Rad Onc Twitter

This forum made possible through the generous support of SDN members, donors, and sponsors. Thank you.


will be soon that there's an MR linac on every corner
Members don't see this ad.
 
OTN said:
What's challenging about feathering?
Click to expand...
Ha. Nothing*. And I don't feather. I just don't overlap beams where there is no breast tissue.

*Never say this to your dosimetrist
 
  • Like
Reactions: 1 users
“No 4DCT, no feathering electron photon junctions, patients do “fine”. In fact, they did just “fine” when we did fields in film. We waste a lot of time!”
 
  • Like
Reactions: 2 users
Members don't see this ad :)
Mandelin Rain said:
Do you even feather, brah?

Gotta cover that pre-sternal breast tissue (I learned anatomy from Total Recall).
Click to expand...
If my calculations are correct Martians should have a 33% increase in demand for breast RO services compared with earthlings…
 
  • Haha
Reactions: 1 users
How many years into the past would one have to travel to land in a time where this patient gets at least an RT recommendation in tumor board 100% of the time…
 
  • Like
Reactions: 1 users


Master clinician Jordan!
 
  • Haha
  • Angry
  • Dislike
Reactions: 2 users
jondunn said:


Master clinician Jordan!
Click to expand...

Wow… WTF!!? I hate admins. It’s never enough with them. How did we as a profession ever get to this when a guy in a suit determines the amount of work you are doing? I’ve always been the one to ask them where would they be without us?
 
Last edited:
  • Like
Reactions: 7 users
To me it's a we get what money we can from insurance issue. They'll stiff us on same day sim treat, so there are ways to make up for that. Having this conversation is acknowledging 77470 as a valid way of justifying underpayment in the first place.
 
  • Like
Reactions: 1 users
Can always reply that with concurrent therapy there is a greater need to start, monitor and modulate steroids, antiemetics, pain medications and anti diarrheal medications. More likely to require mid week assessment for treatment tolerance, more likely to be put on break, more likely to require emergent referral for hospitalization, more likely to require IVF or labs outside of those protocolized by medonc.
 
  • Like
Reactions: 5 users
Members don't see this ad :)
communitydoc13 said:
Can always reply that with concurrent therapy there is a greater need to start, monitor and modulate steroids, antiemetics, pain medications and anti diarrheal medications. More likely to require mid week assessment for treatment tolerance, more likely to be put on break, more likely to require emergent referral for hospitalization, more likely to require IVF or labs outside of those protocolized by medonc.
Click to expand...
Gonna template this
 
  • Like
Reactions: 1 user
RealSimulD said:
Gonna template this
Click to expand...
Won’t be enough. Next year, they’ll ask for documentation that you ask these specific questions, documented their Creatinine, gave them drugs, etc, etc. it will never be enough. Their purpose is to drain your soul.
 
Last edited:
  • Like
Reactions: 6 users
communitydoc13 said:
Can you even do NTCP modeling when you don’t know what effective dose you are delivering?
Click to expand...
Garbage in, garbage out.

Wonder what risk of rib fracture the NTCP spits out? IRL it's ~25% for unilateral, so....bilateral must be higher.

What about esophagitis? 30%?
 
Last edited:
  • Like
Reactions: 2 users
RadOncDoc21 said:
Won’t be enough. Next year, they’ll ask for documentation that you ask these specific questions, documented their Creatinine, gave them drugs, etc, etc. it will never be enough. Their purpose is to drain your soul.
Click to expand...
Please Don’t give Ron D any ideas for scaring docs into buying his services. You will need to be present when the creatinine was drawn, despite what cms states.
 
  • Like
  • Haha
Reactions: 4 users


Seriously? Who is this guy? I thought he was a radiation therapist, who pivoted to this new role. But then again, what do I know?
 
  • Like
  • Angry
  • Dislike
Reactions: 4 users
This Jordan dude is a total clown. Many many clown emojis is the only appropriate answer. Healthcare is ****ed up because of these people. My dislike of admins grows more and more by the day. the sad thing it is all over healthcare. Only option is to leave medicine. Empty suit people all over the place.
 
  • Like
Reactions: 7 users
The disrepect and presumptiousness to refer to yourself as “clinical” because you took some classes. These people literally think they know more than you and treat you like an imbecile. Nobody on this board should be seriously claiming this guy is a good guy. He is a grifter among many trying to make money off us
 
  • Like
Reactions: 8 users
SubserviantToABR said:


Seriously? Who is this guy? I thought he was a radiation therapist, who pivoted to this new role. But then again, what do I know?
Click to expand...


Wow.

Simul 100% on this.

Also, you would think somebody whose primary job is "getting things paid" would know how to spell payors.
 
  • Like
Reactions: 5 users
I had a payor deny this on a head and neck patient who needed me to coordinate feeding tube placement midtreatment and then manage the nutrition. It works itself out more or less. All this **** is complicated. 2D palliative isnt always a walk in the park.
 
  • Like
Reactions: 1 users
thecarbonionangle said:
This Jordan dude is a total clown. Many many clown emojis is the only appropriate answer. Healthcare is ****ed up because of these people.
Click to expand...
Everyone in rad onc, MDs or non MDs should encircle one another with support, understanding, and unwavering loyalty. Like stupid unthinking loyalty. Like you can do no wrong mentality.

Instead everyone wants to “Yes but” one another at best, act like a Pharisee and point out everyone else’s sin at worst. Meanwhile there are people out there who aren’t even our own religion/faith who want to extinguish us from existence! If there had been twitter in the 1940s I guarantee some rad oncs would have been tweeting “Can I walk on the same sidewalk as the Schutzstaffel? And I’m not sure Bob’s papers are in order.”
 
  • Like
Reactions: 5 users
Not sure who is the bigger grifter - Jordan or Ron G
 
  • Like
Reactions: 1 users


The topic that won’t die
 
  • Like
Reactions: 1 users
Ray D. Ayshun said:
I had a payor deny this on a head and neck patient who needed me to coordinate feeding tube placement midtreatment and then manage the nutrition. It works itself out more or less. All this **** is complicated. 2D palliative isnt always a walk in the park.
Click to expand...
I recently got told from the VA that I couldn't bill for laryngoscopy as they deemed our specialty to be one that didn't give adequate training for that. I still do it, and the clinic loses money on the disposable scope, but someone trying to justify that we, community docs at least, ask for less, doesn't get it.
 
  • Like
  • Wow
Reactions: 4 users
TheWallnerus said:
Everyone in rad onc, MDs or non MDs should encircle one another with support, understanding, and unwavering loyalty. Like stupid unthinking loyalty. Like you can do no wrong mentality.

Instead everyone wants to “Yes but” one another at best, act like a Pharisee and point out everyone else’s sin at worst. Meanwhile there are people out there who aren’t even our own religion/faith who want to extinguish us from existence! If there had been twitter in the 1940s I guarantee some rad oncs would have been tweeting “Can I walk on the same sidewalk as the Schutzstaffel? And I’m not sure Bob’s papers are in order.”
Click to expand...
Never seen more backstabbing/divide between community and academic centers than in xrt.
 
  • Like
Reactions: 9 users
Ray D. Ayshun said:
I recently got told from the VA that I couldn't bill for laryngoscopy as they deemed our specialty to be one that didn't give adequate training for that. I still do it, and the clinic loses money on the disposable scope, but someone trying to justify that we, community docs at least, ask for less, doesn't get it.
Click to expand...
Wow, maybe we shouldn’t plan using imaging either.
 
  • Like
Reactions: 1 user
Ray D. Ayshun said:
I recently got told from the VA that I couldn't bill for laryngoscopy as they deemed our specialty to be one that didn't give adequate training for that. I still do it, and the clinic loses money on the disposable scope, but someone trying to justify that we, community docs at least, ask for less, doesn't get it.
Click to expand...
WHAT??

That's insane.
 
Ray D. Ayshun said:
I recently got told from the VA that I couldn't bill for laryngoscopy as they deemed our specialty to be one that didn't give adequate training for that. I still do it, and the clinic loses money on the disposable scope, but someone trying to justify that we, community docs at least, ask for less, doesn't get it.
Click to expand...
Yeah this is pretty outrageous.

I like to keep a low profile but hearing stuff like this makes me want to fight
 
  • Like
Reactions: 4 users
Ray D. Ayshun said:
I recently got told from the VA that I couldn't bill for laryngoscopy as they deemed our specialty to be one that didn't give adequate training for that. I still do it, and the clinic loses money on the disposable scope, but someone trying to justify that we, community docs at least, ask for less, doesn't get it.
Click to expand...
RickyScott said:
Never seen more backstabbing/divide between community and academic centers than in xrt.
Click to expand...
RadOncDoc21 said:
Ask him how many patients is he licensed to treat?
Click to expand...
There comes a time in every rad onc's career where he/she realizes that it's not about what's right or wrong, what you think you know or don't, and so on. The person who bills (and the admin who is the boss of the biller) is the person with final say. They have the "license to bill," and the license to tell you what's what, all of which is actually more important than the license to treat. And if the payor (ie VA) says you don't have "adequate training," it doesn't matter what you think. If Evicore changes a guideline tomorrow that says RT is no longer indicated for a certain diagnosis and the data doesn't support it, it doesn't matter if there are studies showing it works...
 
  • Like
Reactions: 1 users
License to Bill was the worst roger Moore film
 
  • Haha
Reactions: 1 user
1653057903922.png


Taika Waititi Ifc GIF by Film Independent Spirit Awards
 
Pretty sure Bob’s fly is unzipped here , but it’s probably because his pants can’t hold his massive stones.

Absolute legend.

 
  • Like
  • Haha
Reactions: 4 users
Moonbeams said:
Somebody who scored a 22 on his MCAT in 2008 and has held a serious chip on his shoulder ever since. I encounter people like this in the medical field all the time who tell a story of how they were premed but felt they could make a bigger impact in healthcare doing X or something...
Click to expand...
If I met a biller coder person who actually took MCAT I would respect that a little more. The biller coders often times seem to think they know more than dosi, phys, the therapists, and the MD combined!
 
  • Like
Reactions: 1 users
TheWallnerus said:
If I met a biller coder person who actually took MCAT I would respect that a little more. The biller coders often times seem to think they know more than dosi, phys, the therapists, and the MD combined!
Click to expand...
One time I was asked to call a patients daughter who was “in the medical field” to discuss treatment recommendations. Of course she was a biller.
 
  • Like
Reactions: 1 users
You must log in or register to reply here.
Next unread thread

Similar threads

P
Rad Onc oral boards
Replies
10
Views
667
Barcelona PSG
B
Gfunk6
Rad Onc? Burnt Out?
Replies
36
Views
2K
thecarbonionangle
thecarbonionangle
TheWallnerus
Rad onc supervision, the epilogue
Replies
10
Views
1K
elementaryschooleconomics
elementaryschooleconomics
U
Why is rad onc not more competitive?
2 3 4 5
Replies
233
Views
9K
medgator
M
D
Rad onc as a second residency?
Replies
25
Views
2K
SneakyBooger
SneakyBooger
Top