Rad Onc Twitter

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I don't know about anyone else, but I find the righteous indignation here a little funny.

"No! I will not work for you sir, you charge insurance companies too much"... said no one here...ever.

To say nothing of the fact that junior faculty at academic institutions are extremely far removed from financial decisions (as opposed to say, a partner in PP)... and, if someone was going to change a place like MSKCC from the inside, it would be Dr. Chino.

Lastly, don't throw stones at people you don't know. One of the other reasons people don't like doctors is they think we stab each other in the back to get ahead.
 
Lamount said:
I don't know about anyone else, but I find the righteous indignation here a little funny.

"No! I will not work for you sir, you charge insurance companies too much"... said no one here...ever.

To say nothing of the fact that junior faculty at academic institutions are extremely far removed from financial decisions (as opposed to say, a partner in PP)... and, if someone was going to change a place like MSKCC from the inside, it would be Dr. Chino.

Lastly, don't throw stones at people you don't know. One of the other reasons people don't like doctors is they think we stab each other in the back to get ahead.
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I totally agree she has nothing to do with the financial decisions at MSKCC and in her position would have also accepted a job. You also make a very good point about not knowing her, I don't and I have no idea what her practice patterns are. My comment is not meant to stab her in the back, as her success has no bearing on mine. I sincerely hope her research brings to light the financial challenges faced for cancer patients. At the same time, however, I hope that the politics of rad onc do not get in the way of continuing to speak out against this challenge.
 
Lamount said:
I don't know about anyone else, but I find the righteous indignation here a little funny.

"No! I will not work for you sir, you charge insurance companies too much"... said no one here...ever.

To say nothing of the fact that junior faculty at academic institutions are extremely far removed from financial decisions (as opposed to say, a partner in PP)... and, if someone was going to change a place like MSKCC from the inside, it would be Dr. Chino.

Lastly, don't throw stones at people you don't know. One of the other reasons people don't like doctors is they think we stab each other in the back to get ahead.
Click to expand...

Physicians should be able to dictate which tests their patients receive, which is a clinical decision rather than a financial one. I do agree that it's great Dr. Chino is addressing the issue, but in not addressing the financial toxicity in her own house, it makes it appear as if she's ignoring the very large elephant in the room.
 
OTN said:
Physicians should be able to dictate which tests their patients receive, which is a clinical decision rather than a financial one. I do agree that it's great Dr. Chino is addressing the issue, but in not addressing the financial toxicity in her own house, it makes it appear as if she's ignoring the very large elephant in the room.
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how is she ignoring the elephant in the room when she is the one that mentioned the elephant though
 
PhotonBomb said:
how is she ignoring the elephant in the room when she is the one that mentioned the elephant though
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Very good point, I do stand corrected re: ignoring. Not the best analogy on my end.

I'm glad to see she's getting into the nitty-gritty of how financial toxicity can be reduced, but up until now it's all been theoretical stuff that of course no one is going to disagree with. I haven't yet seen- outside of "don't do EKGs on all radiation patients", which really shouldn't even have to be said, any concrete proposals on what to do to help reduce financial toxicity for her/our patients.
 
OTN said:
Very good point, I do stand corrected re: ignoring. Not the best analogy on my end.

I'm glad to see she's getting into the nitty-gritty of how financial toxicity can be reduced, but up until now it's all been theoretical stuff that of course no one is going to disagree with. I haven't yet seen- outside of "don't do EKGs on all radiation patients", which really shouldn't even have to be said, any concrete proposals on what to do to help reduce financial toxicity for her/our patients.
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Idk.. sort of like broken-window policing. Start with the little things, and then go bigger. Starts with EKGs, than the excessive other testing/imaging, then with the 2nd, 3rd, 4th opinions from your specialists, even though patient only came to see a rad-onc or whatever, then the expensive meds, then the extra fractions or protons. Gotta start somewhere.
 
Working for a large company, it is very hard for a physician to fight overuse of healthcare resources. Hospital I'm working for now has written all sort of small billable things into their "policies". CBCT always once daily, immobilization devices for all palliative cases, etc.

OTN said:
Physicians should be able to dictate which tests their patients receive, which is a clinical decision rather than a financial one. I do agree that it's great Dr. Chino is addressing the issue, but in not addressing the financial toxicity in her own house, it makes it appear as if she's ignoring the very large elephant in the room.
Click to expand...
 
seper said:
Working for a large company, it is very hard for a physician to fight overuse of healthcare resources. Hospital I'm working for now has written all sort of small billable things into their "policies". CBCT always once daily, immobilization devices for all palliative cases, etc.
Click to expand...

Hopefully she will use her growing soapbox to start to speak about against predatory hospital billing, including that of her own institution. If she does I will happily eat my crow, as long as it's prepared a la lamb biryani.
 
seper said:
Working for a large company, it is very hard for a physician to fight overuse of healthcare resources. Hospital I'm working for now has written all sort of small billable things into their "policies". CBCT always once daily, immobilization devices for all palliative cases, etc.
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Site neutral bundles can't come quick enough (including to the special PPS exempt institutions)
 
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OTN said:
Hopefully she will use her growing soapbox to start to speak about against predatory hospital billing, including that of her own institution. If she does I will happily eat my crow, as long as it's prepared a la lamb biryani.
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Where I am right now, we somehow always find a way to get drugs for pts even illegals. A lot of times pharm reps help us. But so what? The real damage is the huge bills being paid by insurances and Medicare for the drugs. When companies like valient and Martin shkeli would buy an old aids drug and jack up the price over 20000% they would always provide it free to those without insurance (for public relations) but that does not detract from their evil.

The hidden prices being born by insurance is where the harm is at.
 
RickyScott said:
Where I am right now, we somehow always find a way to get drugs for pts even illegals. A lot of times pharm reps help us. But so what? The real damage is the huge bills being paid by insurances and Medicare for the drugs. When companies like valient and Martin shkeli would buy an old aids drug and jack up the price over 20000% they would always provide it free to those without insurance (for public relations) but that does not detract from their evil.

The hidden prices being born by insurance is where the harm is at.
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I would argue that the government is the one being screwed. Insurers are doing just fine (see below)

 
RO28 said:
It is completely ridiculous. Unless you are actively trying to change the system and speaking out you are part of it. No wonder the public has such mistrust of physicians and believes we are a bunch of money grubbing gremlins.
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um reading much of this forum the public would think we’re money grubbing gremlins.

Can’t get a starting salary more than $300k? Might as well do psych
 
Krukenberg said:
Can’t get a starting salary more than $300k? Might as well do psych
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Some people would gladly take that in RO if it meant getting their geographic preference which seems to be the far bigger problem to anyone that's been paying attention more than the salary issue
 
Chartreuse Wombat said:
I would argue that the government is the one being screwed. Insurers are doing just fine (see below)

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They do fine because they pass the costs on to us, and employers wIth higher premiums. They are just middlemen taking their cut. Cost of health care insurance for family 4 can be like 15-20k a year? Makes many employers think twice about hiring full time employees?

THE WALL STREET JOURNALAverage cost of employer-provided family health coverage clears $20,000-a-year mark
By Anna Wilde Mathews
Published: Sept 26, 2019 8:07 a.m. ET
 
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Krukenberg said:
um reading much of this forum the public would think we’re money grubbing gremlins.

Can’t get a starting salary more than $300k? Might as well do psych
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Yes yes yes, because location location location is the prime motivator for jobs per surveys. Twitter crowd, many work in desirable locations and instituitons, imply the true pure radoncs should be willing to work far from family and friends where spouse may not be employable.

salaries are lower because of oversupply not because of big changes in reimbursement! This is a critical point because it means things will get worse. ID may not pay a lot because of reimbursement but certainly have choice of geography. lots of other great rewarding specialties that we compete for applicants with. No one was born with a special destiny calling to be a radonc!
 
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Krukenberg said:
um reading much of this forum the public would think we’re money grubbing gremlins.

Can’t get a starting salary more than $300k? Might as well do psych
Click to expand...

Someone is making the money- a drop in radonc salaries won't be because of a drop in prices charged to patients. By saying "doctors shouldn't be making that money off of radiation treatment", what you are actually saying is "I would rather hospital administrators and institutional investors make money off of radiation treatment than doctors."
 
OTN said:
Someone is making the money- a drop in radonc salaries won't be because of a drop in prices charged to patients. By saying "doctors shouldn't be making that money off of radiation treatment", what you are actually saying is "I would rather hospital administrators and institutional investors make money off of radiation treatment than doctors."
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You shouldn’t care about money and geography if you are a truly dedicated pure radonc. You should also signal your virtues to otherS. the Other specialties are for the greedy. Mskcc and mdacc don’t care about money as they are all about sustainable rates.
 
Krukenberg said:
um reading much of this forum the public would think we’re money grubbing gremlins.

Can’t get a starting salary more than $300k? Might as well do psych
Click to expand...

Poster continuously presses for people to out themselves and reveal their identity, also seems to be on side of clown bullies who want to reduce salaries to peds levels. I’ll let you figure out what side poster is on
 
frijoles said:
Well this should be good...





Sent from my iPhone using SDN
Click to expand...

With stellar individuals like DM and KO trying to always make it personal, it's a wonder more of us don't want to engage in meaningful conversation with the RO Twitter crowd. Apparently we are mentally ill, so why even try?
 
Wow, stop the presses. This guy can assess someone's mental health solely from a name. Incredible!

It's a lame cop-out to dismiss anonymous opinions and act like they're the courageous ones because they publicly promote the status quo.
 
medgator said:
With stellar individuals like DM and KO trying to always make it personal, it's a wonder more of us don't want to engage in meaningful conversation with the RO Twitter crowd. Apparently we are mentally ill, so why even try?
Click to expand...

DM is the classic angry napoleon complex chap. Bless his soul as the southerners say. Looked like a total clown!
 
Drew Moghanaki is, unfortunately, a terrible person. Sorry, just going to come out and say it. His whole career is based off of latching himself onto other people and riding on their coattails. Moreover, his tweets epitomizes what virtue signaling is, such as tweeting stupid things about lung cancer screening because most of his followers are lung cancer survivors, calling out oncologists and epidemiologists who challenge the role of screening, with their basis on the trial design and results. He, instead of actually thinking for himself, likes to tug on heart strings of cancer survivors for a quick Twitter like.

One quick story about him. I was at a meeting when I was a junior resident, not too long ago. He introduced his VALOR study, of which, overlapped with my own research. Anyways, after the talk, I thought I would take the opportunity to meet him and foster collaboration. I walked up to him and introduced myself. I asked about a couple of things, and he said 'oh yeah that sounds good, just email me.' He then just walked away, only to catch up with other 'academic well-knowns' to brown nose or whatever he does best. Surely, he would've given me more time, if I tweeted about how awesome of a guy Drew is, making sure I tag him and all of his academic superiors. It's people like him who gives academics a bad name. He is all about his own image, instead of doing good science...particularly because I don't think he has the chops for it.
 
SubserviantToABR said:
Drew Moghanaki is, unfortunately, a terrible person. Sorry, just going to come out and say it. His whole career is based off of latching himself onto other people and riding on their coattails. Moreover, his tweets epitomizes what virtue signaling is, such as tweeting stupid things about lung cancer screening because most of his followers are lung cancer survivors, calling out oncologists and epidemiologists who challenge the role of screening, with their basis on the trial design and results. He, instead of actually thinking for himself, likes to tug on heart strings of cancer survivors for a quick Twitter like.

One quick story about him. I was at a meeting when I was a junior resident, not too long ago. He introduced his VALOR study, of which, overlapped with my own research. Anyways, after the talk, I thought I would take the opportunity to meet him and foster collaboration. I walked up to him and introduced myself. I asked about a couple of things, and he said 'oh yeah that sounds good, just email me.' He then just walked away, only to catch up with other 'academic well-knowns' to brown nose or whatever he does best. Surely, he would've given me more time, if I tweeted about how awesome of a guy Drew is, making sure I tag him and all of his academic superiors. It's people like him who gives academics a bad name. He is all about his own image, instead of doing good science...particularly because I don't think he has the chops for it.
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Ultimate brown noser riding every pony he can, especially the mdacc horse. People say guy’s nose smells like my finger after a DRE!! you wanna smell my finger?
 
I don't disagree with you, PhotonBomb. On a different note, if I run into Simul at a meeting, I'm buying him drinks all night. I've always enjoyed his perspective on things, ever since I was a med student, and appreciate his voice more so than ever.
 
SubserviantToABR said:
I don't disagree with you, PhotonBomb. On a different note, if I run into Simul at a meeting, I'm buying him drinks all night. I've always enjoyed his perspective on things, ever since I was a med student, and appreciate his voice more so than ever.
Click to expand...

Simul is on fire right now. He's really doling out some truth.
 
frijoles said:
Well this should be good...





Sent from my iPhone using SDN
Click to expand...


I HiGHLY disagree with this statement by DM right here, but will note that whenever I have met him he has been incredibly gracious to me (maybe a fan of the RadOncMegatron?!?) I never had a bad interaction the many times I’ve met him.

Seriously, VALOR is a dope study and should be lauded. One of the few rad oncs doing substantial potentially game changing research. His tweet saying we are all mentally ill here not so much...
 
RadOncMegatron said:
I HiGHLY disagree with this statement by DM right here, but will note that whenever I have met him he has been incredibly gracious to me (maybe a fan of the RadOncMegatron?!?) I never had a bad interaction the many times I’ve met him.

Seriously, VALOR is a dope study and should be lauded. One of the few rad oncs doing substantial potentially game changing research. His tweet saying we are all mentally ill here not so much...
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I agree with praising VALOR. I also witnessed Drew do something nice for a colleague (to help that colleague professionally) once.

That being said, Drew's personal reputation precedes him in a negative way, nationwide. Tweets like this are great examples. A long time ago I was warned by a close mentor to avoid Drew because of his propensity to throw people under the bus - hard - if he felt slighted by them. In the years I had known this mentor, this was literally the only negative thing I heard them say about...anyone, really. It was startling. In subsequent years, I have felt very thankful for heeding this advice.

Like @PhotonBomb said, most of the people in this profession are nice and relatively normal (in a quirky, medicine way). Drew and Ralph are the notable exceptions. But the other folks who pop up on Twitter a lot - I may disagree with their ideas regarding the profession right now, but I find the ones I know in real life to be lovely people.
 
The brief interactions I have had with some of these guys has been positive, but at the end of day who cares? It’s like they are fighting gravity or declaring the earth is flat. I don’t care how smart or stupid they are. They are just wrong.
Also,if posters on sdn have mental issues, under influence of drugs, have low iqs etc facts are still facts: resident numbers have doubled, fractionation is decreasing, indications and regulations are changing.
 
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1574400346727.png


There we go.

This is the Drew Moghanaki we all know and love.

Awesome.
 
A recruiter who spoke to him once mentioned he was a “misogynistic jerk.” She was correct.
He is totally unprofessional and an embarrassment for Emory and the VA system (which is already somewhat embarrassing). This is your leadership? Someone who would make these types of comments not only privately but in a public forum? Yikes.

elementaryschooleconomics said:
View attachment 287018

There we go.

This is the Drew Moghanaki we all know and love.

Awesome.
Click to expand...
elementaryschooleconomics said:
View attachment 287018

There we go.

This is the Drew Moghanaki we all know and love.

Awesome.
Click to expand...
 
RadDoc11 said:
A recruiter who spoke to him once mentioned he was a “misogynistic jerk.” She was correct.
He is totally unprofessional and an embarrassment for Emory and the VA system (which is already somewhat embarrassing). This is your leadership? Someone who would make these types of comments not only privately but in a public forum? Yikes.
Click to expand...
Guessing there is a reason he is probably at the VA and not Emory, they seem to tolerate more $h!t over there
 
RickyScott said:
The brief interactions I have had with some of these guys has been positive, but at the end of day who cares? It’s like they are fighting gravity or declaring the earth is flat. I don’t care how smart or stupid they are. They are just wrong.
Also,if posters on sdn have mental issues, under influence of drugs, have low iqs etc facts are still facts: resident numbers have doubled, fractionation is decreasing, indications and regulations are changing.
Click to expand...

Also, it seems like he is the one with the “mental illness” based on what I’ve seen thus far. Either way, crack is wack!
 
medgator said:
Guessing there is a reason he is probably at the VA and not Emory, they seem to tolerate more $h!t over there
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No he’s always been part of the VA system (hence the VALOR trial) and was recruited from VCU VA to the Emory VA.
 
thecarbonionangle said:
DM is the classic angry napoleon complex chap. Bless his soul as the southerners say. Looked like a total clown!
Click to expand...
Heh "Bless your heart" is the backhanded/frenemy one. "Bless his soul" is Southern too but implies at least a little compassion. "I loaded sixteen tons of number nine coal, and the straw boss said well bless my soul" ... "Sixteen Tons" made famous by Tennessee Ernie Ford, the song most rad oncs (me included) hum at work every day. Bless Drew's heart and soul!
 
Reminder to not drink and tweet kids. Also screenshots are important for when things disappear in the morning.
 
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