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I don't disagree, but society at large feeds on indicting other groups. If you're going to write a paper proving that more men treat prostate and more women treat gyn, there must be some greater evil you are trying to right. Otherwise, this is just common knowledge, and inconsequential.

"Otherwise, this is just common knowledge, and inconsequential"

Yep

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Men want men doctoring their man parts.
Women want women doctoring their woman parts.
The sky is blue.
Water is wet.
 
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This article offer yet another data point in how sad and mostly useless the Red Journal has become more then anything else.
 
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Men want men doctoring their man parts.
Women want women doctoring their woman parts.
The sky is blue.
Water is wet.
Gender isn't about parts, at least when it comes to the manner in which this conversation is happening. Sex is about parts. From the outset, my issue is that this article conflates the two. My understanding is that gender has to do with social norms etc, while sex is about anatomy etc.
 
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This article offer yet another data point in how sad and mostly useless the Red Journal has become more then anything else.
1) This article certainly doesn't tell us anything we didn't already know
2) Back in the not too distant past (still relatively the stone age) when I was on the interview trail (for attending jobs) it was constantly assumed that I wanted to do breast since I am a woman. Since breast is the worst, I certainly did not, and this got annoying after a while.
 
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There is a Urorad proton center going into St Louis, I believe.

The Mevion-FIT machine, if it will fit in your larger empty vault, is a potential game changer in terms of adoption.

UroRads already has a proton center in Kansas City. (There are also protons available at the the University of Kansas as well). The Kansas City metro area has a population of 2.34 million.


 
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Why does it have to be an indictment? Can't it just be a preference?
It almost certainly will be tied into the so-called gender pay gap. I.e., breast, gyn, and peds are going to produce less RVUs per case than H&N, prostate, and lung. So yes, there is obviously an evil force pigeon-holing academic female rad oncs into the lowest RVU-producing subsites. Nothing else could be going on there. Whenever a discrepancy exists, it can only be because of discrimination.
 
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It almost certainly will be tied into the so-called gender pay gap. I.e., breast, gyn, and peds are going to produce less RVUs per case than H&N, prostate, and lung. So yes, there is obviously an evil force pigeon-holing academic female rad oncs into the lowest RVU-producing subsites. Nothing else could be going on there.
Woah there partner, you gotta slow down and play the academic game: that's for the next manuscript.

We'll follow that up with "Factors influencing sub-specialization among academic radiation oncologists," and get a triple of research that benefits no one except for the people trying to get promoted in a broken system.
 
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Noone "loves primarily breast cancer".
I would not hate it if I were allowed by my overlords to treat every case with VMAT.
J/K I love the constant back and forth with dosi, vigorous field-in-fielding like a meth addict trying to pick specs of dust off the floor for hours, and burning patients more than they need to be burned/burnt/gebrannte/flambé'ed?.
 
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Play for the Mets?

Maybe it's a job posting to be the personal radiation oncologist for the Mets baseball team. Sounds low volume.
Given MSK's propensity to allow fully remote/virtual work, I will take that job even at expected low pay and perform it concurrently with my current job.
 
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Not familiar with him.

Any reason to be optimistic this'll lead to any changes in the culture?

He's been a full-time practicing radonc in private practice his whole career. He's thoughtful, has no ulterior motives, and from what I can tell does truly care about the future of the field.
 
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If they are able to recruit someone like him, why didn’t they fire the previous pos long ago?
Because firing anyone requires a brain to realize it needs to happen and a spine to make it happen.

The people in the ASTRO "leadership" circles have never been blessed with either organ.
 
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Gender isn't about parts, at least when it comes to the manner in which this conversation is happening. Sex is about parts. From the outset, my issue is that this article conflates the two. My understanding is that gender has to do with social norms etc, while sex is about anatomy etc.
Ha - you're saying that this article is 'not woke enough' for 2024? Don't assume the gender of a Rad Onc!

Checkmate, IJROBP!
 
Job market issues, resident overtraining, decrease indications for radiation, reimbursement cut etc… but I’m very happy the great minds of our field are busy trying to figure out why women are treating more female related cancers and men are treating more male related cancers!
 
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I would prefer a female doctor. I think it's "ok" for me to say that since I'm a woman. If my husband were to say he prefers a male doctor, I think he'd get branded as a sexist.

It just seems like there is so much cognitive dissonance with this stuff. "We need more URM in our fields so that URM patients can get treated by URM doctors, the outcomes are better that way!" So are White patient outcomes better with a White doctor?
 
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Having the position "radiotherapist" is such a classic Anderson move.
I'm probably 1/2 way through my community radonc career, and I'm definitely moving inexorably towards being an "Assistant Radiotherapist".

Good on this guy for taking it the other way.

Still, better than being a "virtual support technician". Some of us are on the way to that title.

"You qualify for a five fraction regimen of radiation for your diagnosis of __________. We anticipate few acute side effects, but there is the potential for long term toxicity. Potential long term side effects include but are not limited to:____________. While I will not meet you in person, I will be supervising all aspects of your care, although your care will in fact be provided by other team members. I also will not be providing systemic therapy for your cancer or providing in-person follow-up evaluations. If needed, another "provider" will see you in person if any complications arise."

Some people want this.
 
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I would prefer a female doctor. I think it's "ok" for me to say that since I'm a woman. If my husband were to say he prefers a male doctor, I think he'd get branded as a sexist.

It just seems like there is so much cognitive dissonance with this stuff. "We need more URM in our fields so that URM patients can get treated by URM doctors, the outcomes are better that way!" So are White patient outcomes better with a White doctor?
It is very possible that the urm argument is probably false. Better test scores among doctors correlates with better clinical outcomes.

“Specifically, patients assigned to internists who scored in the top quartile on the exam were 8 percent less likely to die within one week” jama


 
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“Specifically, patients assigned to internists who scored in the top quartile on the exam were 8 percent less likely to die within one week” jama


there's no way you actually believe this could be possibly true. It defies every bit of common sense. come on.
 
there's no way you actually believe this could be possibly true. It defies every bit of common sense. come on.

Given that radonc is now a repository for “challenged” applicants, we should be worried abt competency and saving lives not gender, DEI etc
 
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I said what I said. associations are one thing and have major limitations.

it defies common sense to think having one doctor, out of all the people involved in their care and all other factors, having a top quartile rank has an 8% one-week overall survival advantage.
 
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I said what I said. associations are one thing and have major limitations.

it defies common sense to think having one doctor, out of all the people involved in their care and all other factors, having a top quartile rank has an 8% one-week overall survival advantage.
I think it is entirely possible that someone with severe intellectual limitations- failing 50% of the shelf exams- could contribute to a premature death in a medically complex case. Think of all the boomers who suck in this field. Many sucked in their prime as well.
 
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It is very possible that the urm argument is probably false. Better test scores among doctors correlates with better clinical outcomes.

“Specifically, patients assigned to internists who scored in the top quartile on the exam were 8 percent less likely to die within one week” jama


Ironically, the affirmative action philosophy that engendered this is just going to cause the kind of discrimination it sought to correct for.
 
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Urm don’t deserve docs who failed their step exams multiple times?
I meant more along the lines that It would suck to be a black doctor who got straight As and perfect MCAT and USMLE scores only to have people silently wonder if you are competent because policies allowed incompetent people into and through training because of their skin color. Yes there are racists who think you’re incompetent regardless of your scores but adding this issue to society’s subconscious doesn’t help the problem.

Anesthesia forum (I lurk because I’m jealous of their job market): DEI is ruining UCLA. Seems the DEI pendulum swings too far the wrong way.
 
I meant more along the lines that It would suck to be a black doctor who got straight As and perfect MCAT and USMLE scores only to have people silently wonder if you are competent because policies allowed incompetent people into and through training because of their skin color. Yes there are racists who think you’re incompetent regardless of your scores but adding this issue to society’s subconscious doesn’t help the problem.

Anesthesia forum (I lurk because I’m jealous of their job market): DEI is ruining UCLA. Seems the DEI pendulum swings too far the wrong way.
I just looked at their job market out of curiousity and now i’m depressed! Their worst posting is better than any rad onc job posts i’ve seen.
 
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I'm probably 1/2 way through my community radonc career, and I'm definitely moving inexorably towards being an "Assistant Radiotherapist".

Good on this guy for taking it the other way.

Still, better than being a "virtual support technician". Some of us are on the way to that title.

"You qualify for a five fraction regimen of radiation for your diagnosis of __________. We anticipate few acute side effects, but there is the potential for long term toxicity. Potential long term side effects include but are not limited to:____________. While I will not meet you in person, I will be supervising all aspects of your care, although your care will in fact be provided by other team members. I also will not be providing systemic therapy for your cancer or providing in-person follow-up evaluations. If needed, another "provider" will see you in person if any complications arise."

Some people want this.

I am still five days a week in the clinic. The reality is that 85% of the job is now just simply interacting with a computer.
 
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Are protons in Arkansas the official "jumping the shark" moment or are we past that?
1 single room center in the main metro area of Little Rock, with 750k population, of a 3 million population state, should be viable... unless financed by bonds sold from Wisconsin and run by Proton International. They don't have the best track record for centers staying viable, like UAB for example.
 
UroRads already has a proton center in Kansas City. (There are also protons available at the the University of Kansas as well). The Kansas City metro area has a population of 2.34 million.


1 million population for a single room center should be enough to pay the bills, in theory.

I wouldn't have thought it possible for 21st Century and GenesisCare to go bankrupt though, what with IMRT reimbursement rates being what they were.

I think that the financial issues are more problematic than the medical and technological ones at this point. No debt, no default?
 
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Could you explain the pros and cons of the FIT? I’ve only ever seen the marketing materials, but there’s always more to the story.
Pros: smaller and cheaper than a rotating gantry system
Fits in a big linac vault, in theory but not yet demonstrated

Cons - Mevion systems have a history of going down frequently and needing backup XRAY plans for when that happens.

The upright chair system is unproven in clinic and might not pan out for a while

There is no option to treat patients supine, at least at this point, everyone will be seated or semi-standing. There isn't a lot of know-how for treating upright yet.

The Mevion field size is limited to about 20 cm, so a craniospinal patient requires 6 isocenters and takes an hour to treat, so not very cost effective to do that

The Mevion accelerator in the same room as the patient gives a higher neutron dose than if it were outside the room

The list goes on but less impressively
 
Pros: smaller and cheaper than a rotating gantry system
Fits in a big linac vault, in theory but not yet demonstrated

Cons - Mevion systems have a history of going down frequently and needing backup XRAY plans for when that happens.

The upright chair system is unproven in clinic and might not pan out for a while

There is no option to treat patients supine, at least at this point, everyone will be seated or semi-standing. There isn't a lot of know-how for treating upright yet.

The Mevion field size is limited to about 20 cm, so a craniospinal patient requires 6 isocenters and takes an hour to treat, so not very cost effective to do that

The Mevion accelerator in the same room as the patient gives a higher neutron dose than if it were outside the room

The list goes on but less impressively
Seems like it’s just Mevion, hitachi, and IBA now right? Do you know why varian left the proton industry so fast?
 
Seems like it’s just Mevion, hitachi, and IBA now right? Do you know why varian left the proton industry so fast?
Maybe the same reason they sold themselves to Siemens?

Radiation is a tough business financially in the US, protons aren't making it any easier. Internationally, many countries probably weigh the costs vs theoretical benefits as well. Don't many of the British territories just pay other places to treat their proton cases when they seem it medically necessary.
 
Varian is diversifying their business and investing heavily in other market sectors especially RO staffing.

Focusing on profit from hardware is a sure path to bankruptcy.
Aria on the cloud... Saas

Apple, Tesla, Microsoft etc all do hardware but their value is in services and software, not the hardware as a rule
 
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