Rad Onc Twitter

[KHE88]

Man, all of our leaders are so tone deaf.
Our whole life has been delay gratification. Research years. MD/PhDs, 4 board exams - that all sucks, but we'll put up with if it means we will end up with good jobs (gratification!). It's when you're a PGY5, found out you have to retake physics/rad bio, study for clinicals, while entertaining jobs in BFE is when it gets a little unbearable.

This really sums it up. Don't forget to add in a divorce, mental illness/substance abuse, or screwed up family planning in PGY-4/5 due to all the b.s.
It used to be you'd jump through all these hoops and sacrifice so much of your personal and family well-being because that light at the end of tunnel was always there (pretty much anybody could graduate and work 40 hours a week, make 500k, and be within driving distance of family or otherwise where they wanted to be). That light's gone and the canary died a while ago.

LOL @ med students not wanting to go into this field just because of board exams

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[RO28]

How do we fight this?

Complex question, one that I don't have a great answer to. Personally, when I am able to be eligible for hospital/medical group leadership roles I'm going to put my name in the hat. The collective "we" need to speak up and take up space in these leadership positions, otherwise no one will hear us. Hospital/medical group leadership roles are not often filled by radiation oncologists or oncologists in general for that matter, and I think (at least in my group) our revenue over the last few months has seen a few ups and downs, but has been mostly steady. We've also managed to keep covid relatively in control, which probably helps as well. I'm interested to hear if others have suggestions???

 

[elementaryschooleconomics]

Complex question, one that I don't have a great answer to. Personally, when I am able to be eligible for hospital/medical group leadership roles I'm going to put my name in the hat. The collective "we" need to speak up and take up space in these leadership positions, otherwise no one will hear us. Hospital/medical group leadership roles are not often filled by radiation oncologists or oncologists in general for that matter, and I think (at least in my group) our revenue over the last few months has seen a few ups and downs, but has been mostly steady. We've also managed to keep covid relatively in control, which probably helps as well. I'm interested to hear if others have suggestions???

I think this is the way forward as well.

This is TOTAL CONJECTURE on my part, but back in the days when RadOnc wasn't hypercompetitive, it was filled with people who were maybe bookish and wanted a job with more of a work/life balance, and less of a "medicine owns your soul" attitude. Perhaps FMGs as well? I don't see these people fighting for a place on the board (like Nuc Med or something).

I think an excellent byproduct of the past 20 years of superstar applicants is a cohort coming of age with intelligence, people skills, and a willingness to engage in hospital/medicine politics. Let's get some RadOnc Deans out there!

 

[KHE88]

The collective "we" need to speak up and take up space in these leadership positions, otherwise no one will hear us. Hospital/medical group leadership roles are not often filled by radiation oncologists or oncologists in general for that matter

These positions are typically filled by useful idiots. Upper admin likes it that way. Good luck staying in such a position if you don't play ball and try to advocate for MDs.

 

[RO28]

These positions are typically filled by useful idiots. Upper admin likes it that way. Good luck staying in such a position if you don't play ball and try to advocate for MDs.

You make a good point, I'm definitely not a ball player. We will see how it works out!

 

[bergonieandtribondeau]

In general, everyone is walking on eggshells trying to appropriately virtue signal/brownnose while simultaneously managing to avoid the wrath of the SJW mob. Due to the constantly shifting goal posts, what is perfectly fine to say today may be something that could get you fired tomorrow. It's a sad reflection on the state of society, but nothing us nobodys can really do about it, which goes back to my original point that any rad onc posting on Twitter is an idiot.

This is completely spot on.

 

[GapCalc]

How do we fight this?

We have to seize the means of production! Er, I mean, it helps to own things. If you are part of a group that owns your clinic and machines, or at least has a joint venture with the hospital, then you can have a say in where the income goes. If not, you’re just another cog in the machine.

Happy Friday, comrades!

 

[medgator]

We have to seize the means of production! Er, I mean, it helps to own things. If you are part of a group that owns your clinic and machines, or at least has a joint venture with the hospital, then you can have a say in where the income goes. If not, you’re just another cog in the machine.

Happy Friday, comrades!

The only way to survive going forward is in large independent multi specialty groups. Period. That or be a hospital cog

 

[w00tz]

We have to seize the means of production! Er, I mean, it helps to own things. If you are part of a group that owns your clinic and machines, or at least has a joint venture with the hospital, then you can have a say in where the income goes. If not, you’re just another cog in the machine.

Happy Friday, comrades!

I'm part of a multispecialty PP. Rad onc volume was surprisingly down only 20% at most due to COVID, despite delaying care for things like prostate. Med onc side was the same. Pulmonology barely saw any patients at one point. We took the CARES money and basically gave them the most of it. A lot of rad onc business comes from pulmonology. I'm sure they will return the favor somehow, but easier to do in a small-medium PP vs a large hospital-based system.

 

[Tigerstang]

The only way to survive going forward is in large independent multi specialty groups. Period. That or be a hospital cog

The problem is, in working for these groups, you give up a minimum of 80% of your revenue (all the technical) and often much of your professional (some have you pay for nursing staff, office space lease, etc). You will work at the 99% RVU wise but make at the 50%.

In my humble opinion, the best situation is a hospital PSA where you bill for your own professional (if you don't own your own technical assets, independently or in JV with a hospital).

 

[medgator]

The problem is, in working for these groups, you give up a minimum of 80% of your revenue (all the technical) and often much of your professional (some have you pay for nursing staff, office space lease, etc). You will work at the 99% RVU wise but make at the 50%.

In my humble opinion, the best situation is a hospital PSA where you bill for your own professional (if you don't own your own technical assets, independently or in JV with a hospital).

Not my experience, at least from what I've seen. They usually let you bill pro on your own and share a small slice of the technical. It is probably market/geography dependent, like everything else

 

[Mandelin Rain]

I've certainly seen other docs get jealous of the Rad Onc income in multispecialty PP groups. This leads to resentment and attempts to skim.

No perfect model.

 

[OTN]

The problem is, in working for these groups, you give up a minimum of 80% of your revenue (all the technical) and often much of your professional (some have you pay for nursing staff, office space lease, etc). You will work at the 99% RVU wise but make at the 50%.

In my humble opinion, the best situation is a hospital PSA where you bill for your own professional (if you don't own your own technical assets, independently or in JV with a hospital).

Not all multispecialty groups are the same- my situation has been very different than what you described.

 

[Tigerstang]

Not true, at least from what I've seen. They usually let you bill pro on your own and share a small slice of the technical. It is probably market/geography dependent, like everything else

Yes, I just made up my personal experience because I enjoy lying. Every time I contribute to this board I wonder why I do it.

 

[w00tz]

Yes, I just made up my personal experience because I enjoy lying. Every time I contribute to this board I wonder why I do it.

I don't think he called you a liar, just said that your personal experience isn't everyone's experience...

 

[medgator]

I don't think he called you a liar, just said that your personal experience isn't everyone's experience...

I clarified my original comment to avoid any misunderstanding

 

[Tigerstang]

I don't think he called you a liar, just said that your personal experience isn't everyone's experience...

He stated my comment was "not true." Ok, he didn't call me a liar, he just said what I say is not true. Let's split hairs until we are bald.

 

[w00tz]

He stated my comment was "not true." Ok, he didn't call me a liar, he just said what I say is not true. Let's split hairs until we are bald.

LOL, hmmm. How about "not always true"? Which is how I read it.

 

[medgator]

He's baaack

 

[deleted774703]

He's baaack

Cant hide now!

 

[medgator]

Nice to see a PD speaking the truth on ROhub. Let's see how long this post stays up

 

[scarbrtj]

Nice to see a PD speaking the truth on ROhub. Let's see how long this post stays up

He's prob the most reasonable, pragmatic big-name(ish) guy out there right now.
On the other hand, in open conversation it's tough to just blurt "I'm a big Robert Lee fan." But I am.

 

[KHE88]

LOL @ Steinberg being a stooge and parroting Wallner and repeating the ABR's lies (repeatedly debunked on this site) about the 2018 exam and virtual exam concerns.

"Thankfully the offensive post was taken down"

Hey Steinberg, if you only wish to engage in conversations where you are protected from being offended (through censorship) then your conversation probably doesn't contain anything worth saying. In order to think you have to risk being offensive.

What a tool.

 

[thecarbonionangle]

Many people are saying!

 

[Gfunk6]

Steinberg's response can basically be summarized as follows:

1. The ABR is never wrong. The exam results from last year occurred because the test-takers that year suddenly became stupid.
2. Wallner is a saint and can never be questioned or doubted.
3. Setting up virtual exams is really hard, so let's not even try.
4. Anyone who disagrees with me is stupid.

 

[Ray D. Ayshun]

A novel way of doing oral exams could be creating a program of some type that for 3-4 years trains the residents and evaluates their progress. It could be administered by some of the current examiners even, for which they would be paid and maybe have some of their work done for them. During this period, or at the end, the "examiners" could then decide if a particular individual passed and give them a certificate stating such.

 

[KHE88]

A novel way of doing oral exams could be creating a program of some type that for 3-4 years trains the residents and evaluates their progress. It could be administered by some of the current examiners even, for which they would be paid and maybe have some of their work done for them. During this period, or at the end, the "examiners" could then decide if a particular individual passed and give them a certificate stating such.

Great idea! Maybe we could have formal ways to evaluate trainees like annual competency tests to track progress and milestone evaluations. And the programs themselves could be evaluated by an accreditation board or something to ensure only competent radiation oncologists can be allowed to receive diplomas.

But one big problem -- How would the ABR get paid? They already lose money on certifying rad oncs. Paul Wallner said so. They do it out of the goodness of their hearts. Maybe the training progams could support the ABR with a charity stipend?

 

[Haybrant]

I wish steinberg would come here or please screen shot our responses and post them where he looks. He’s got his head in the sand the way he is talking, I hope you hear this Steinberg. Time for you and Wallner to step the F aside. Like just get out. You guys don’t want to face the facts that we are telling you and have been telling you literally since 2014. Ya let’s investigate this further no way the Board Pass rate is involved in the decline in interest of our specialty right? Must be some magical reasons that we need to have deep investigations about. Nothing about residency expansion and inability find jobs right. You’re happy you’re drawing 900k+/year at UCLA right while the interest in Rad onc plummets.

You guys will never open your eyes, YOU are the reason for the decline. Like just leave, you and Wallner, take Kachnic with you.

 

[medgator]

Steinberg's response can basically be summarized as follows:

1. The ABR is never wrong. The exam results from last year occurred because the test-takers that year suddenly became stupid.
2. Wallner is a saint and can never be questioned or doubted.
3. Setting up virtual exams is really hard, so let's not even try.
4. Anyone who disagrees with me is stupid.

5. Sdn is an "anonymous medical student blog" responsible for "bad-mouthing" and tanking the specialty

 

[KHE88]

You guys will never open your eyes, YOU are the reason for the decline. Like just leave, you and Wallner, take Kachnic with you.

They really should have their good-old-boys-club certified-for-life status revoked due to their repeated demonstrations of gross incompetence when it comes to understanding bias/confounders and interpreting exam data and statistics. If you can't understand that a 5 sigma deviation on an exam is not just a trivial statistical anomaly then you are not safe to treat patients.

 

[KHE88]

5. Sdn is an "anonymous medical student blog" responsible for "bad-mouthing" and tanking the specialty

Mark my words, Wallner is going to threaten baseless litigation against SDN and try to get this place shut down.
It's the M.O. of despots like him everywhere.

 

[OTN]

Mark my words, Wallner is going to threaten baseless litigation against SDN and try to get this place shut down.
It's the M.O. of despots like him everywhere.

The discovery part of that lawsuit would be fun at least

 

[Radonc90]

...He's baaack...

Yeah,

I read the whole post by the Chair from the City of Angels on ROHub.

He is a disgrace to our field. A. Complete. Disgrace.
He and PW and LK, a complete disgrace.
These are the people that give us bad names...

Lee is a great guy. I respect and admire him.

 

[Radonc90]

Re the post by the Chair from the City of Angels on ROHub.
- It is mostly wrong and defensive, justifying him, ABR etc.
- He does NOT stand up for the residents. Instead, he accused them for being "whiny".
- So, with the #BLM issues, do we accuse the black people for being whiny? Absolutely not. We need to do what is right and protect not only the black people but all people no matter what color of their skin is.
- If ASTRO has any skin in the game, then they should remove his post.
- Now, if this stupid post is still up and nobody from ASTRO, junior and senior members alike, writes any rebuttal, then "Silence is Complicity".
I'd like to see ASTRO members write rebuttals. Enough is enough. They should feel free to write on ROHub without fear of retribution.
- This field is full of people of small mind, this is why this Titanic is going down...

 

[Radonc90]

Can someone attach the very original post that the chair from the City of Angels replied to?
That very original post was removed from ROHub.
Anyone with a screenshot of that original post?

PS: I wonder why the chair at City of Angels said "thankfully that offensive was removed" from ROHub...

 

[medgator]

Can someone attach the very original post that the chair from the City of Angels replied to?
That very original post was removed from ROHub.
Anyone with a screenshot of that original post?

PS: I wonder why the chair at City of Angels said "thankfully that offensive was removed" from ROHub...

 

[w00tz]

Wow...Poor Simul. Guy must have terrible back pain from having to lug around his HUGE CAJONES. Omg.

 

[thecarbonionangle]

Wow...Poor Simul. Guy must have terrible back pain from having to lug around his HUGE CAJONES. Omg.

this big balled bull also came on this board, reactivating an old account, to advocate for censorship and defend a residency program’s horrific actions. He advocated for same censorship he now receives. He did not like “getting offended”. Guy talks out of both sides. Our specialty can do better than this.

 

[medgator]

this big balled bull also came on this board, reactivating an old account, to advocate for censorship and defend a residency program’s horrific actions. He advocated for same censorship he now receives. He did not like “getting offended”. Guy talks out of both sides. Our specialty can do better than this.

He gave his side of the story, having been a resident there and he's done plenty in Twitter under his own account. .. What did you do again? Have you rotated at pitt? I have and i can think of dozens of worse programs

 

[deleted774703]

this big balled bull also came on this board, reactivating an old account, to advocate for censorship and defend a residency program’s horrific actions. He advocated for same censorship he now receives. He did not like “getting offended”. Guy talks out of both sides. Our specialty can do better than this.

let’s cut Simul some slack. He’s the only one of us who has any balls to say something with his real name associated with it on Twitter

Even dan Spratt came on here to defend himself but still hasn’t said shi* to the twitterati

 

[thecarbonionangle]

He gave his side of the story, having been a resident there and he's done plenty in Twitter under his own account. .. What did you do again? Have you rotated at pitt? I have

don’t be so offended, put a smile on it!

 

[RickyScott]

this big balled bull also came on this board, reactivating an old account, to advocate for censorship and defend a residency program’s horrific actions. He advocated for same censorship he now receives. He did not like “getting offended”. Guy talks out of both sides. Our specialty can do better than this.

this big balled bull also came on this board, reactivating an old account, to advocate for censorship and defend a residency program’s horrific actions. He advocated for same censorship he now receives. He did not like “getting offended”. Guy talks out of both sides. Our specialty can do better than this.

I really appreciate his openness and have all the respect in the world for him. Did offend him at one point by referring to satellite “fluffers” but that was just expressing frustration about the price gouging that has allowed nci/university centers to open up satellites with extorinisitic pricing and then expand residencies to service huge departments.

 

[thecarbonionangle]

I really appreciate his openness and have all the respect in the world for him. Did offend him at one point by referring to satellite “fluffers” but that was just expressing frustration about the price gouging that has allowed nci/university centers to open up satellites with extorinisitic pricing and then expand residencies to service huge departments.

i’ll give him credit on at least standing by his words regarding racist comment by his clown bully chair.

censorship advocacy ain’t cool though.

 

[RickyScott]

i’ll give him credit on at least standing by his words regarding racist comment by his clown bully chair.

censorship advocacy ain’t cool though.

At least as it relates to my comment, I think he found the notion of “fluffer” being used in a proffesional forum to be uncouth and highly unbecoming of a physician. I can forgive him for that.

 

[OTN]

Simul posted his ROHub letter- see below. If the illustrious chair from UCLA thinks that's tough, it's probably best he doesn't venture into this "anonymous student blog."

 

[metallica81788]

Simul's ROHub post was well-written and completely accurate. Fail to see the "offense"

 

[Chartreuse Wombat]

In the 21st century offense is in the eye of the offended.

 

[Radonc90]

Hmm,

Simul posted a few tweets this morning then delete them...

 

[deleted774703]

Hmm,

Simul posted a few tweets this morning then delete them...

Instead of helping, ASTRO got to him again?

 

[thecarbonionangle]

Instead of helping, ASTRO got to him again?

multimillionaire rad oncs can sue you and bankrupt you in court