Rad Onc Twitter

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Chartreuse Wombat said:
ANyone gonna call out KO for Mayo refusal to provide charity care/medicaid? Maybe they can pick up some of the people not cared for by MCW
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Is it really true that they don't take medicaid?

I saw where Brendan Styles called out MSKCC for that issue a while back, but I wasn't sure if Mayo was in the no medicaid group as well.
 
BobbyHeenan said:
Is it really true that they don't take medicaid?

I saw where Brendan Styles called out MSKCC for that issue a while back, but I wasn't sure if Mayo was in the no medicaid group as well.
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Mayo does not take Medicare or Medicaid. private insurance only. If you are medicare, they are non contracted. Meaning, you pay upfront and then Medicare reimburses you.
 
It is very interesting how many of these “big name” places have systems that essentially discriminate against poor URMs and poor white people indirectly by not taking medicare and medicaid yet lecture you on “justice”. Is it justice when they tell the poor person to walk across the street to be treated? Maybe to their own pocketbooks. This farce of refusing to take poor people needs to end. You don’t get any federal or state funds, have access to federally backed things, if you dont take medicaid and medicare. even out the unfunded one sided mandate, this is why poor county hospitals are always overwhelmed.
 
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All hospital systems who refuse to see governmental insurers should IMMEDIATELY lose non-profit status and the tax protection that come with it. (really this should happen to all systems, but gotta start somewhere)
 
thecarbonionangle said:
It is very interesting how many of these “big name” places have systems that essentially discriminate against poor URMs and poor white people indirectly by not taking medicaid and medicaid yet lecture you on “justice”. Is it justice when they tell the poor person to walk across the street to be treated? Maybe to their own pocketbooks. This farce of refusing to take poor people needs to end. You don’t get any federal or state funds, have access to federally backed things, if you dont take medicaid and medicare. even out the unfunded one sided mandate, this is why poor county hospitals are always overwhelmed.
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This was just unfathomable to me when I first learned that places did this, coming from systems which saw/see a ton of Medicare/Medicaid patients.

Eventually I realized I live and practice in America, and there's probably a class all MBA healthcare admins take entitled "Poor and Elderly People are Not Full Humans" or something like that.
 
elementaryschooleconomics said:
This was just unfathomable to me when I first learned that places did this, coming from systems which saw/see a ton of Medicare/Medicaid patients.

Eventually I realized I live and practice in America, and there's probably a class all MBA healthcare admins take entitled "Poor and Elderly People are Not Full Humans" or something like that.
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Mskcc and mdacc are the worst. To Harvard’s credit, they seem to take anyone.
 
One of the positive things that has become evident from the pandemic is the extent to which "WorldClassMedicalCenters" rely on cost-shifting, refusing government insurance and elective procedures for their success.

Combine this with the fraud of the scientists who take money from foreign governments that is not reported (Thousand Talents) and you can begin to see how incredibly corrupt our "elites" truly are.
 
RadOncMegatron said:
It's starting to get good... *grabs popcorn* :corny:

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I must be dense, but after review of the Medical College of Wisconsin's radiation oncology website (Faculty and Staff | Radiation Oncology | Medical College of Wisconsin), I am not seeing any African Americans on faculty, either as a physician, advanced practice provider, medical physics faculty, or research faculty. Moreover, I am not seeing any African American residents either. neither in their medical or physics residency (Education | Radiation Oncology | Medical College of Wisconsin). For a decent sized department, you would think there would at least be ONE person...

If Malika Siker is motivated for change, would it be better to start at home, in her own department? Honest question.
 
SubserviantToABR said:
I must be dense, but after review of the Medical College of Wisconsin's radiation oncology website (Faculty and Staff | Radiation Oncology | Medical College of Wisconsin), I am not seeing any African Americans on faculty, either as a physician, advanced practice provider, medical physics faculty, or research faculty. Moreover, I am not seeing any African American residents either. neither in their medical or physics residency (Education | Radiation Oncology | Medical College of Wisconsin). For a decent sized department, you would think there would at least be ONE person...

If Malika Siker is motivated for change, would it be better to start at home, in her own department? Honest question.
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This is when the nuances of pigment become manifest.
 
SubserviantToABR said:
I must be dense, but after review of the Medical College of Wisconsin's radiation oncology website (Faculty and Staff | Radiation Oncology | Medical College of Wisconsin), I am not seeing any African Americans on faculty, either as a physician, advanced practice provider, medical physics faculty, or research faculty. Moreover, I am not seeing any African American residents either. neither in their medical or physics residency (Education | Radiation Oncology | Medical College of Wisconsin). For a decent sized department, you would think there would at least be ONE person...

If Malika Siker is motivated for change, would it be better to start at home, in her own department? Honest question.
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Thank you ABRO for calling Malika out. Her stances have been hypocritical at best
 
Bearstronaut said:
Not sure where this is from? They don't provide out-of-state Medicaid services: Medical Assistance (Medicaid) - Mayo Clinic

Rochester in-state includes Iowa, Minnesota, North Dakota, South Dakota and Wisconsin. Arizona and Florida less accessible.

It looks like they bill Medicare as well? More about Medicare - Mayo Clinic
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www.healthleadersmedia.com

Mayo Clinic in Arizona to stop treating some Medicare patients

The Mayo Clinic stopped accepting Medicare patients on Jan 1 at one of its primary-care clinics in Arizona, saying the U.S. government pays too little. More than 3,000 patients eligible for Medicare will be forced to pay cash if they want to continue seeing their doctors at a Mayo family clinic...
www.healthleadersmedia.com www.healthleadersmedia.com

www.modernhealthcare.com

Cherry-picking patients? Mayo Clinic aims to 'prioritize' privately insured

Preferring commercially insured patients over those covered by Medicare and Medicaid has long been one of the healthcare industry's dirty secrets.
www.modernhealthcare.com www.modernhealthcare.com

In my practice we treat everyone the same and do not discriminate against CMS patients
 
No Jobs.JPG


Is this really radiation oncology? Seriously, from 10 years ago to now, if there are any doubters about the job market it should END NOW. We have a URM MD PHD asking for jobs on Twitter? I'm only mentioning URM b/c academic centers are cheerleading and wild about diversity (just lip service as there are no jobs to give out for diversity?), but even as the best candidate possible ie Female URM w/ Ph.D. who wants to do Gyn (you know you hate brachy) with proton experience can't get a JOB? The solution ... GO TO CANADA!?!?!?!?!??! :dead: :sendoff::whoa:

source: link
 
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RadOncMegatron said:
View attachment 312567

Is this really radiation oncology? Seriously, from 10 years ago to now, if there are any doubters about the job market it should END NOW. We have a URM MD PHD asking for jobs on Twitter? I'm only mentioning URM b/c academic centers are cheerleading and wild about diversity (just lip service as their are no jobs to give out for diversity?), but even as the best candidate possible ie Female URM who wants to do Gyn (I hate brachy) with proton experience can't get a JOB? The solution ... GO TO CANADA!?!?!?!?!??! :dead: :sendoff::whoa:

source: link
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FML I can’t compete with that
 
RadOncMegatron said:
View attachment 312567

Is this really radiation oncology? Seriously, from 10 years ago to now, if there are any doubters about the job market it should END NOW. We have a URM MD PHD asking for jobs on Twitter? I'm only mentioning URM b/c academic centers are cheerleading and wild about diversity (just lip service as there are no jobs to give out for diversity?), but even as the best candidate possible ie Female URM w/ Ph.D. who wants to do Gyn (you know you hate brachy) with proton experience can't get a JOB? The solution ... GO TO CANADA!?!?!?!?!??! :dead: :sendoff::whoa:

source: link
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She has proton experience so should be able to find a job in an underserved area...
 
RadOncMegatron said:
View attachment 312567

Is this really radiation oncology? Seriously, from 10 years ago to now, if there are any doubters about the job market it should END NOW. We have a URM MD PHD asking for jobs on Twitter? I'm only mentioning URM b/c academic centers are cheerleading and wild about diversity (just lip service as there are no jobs to give out for diversity?), but even as the best candidate possible ie Female URM w/ Ph.D. who wants to do Gyn (you know you hate brachy) with proton experience can't get a JOB? The solution ... GO TO CANADA!?!?!?!?!??! :dead: :sendoff::whoa:

source: link
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I'm extremely pessimistic about the job market, and even I think this is premature.

As someone currently looking for a job, there seems to be three scenarios right now:

1) Definitely hiring for next summer (or earlier) because someone retired or otherwise left the department/practice and they're not at full strength
2) Not sure if they're hiring because of COVID etc, want to circle back in the Fall
3) Definitely not hiring

I have encountered Scenario #1 and #2, and not found Scenario #3 (though this could be because of both selection bias on my part and that no one wants to close doors too early).

As a female URM open to academic gyn, the ONLY way she won't have a job is if she's extraordinarily restricted due to geography. There's literally a Women's Health RadOnc job posted right now for Pittsburgh. Even in the insanely overcrowded California Bay Area market, they're actively advertising.

Obviously I don't know her personal story. The rest of the discussion on Twitter is interesting - perhaps she's going to start a new trend with this:

1594560997392.png


I agree, I have no desire to "tip my hand" in terms of who I'm talking to, not only with my current institution but also letting potential employers see that I'm actively talking to several places ("Well we've seen your activity on Twitter, we assume you're just using us to gauge what's out there").

(Edit: forgot to say, while I haven't encountered "we're definitely not hiring" others in my cohort have)
 
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I'd take "definitely not hiring" with a huge grain of salt. My current job was definitely not hiring until I contacted my current chair for the fifth time and all of a sudden, "we're almost done interviewing but I can add you last I think." Or another program that had multiple people tell me multiple times they were overstaffed and definitely not hiring, only to hire their own resident later. Or where I trained that wasn't hiring but they'd consider me for a fellowship, then ended up hiring a new grad attending...
 
Neuronix said:
I'd take "definitely not hiring" with a huge grain of salt. My current job was definitely not hiring until I contacted my current chair for the fifth time and all of a sudden, "we're almost done interviewing but I can add you last I think." Or another program that had multiple people tell me multiple times they were overstaffed and definitely not hiring, only to hire their own resident later. Or where I trained that wasn't hiring but they'd consider me for a fellowship, then ended up hiring a new grad attending...
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This specialty is beyond ridiculous, I might as well have gone into iBanking for all the games and politicking we're asked to do.
 
Neuronix said:
I'd take "definitely not hiring" with a huge grain of salt. My current job was definitely not hiring until I contacted my current chair for the fifth time and all of a sudden, "we're almost done interviewing but I can add you last I think." Or another program that had multiple people tell me multiple times they were overstaffed and definitely not hiring, only to hire their own resident later. Or where I trained that wasn't hiring but they'd consider me for a fellowship, then ended up hiring a new grad attending...
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Agree. Don’t always believe what everyone tells you, either, as they could be willfully misleading you.

When I was interviewing for jobs, I cold called/emailed every radonc in the ASTRO directory in every city in which I would be happy. More than 240 of them, and this was 11 years ago. One in a particular city told me the city was “very full” and no one would be hiring.

That’s the city in which I was hired, by a former co-resident. The other doc was just trying to limit incursion of competition into the area.
 
Taking a dissenting view: a black femal md/PhD from Harvard would pretty much have a standing job offer from every good program in the past (assuming she has a reputation for competence). She would be good pr for the entire health system, and probably worth her salary even if she did not treat patients.

Several years ago, she would not even had to make inquiries.(Like in other specialties)
 
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RadOncMegatron said:
View attachment 312567

Is this really radiation oncology? Seriously, from 10 years ago to now, if there are any doubters about the job market it should END NOW. We have a URM MD PHD asking for jobs on Twitter? I'm only mentioning URM b/c academic centers are cheerleading and wild about diversity (just lip service as there are no jobs to give out for diversity?), but even as the best candidate possible ie Female URM w/ Ph.D. who wants to do Gyn (you know you hate brachy) with proton experience can't get a JOB? The solution ... GO TO CANADA!?!?!?!?!??! :dead: :sendoff::whoa:

source: link
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"Strong interest in women's cancers (gyn and breast)..."
Cervical cancer e.g. by definition a rare cancer, and getting rarer, and not a *huge* role for RT in most endometrial... so here we have an MD looking for a job in a tight job market for non-rare-cancer to treat rare cancers/RT-mediocrely-utilized cancers... bonne chance
And when breast fully goes from ~6 week to ~1 week treatments we will need ~1/6th as many "breast rad oncs" (and for certain, linacs will be treating 1/6th the breast volume) as we have now... bonne chance

"Also interested in GI and GU..."
[RT use in GU malignancies] decreased from 46.5 to 39.0 (24% decrease, r=-0.96, p<0.001) from 2007 to 2018..."

Again, bonne chance à vous et à nous!
 
Neuronix said:
Meh, it's July 2020. This person is graduating next summer and looking for a job then. It's really early to be looking. You guys are making a mountain out if a molehill.

If she comes back in July 2021 still looking for a job, it's a different story!
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SMOKE:
Meh, it's July 2020. This person is graduating next summer and looking for a job then. It's really early to be looking. You guys are making a mountain out if a molehill.
FIRE:
If she comes back in July 2021 still looking for a job, it's a different story!
 
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scarbrtj said:
SMOKE:
Meh, it's July 2020. This person is graduating next summer and looking for a job then. It's really early to be looking. You guys are making a mountain out if a molehill.
FIRE:
If she comes back in July 2021 still looking for a job, it's a different story!
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She will have a job by 2021. She is at the front of the line. What is depressing is she has to apply and does not have multiple unsolicited offers, like an Im pgy3 at a crap program.
 
elementaryschooleconomics said:
View attachment 312588

Over 500 likes and 86 retweets, one of which by Vinay Prasad and his 40k followers.

I bet she has a contract by August.
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Agreed. I think it was a wise move to stick her hand up on twitter. Especially in the current environment. She could have just said "I'm a black female and need a job next year... who's it gonna be?"

Lets see who follows suit....
 
dieABRdie said:
Agreed. I think it was a wise move to stick her hand up on twitter. Especially in the current environment. She could have just said "I'm a black female and need a job next year... who's it gonna be?"
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Yeah I uh, don't think this would have worked so well had I or some of my friends tried this. On further reflection, this was well-played by her.
 
RickyScott said:
She will have a job by 2021. She is at the front of the line. What is depressing is she has to apply and does not have multiple unsolicited offers, like an Im pgy3 at a crap program.
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You think its depressing that someone has to apply and does not have multiple unsolicited offers? Even in rad onc's golden age people hustled for the job they wanted. Simul graduated at peak rad onc and was still cold calling chairs.


Twitter is just another avenue. There are many well-thought out and factual reasons why the job market sucks and is going to get worse, so no reason to start inventing more stuff

The depressing thing for me would be to have to round at 7am on a weekend in the hospital during a pandemic, which many of those IM pgy3s at a crap program will have to do if they take those unsolicited offers
 
radiation said:
You think its depressing that someone has to apply and does not have multiple unsolicited offers? Even in rad onc's golden age people hustled for the job they wanted. Simul graduated at peak rad onc and was still cold calling chairs.


Twitter is just another avenue. There are many well-thought out and factual reasons why the job market sucks and is going to get worse, so no reason to start inventing more stuff

The depressing thing for me would be to have to round at 7am on a weekend in the hospital during a pandemic, which many of those IM pgy3s at a crap program will have to do if they take those unsolicited offers
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Even during peak rad Onc, yes finding the best jobs required some hustle, which is why it continues to boggle my mind why expansion was ever allowed to take place. There were no mvp recruitment offers or signing bonuses if you were looking for positions outside of BFE
 
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medgator said:
Even during peak rad Onc, yes finding the best jobs required some hustle, which is why it continues to boggle my mind why expansion was ever allowed to take place. There were no mvp recruitment offers or signing bonuses if you were looking for positions outside of BFE
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That's a greally good point. It never felt like there were an overabundance of jobs in radonc, even 11 years ago when I came out. The balance felt juuuuuust about right. The only jobs that had trouble filling were in traditionally very underserved areas (hard to get any specialists there) or exploitative.
 
OTN said:
That's a greally good point. It never felt like there were an overabundance of jobs in radonc, even 11 years ago when I came out. The balance felt juuuuuust about right. The only jobs that had trouble filling were in traditionally very underserved areas (hard to get any specialists there) or exploitative.
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Expansion was allowed because there is no entity that can disallow expansion. ACGME was limited in its abilities; as I have said many times before if the program can show the ability (resources) the ACGME was required to approve increases. Programs viewed residents as cheap labor especially as they consumed community practices into the network allowing for monopolistic pricing. Tragedy of the Commons.
 
Tragedy of the commons is exactly right.

However, the only thing I would add is this: Even though "no entity" could **officially** disallow expansion, strong leadership from Chairs and PDs with a broad minded interest in the health of the field outside their own individual dept (combined with lobbying in SCAROP and amongst PDs) could have prevented this. Of course, leadership in our field is a laughingstock, so this didn't happen.
 
RollTideRadOnc said:
Tragedy of the commons is exactly right.

However, the only thing I would add is this: Even though "no entity" could **officially** disallow expansion, strong leadership from Chairs and PDs with a broad minded interest in the health of the field outside their own individual dept (combined with lobbying in SCAROP and amongst PDs) could have prevented this. Of course, leadership in our field is a laughingstock, so this didn't happen.
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100%!
 
RollTideRadOnc said:
Tragedy of the commons is exactly right.

However, the only thing I would add is this: Even though "no entity" could **officially** disallow expansion, strong leadership from Chairs and PDs with a broad minded interest in the health of the field outside their own individual dept (combined with lobbying in SCAROP and amongst PDs) could have prevented this. Of course, leadership in our field is a laughingstock, so this didn't happen.
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It did happen once before where leaders stepped in an addressed the issue which back then was due to over exapsion, not overexpansion coupled with decreased utilization.
 
RickyScott said:
It did happen once before where leaders stepped in an addressed the issue which back then was due to over exapsion, not overexpansion coupled with decreased utilization.
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Unlike the 90s, much of the current leadership is gaslighting us about this problem and many seem to have no intention of addressing it
 
Chartreuse Wombat said:
"Leaders" are by definition employers. It is not in their best interest to solve the problem. They view it as a feature, not a bug.
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Remember in that one Start Trek:TNG episode when someone discovered that warping was polluting the universe (destroying the fabric of spacetime or some such). And the Federation was like warping, warping, warping, we love warping. The more warping the better! It was almost inconceivable that they were doing wrong, "warping CAN'T be bad can it?" And wow, warping DID have self-serving (economic, convenience, etc.) benefits. Warping had expanded at rad-onc-residency-expansion levels. But finally, everyone agreed: we have to tone down all the warping, especially above warp 7. Hard to believe that one's good acts, or benign acts, are wrong, even when proof right under nose. I think there's a lot of that now going on in the leaders' psyches (of course I tend to give benefit of doubt). Mental switches are the hardest to flip.
 
scarbrtj said:
Remember in that one Start Trek:TNG episode when someone discovered that warping was polluting the universe (destroying the fabric of spacetime or some such). And the Federation was like warping, warping, warping, we love warping. The more warping the better! It was almost inconceivable that they were doing wrong, "warping CAN'T be bad can it?" And wow, warping DID have self-serving (economic, convenience, etc.) benefits. Warping had expanded at rad-onc-residency-expansion levels. But finally, everyone agreed: we have to tone down all the warping, especially above warp 7. Hard to believe that one's good acts, or benign acts, are wrong, even when proof right under nose. I think there's a lot of that now going on in the leaders' psyches (of course I tend to give benefit of doubt). Mental switches are the hardest to flip.
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What changed in 2010-2020 vs 1990-1996?
 
My goodness. It's well played by the URM female MD/PhD who is acting on social media as I'm sure she will have her pick of academic jobs as all these departments are falling over themselves to hire more URM.

But have no doubts, a similar tactic is not going to work for her non female URM co residents or others who don't check the appropriate diversity box.

We're now in the era where social media presence will be used as a tool to separate applicants for attending jobs from one another. What a sad, sad day we've reached.
 
medgator said:
What changed in 2010-2020 vs 1990-1996?
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IMRT juiced the first decade of the 21st century and the money came rolling in. That gravy train slowly decreased and massive consolidation of health systems/taking over community hospitals occurred the second decade. The ACA spurred on this consolidation as the efforts to "bend(not flatten) the curve" failed as large providers could negotiate monopolistic prices. Some of those hospital had rad onc departments and these MDs either left or demanded residents that they could train. The academic chairs knew how the game was played.
 
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