Rad Onc Twitter

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elementaryschooleconomics said:
*sigh*

One more time, for the folks in the back: the actual job of Radiation Oncology is incredible. It's the getting of the job that's the problem.

Might has well have Bezos get on Twitter being like "tell me what you love about being the CEO of a multi-billion dollar company" or Jay-Z Tweeting "tell me what you love about being a multi-platinum world-renowned artist".

I wish #RaRaRadOnc would stop trying to spin this like the "angst" is about the actual work.
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I think you’re projecting. I don’t believe the poster was saying otherwise. It was simple - what do you like about rad onc?

one could argue you’re the one who seems strange comparing being an employed rad onc to being a billionaire.

this ain’t it, chief
 
jondunn said:
I think you’re projecting. I don’t believe the poster was saying otherwise. It was simple - what do you like about rad onc?

one could argue you’re the one who seems strange comparing being an employed rad onc to being a billionaire.

this ain’t it, chief
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Don't be dense, bud.

The intent of the Tweet is clear. My analogy is hyperbole to hang a lantern on what the resident is trying to do.
 
jondunn said:
I think you’re projecting. I don’t believe the poster was saying otherwise. It was simple - what do you like about rad onc?

one could argue you’re the one who seems strange comparing being an employed rad onc to being a billionaire.

this ain’t it, chief
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did you read the tweet?

if clearly says to motivate applicants and students

wonder what for……
 
jondunn said:
I think you’re projecting. I don’t believe the poster was saying otherwise. It was simple - what do you like about rad onc?

one could argue you’re the one who seems strange comparing being an employed rad onc to being a billionaire.

this ain’t it, chief
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Poster is ignoring a major issue in rad Onc.... Kinda like you are
 
medgator said:
Poster is ignoring a major issue in rad Onc.... Kinda like you are
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this is the problem with you and some others here. You always think people are ignoring an issue. Lmao. Dude. I’m not. I just have a bit of sense. Literally everyone of us knows the problems.
 
ROforbetterorworse said:
you can apply to more than 1 specialty at once…

Also it’s suggestive for students who have yet to apply
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okay fair point, though I remain doubtful that smart med students are going to be convinced by one tweet thread in a sea of overall negativity.

to me it was in line with what I have done with a few medical students I have talked to (I am in PP so interactions are limited but I’ve talked to some and also friends of family):

- for medical students considering it, I tell them I love my job but that my job may not exist for them or it may be hard to find, and they that should look at other fields and only do rad onc if they still really really can’t do anything else

- for people who ARE still applying (I have talked to one) - I told her similar but at this point there is mo point in making them feel ****ty about their experience. I don’t want to be that dingus like
I knew in med school who would be like LOL WHY when someone wanted to genuinely do neurology, psych, peds, path, psych or other ‘lower tier at the time’ fields. Who the **** am I to put people down??

sue me.
 
jondunn said:
okay fair point, though I remain doubtful that smart med students are going to be convinced by one tweet thread in a sea of overall negativity.

to me it was in line with what I have done with a few medical students I have talked to (I am in PP so interactions are limited but I’ve talked to some and also friends of family):

- for medical students considering it, I tell them I love my job but that my job may not exist for them or it may be hard to find, and they that should look at other fields and only do rad onc if they still really really can’t do anything else

- for people who ARE still applying (I have talked to one) - I told her similar but at this point there is mo point in making them feel ****ty about their experience. I don’t want to be that dingus like
I knew in med school who would be like LOL WHY when someone wanted to genuinely do neurology, psych, peds, path, psych or other ‘lower tier at the time’ fields. Who the **** am I to put people down??

sue me.
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I completely agree with you. If someone comes to me and says "look, I know about the issues with the field on an economic/market level, but I literally can't see myself doing anything else, I need to do Radiation Oncology", then I'm totally on board with that person joining the field, and will welcome them with open arms.

While there's a "sea of overall negativity" online, this is offset (at least until recently) by real-life faculty and residents telling students that everything they read online is a myth and lies perpetuated by disgruntled internet trolls.

There is, of course, a middle ground. Radiation for cancer isn't going anywhere any time soon. People will retire or leave the field for other reasons, and there will always be some level of jobs available. However, the level of jobs available does not create a need for the production of 200 new RadOncs a year, and this imbalance is suffered mostly by new grads. Entrenched docs 20 years into their careers will be fine.

If there were more Emma Fields and Brian Kavanaghs around in leadership positions, saying "hey we know there's issues let's work on it but the job is still great", I think a lot of us would feel a lot better.

However, the people holding leadership positions right now with an iron grip are still most denying issues. Again...fields, like science, progress one funeral at a time.
 
When I push back on certain troll like behavior (IMO) it is really because I don’t think we should look upon it favorably. When we say ridiculous or exaggerated things, it takes away from the reality and facts of the case, which are clear.
 
elementaryschooleconomics said:
I completely agree with you. If someone comes to me and says "look, I know about the issues with the field on an economic/market level, but I literally can't see myself doing anything else, I need to do Radiation Oncology", then I'm totally on board with that person joining the field, and will welcome them with open arms.

While there's a "sea of overall negativity" online, this is offset (at least until recently) by real-life faculty and residents telling students that everything they read online is a myth and lies perpetuated by disgruntled internet trolls.

There is, of course, a middle ground. Radiation for cancer isn't going anywhere any time soon. People will retire or leave the field for other reasons, and there will always be some level of jobs available. However, the level of jobs available does not create a need for the production of 200 new RadOncs a year, and this imbalance is suffered mostly by new grads. Entrenched docs 20 years into their careers will be fine.

If there were more Emma Fields and Brian Kavanaghs around in leadership positions, saying "hey we know there's issues let's work on it but the job is still great", I think a lot of us would feel a lot better.

However, the people holding leadership positions right now with an iron grip are still most denying issues. Again...fields, like science, progress one funeral at a time.
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this notion that we can’t be happy doing something eles is a totally false conception that we tell ourselves once we get excited about the field. Almost none of us knew about radonc before we went to medschool. Medicine has so many diverse options and I am sure that on another branch of the wave function, I am just as happy in gi or medical oncology.

If a psych or neuro doc pushes back on a medstudents because the attending thinks the field has gone to the dogs vs us pushing back on a med student determined to pursue radonc: big difference here is that medstudents applying to radonc probably wont end up with a job so it is irrelevant how much they love the field or how optimistic and confident they are.
 
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RickyScott said:
this notion that we can’t be happy doing something eles is a totally false conception that we tell ourselves once we get excited about the field. Almost none of us knew about radonc before we went to medschool. Medicine has so many diverse options and I am sure that on another branch of the wave function, I am just as happy in gi or medical oncology.

If a psych or neuro doc pushes back on a medstudents because the attending thinks the field has gone to the dogs vs us pushing back on a med student determined to pursue radonc: big difference here is that medstudents applying to radonc probably wont end up with a job so it is irrelevant how much they love the field or how optimistic and confident they are.
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I am not happy doing Optune at all. Also never really got into acupuncture. I wish I had known about acupuncture and Optune before I became a radiation oncologist. I might've been happier as a botoxologist or doing electroconvulsive therapy. I mean if med students love Optune and acupuncture though, by all means: get into rad onc.
 
TheWallnerus said:
I am not happy doing Optune at all. Also never really got into acupuncture. I wish I had known about acupuncture and Optune before I became a radiation oncologist. I might've been happier as a botoxologist or doing electroconvulsive therapy. I mean if med students love Optune and acupuncture though, by all means: get into rad onc.
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Guessing you probably operate optune hardware as much as you do linac hardware?
 


I have seen this guy post a lot recently on rad onc twitter. Anyone know if he’s legit or is he a scam artist?
 
ROforbetterorworse said:
Hes hustlin

Looks like doing legit work, but clearly overmarketing

No different than most academic radonc scam
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He's legit in that he's running a business. I generally like him and his work. In real life (not SDN or Twitter), my department admins find him very helpful as we try to navigate APM and reimbursement cuts.
 
jondunn said:


I have seen this guy post a lot recently on rad onc twitter. Anyone know if he’s legit or is he a scam artist?
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He is as real as it gets. Previous clinician in academia and Rural RO. Also a previous administrator. Created numerous tools and content for the RO profession. Disruptive to hold vendor accountable in the risk share model. Published lots of content related to supervision. Works DIRECTLY with payers, MACs and CMMI to influence models.
 
jondunn said:


I have seen this guy post a lot recently on rad onc twitter. Anyone know if he’s legit or is he a scam artist?
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Here is some of the original work. The goal has been to perform audits and reviews unify data and create relational RO pathways to go back to payers and vendors with
 

Attachments

Cool. If we can get a database of them, I can add them to what we have created for the RO and MO Prior auth platform.
AuthParency
 
johnsojo said:
Cool. If we can get a database of them, I can add them to what we have created for the RO and MO Prior auth platform.
AuthParency
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Prior to this year, the extent of hospital price gouging was not widely known and jj has helped bring awareness in radonc . Academics at the likes of mdacc etc could hide behind plausible deniability while they fraction shamed and greedily expanded residencies. Awareness of price transparency helps delegitimize this thieving cadre that has (and continues) to damage this specialty.
Thank you for your advocacy.
 
Ray D. Ayshun said:
I don't really understand this imrt vs 3d nonsense. Our job is to deliver a cloud of energy to cancer. Imrt is just a more conformal version of 3d, not a prohibitively expensive particle.
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Exactly! It's an easy strawman for these guys though.

Photon-based radiation is like driving a car with four-wheel drive. Still the same car, but you can switch between 2WD and 4WD depending on the situation.

Protons/carbon is like buying a completely different car. It's like buying a Maybach claiming that you need it because it's better, even though you mostly just drive to and from the office and get groceries sometimes.

But yeah...let's justify carbon ions by saying "if you accept IMRT you should accept this, checkmate!"
 
Soapcat said:
I dont have twitter. can someone point out that he is NOT a radiation oncologist?

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medgator said:
Guessing RD is happy to see more CPT codes and radiation revenue for revenue cycle to generate business off of, healthcare economics and Medicare spending be damned
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RD thinks he knows more than every other radiation oncologist in America. Except the radiation oncologists who give him fat stacks. Those rad oncs are brilliant and only have the patient's best interests in mind. There's a word for this kind of mindset, but I just can't think of it. Let's call it a self-serving logic of financial convenience.

Picture CMS as God. ASTRO's Choosing Wisely on IMRT and Revenue Cycle's "there's a correct utilization rate of IMRT" piousness were meant to honor God... show God the inherent goodness of ASTRO, RD, whoever. They could use this piousness to shame others in the public square. But, lo, God is not impressed. He is sending the APM flood as judgment on the writhing masses, judging even those who tried to stamp out all of the IMRT sinning. Woopsies. Now the ASTROs and the DiGiaimos are getting cognitive dissonance and it shows badly. "God, we are still good people, but sex before marriage and protons are actually wonderful."

SXIntNP.png
 
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jondunn said:
Johnson and this RON D fellow are NOT your friends.

they will bleed you dry if you let them stick.
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In general my heuristic is to be very very cautious of people making money off of rad onc (or in the rad onc industry) who do not actually treat patients/practice in the trenches radiation oncology.

Not to say they’re all bad actors, but be wary.
 
BobbyHeenan said:
In general my heuristic is to be very very cautious of people making money off of rad onc (or in the rad onc industry) who do not actually treat patients/practice in the trenches radiation oncology.

Not to say they’re all bad actors, but be wary.
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including referring med oncs!
 
BobbyHeenan said:
In general my heuristic is to be very very cautious of people making money off of rad onc (or in the rad onc industry) who do not actually treat patients/practice in the trenches radiation oncology.

Not to say they’re all bad actors, but be wary.
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Good rule of thumb
 

2 Corinthians 11:13-15 ESV​

For such men are false apostles, deceitful workmen, disguising themselves as apostles of Christ. And no wonder, for even Satan disguises himself as an angel of light. So it is no surprise if his servants, also, disguise themselves as servants of righteousness. Their end will correspond to their deeds.
 
Frankly, doctors hate it when anyone brings up costs. He looks at pricing data and pushes transparency. The numbers are the numbers. Can like him or not, no one else is doing this and “big Rad Onc” is incentivized to keep its eyes closed / head in the sand. He’s a false prophet? What is Astro doing about prices/transparency? What are commercial payors doing other than closing ranks and becoming more secretive?

Rather than looking at the body of work or what is being done, it’s fashionable to attack the person, their motives or that they are trying to earn money…
 
TheWallnerus said:
Ron's company got the exclusive contract for the Manhattan proton center. But he and many others want to make sure to continue telling the rest of rad onc what the proper level of IMRT utilization is. If you go above that level, you are unsafe... reckless... an onanist.
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RealSimulD said:
Frankly, doctors hate it when anyone brings up costs. He looks at pricing data and pushes transparency. The numbers are the numbers. Can like him or not, no one else is doing this and “big Rad Onc” is incentivized to keep its eyes closed / head in the sand. He’s a false prophet? What is Astro doing about prices/transparency? What are commercial payors doing other than closing ranks and becoming more secretive?

Rather than looking at the body of work or what is being done, it’s fashionable to attack the person, their motives or that they are trying to earn money…
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MDACC is breaking both state and federal law here. (And mskcc and others). LLaw breaking as an actual policy strategy by these kind of institutions is just inconceivable. Greed rules. Ask Ben smith.
 
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RealSimulD said:
Frankly, doctors hate it when anyone brings up costs. He looks at pricing data and pushes transparency. The numbers are the numbers. Can like him or not, no one else is doing this and “big Rad Onc” is incentivized to keep its eyes closed / head in the sand. He’s a false prophet? What is Astro doing about prices/transparency? What are commercial payors doing other than closing ranks and becoming more secretive?

Rather than looking at the body of work or what is being done, it’s fashionable to attack the person, their motives or that they are trying to earn money…
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IMRT and urorads shaming from ASTRO happened on a scale that proton shaming never will see (foreign concept to them, honestly)
 
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