Rad Onc Twitter

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Ray D. Ayshun said:
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.
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"Otherwise, this is just common knowledge, and inconsequential"

Yep
 
Mandelin Rain said:
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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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.
 
fiji128 said:
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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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.
 
IonsAreOurFuture said:
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.
Click to expand...

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.

Kansas City Proton Institute (KCPI) - Proton Therapy

At Kansas City Proton Institute, our mission is to pioneer proton therapy for cancer. Explore our cutting-edge approach to cancer treatment.
kansascityprotoninstitute.com kansascityprotoninstitute.com

Proton Therapy Center | The University of Kansas Cancer Center

The University of Kansas Cancer Center in Kansas City offers proton therapy treatment for tumors for brain, spine, head and neck and other areas of the body using targeted radiation.
www.kucancercenter.org www.kucancercenter.org
 
OTN said:
Why does it have to be an indictment? Can't it just be a preference?
Click to expand...
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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MidwestRadOnc said:
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.
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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.
 
1718808920251.png
 
Ray D. Ayshun said:
Play for the Mets?
Click to expand...

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.
 
CurbYourExpectations said:
I think you guys misread his the tweet. He is clearly looking for a regional breast RadOnc that treats only RNI. Very sub-specialized, you wouldn't understand...
Click to expand...
Explains that one ad he placed looking for someone who’s partially a doctor who treats breast
 
RickyScott said:
If they are able to recruit someone like him, why didn’t they fire the previous pos long ago?
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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.
 
Ray D. Ayshun said:
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.
Click to expand...
Ha - you're saying that this article is 'not woke enough' for 2024? Don't assume the gender of a Rad Onc!

Checkmate, IJROBP!
 
drowsy12 said:

x.com

x.com x.com
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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!
 
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?
 
elementaryschooleconomics said:
Having the position "radiotherapist" is such a classic Anderson move.
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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.
 
MegaVoltagePhoton said:
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?
Click to expand...
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

freebeacon.com

'A Failed Medical School': How Racial Preferences, Supposedly Outlawed in California, Have Persisted at UCLA

Long considered one of the best medical schools in the world, the University of California, Los Angeles's David Geffen School of Medicine receives as many as 14,000 applications a year. Of those, it accepted just 173 students in the 2023 admissions cycle, a record-low acceptance rate of 1.3...
freebeacon.com freebeacon.com

 
RickyScott said:
“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
Click to expand...


there's no way you actually believe this could be possibly true. It defies every bit of common sense. come on.
 
drowsy12 said:
there's no way you actually believe this could be possibly true. It defies every bit of common sense. come on.
Click to expand...
jamanetwork.com

Associations of Milestone Ratings and Certification Examination Scores With Patient Outcomes

This study examines the association between physicians’ milestone ratings and certification examination scores and hospital outcomes for their patients.
jamanetwork.com jamanetwork.com

Given that radonc is now a repository for “challenged” applicants, we should be worried abt competency and saving lives not gender, DEI etc
 
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.
 
drowsy12 said:
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.
Click to expand...
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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RickyScott said:
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

freebeacon.com

'A Failed Medical School': How Racial Preferences, Supposedly Outlawed in California, Have Persisted at UCLA

Long considered one of the best medical schools in the world, the University of California, Los Angeles's David Geffen School of Medicine receives as many as 14,000 applications a year. Of those, it accepted just 173 students in the 2023 admissions cycle, a record-low acceptance rate of 1.3...
freebeacon.com freebeacon.com

Click to expand...
Ironically, the affirmative action philosophy that engendered this is just going to cause the kind of discrimination it sought to correct for.
 
RickyScott said:
Urm don’t deserve docs who failed their step exams multiple times?
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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.
 
MidwestRadOnc said:
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.
Click to expand...
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.
 
communitydoc13 said:
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.
Click to expand...

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.
 
MidwestRadOnc said:
Are protons in Arkansas the official "jumping the shark" moment or are we past that?
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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.
 
fiji128 said:
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.

Kansas City Proton Institute (KCPI) - Proton Therapy

At Kansas City Proton Institute, our mission is to pioneer proton therapy for cancer. Explore our cutting-edge approach to cancer treatment.
kansascityprotoninstitute.com kansascityprotoninstitute.com

Proton Therapy Center | The University of Kansas Cancer Center

The University of Kansas Cancer Center in Kansas City offers proton therapy treatment for tumors for brain, spine, head and neck and other areas of the body using targeted radiation.
www.kucancercenter.org www.kucancercenter.org
Click to expand...
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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grenz said:
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.
Click to expand...
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
 
IonsAreOurFuture said:
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
Click to expand...
Seems like it’s just Mevion, hitachi, and IBA now right? Do you know why varian left the proton industry so fast?
 
grenz said:
Seems like it’s just Mevion, hitachi, and IBA now right? Do you know why varian left the proton industry so fast?
Click to expand...
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.
 
Gfunk6 said:
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.
Click to expand...
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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