
Yet most of them still need to publish. This is the problem. Pay or rank should not be tied to papers in a mostly clinical position. Yet this is how it works at most academic shops.
Click to expand...
Yup, there should be clinical and research tracks. Clinical promotion being based on clinical factors and resident education/teaching, while research based on grants/research, skewed heavily towards prospective trials or bench/translational work.
 
DoctwoB said:
Yup, there should be clinical and research tracks. Clinical promotion being based on clinical factors and resident education/teaching, while research based on grants/research, skewed heavily towards prospective trials or bench/translational work.
Click to expand...

Agreed, it depends on institution

Only one place I interviewed had separate clinical, teaching, and research tracks with different promotion criteria

unfortunately too many places use academic achievements as form of salary suppression
 
Last edited:
FrostyHammer said:
This book is what every resident who graduated (or will graduate) from Baylor, NY Methodist, MUSC, Alleghany, LIJ, etc should read.
Click to expand...

While there are a lot of reasons not to go these programs, it's disingenuous to claim the faculty at these programs are not providing competent care. It's not like radonc is hard. What a joke of a book. Is it all of medicine or just radonc where common sense is published ad nauseam.
 
Reaganite said:
Medicare patients have secondary insurances that kick in the remainder of payment often up to the negotiated amount that an entity has with the private insurer. I don't believe these payments are reflected in the Medicare utilization data academic centers love to quote, but they likely account for the profound differences in reimbursement between freestanding and hospital/academic centers. If I'm treating a medicare/PPO patient, my max reimbursement is determined by the PPO contract, not the Medicare contract. Medicare will pay 80% of "Medicare Allowable," and the PPO kicks in the rest up to our negotiated amount. Our best contracts may hover in the 125-150% of Medicare range, so in a best case scenario, we may get an additional 70% of Medicare allowable (80 + 70= 150). Importantly, none of our contracts have a cap on the secondary payment. If the same reimbursement structure holds true for hospitals/academic centers (esp no cap on the secondary payment), they may be getting 500%+ of Medicare allowable from the secondary insurances, even though they receive only 80% from Medicare. So from a purely Medicare cost standpoint, they may look reasonable, but this doesn't tell the real story because they are gouging on the private end.

As others have pointed out, the real enemy of these places is the Medicare Advantage type plans where the health plan is globally at risk rather than serving as an insurance agent. My neck of the woods has a heavy medicare advantage-type insurance structure, and they are putting a beating on the academic entities. Of course, the academics are trying to set up all sorts of questionable arrangements to circumvent this (one center is essentially treating under 2 separate licenses in the same facility to simultaneously bill hospital and foundation rates depending on the insurance), but so far they've been shut out from a hefty percentage of the business.
Click to expand...
Are the inflated prices a reflection of the technical fees mainly or both the technical and professional fees? Obviously most of the bill is technical, but if they’ve negotiated for example 500% of Medicare rates, are the professional fees also 500%?
 
You must log in or register to reply here.

Similar threads

uchihastan
Rad Onc vs. Heme/Onc
Replies
18
Views
2K
medgator
M
B
Rad Onc Procedures and RVUs
Replies
35
Views
5K
CurbYourExpectations
CurbYourExpectations
D
Saving Rad Onc
2
Replies
60
Views
6K
RickyScott
R
TheWallnerus
Rad Onc is in a dark place
Replies
13
Views
3K
RickyScott
R
D
Future of rad onc job market
2
Replies
58
Views
9K
BobbyHeenan
B
Top