Rad Onc Twitter

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Let’s get one thing straight OTN - you didn’t take any great financial risk lol.

Something tells me you’re big into ‘pull yourself up by the bootstraps’ mentality
 
jondunn said:
Let’s get one thing straight OTN - you didn’t take any great financial risk lol.

Something tells me you’re big into ‘pull yourself up by the bootstraps’ mentality
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Never said I did take great financial risk. Would have been tremendously stupid in the environment into which I graduated after residency. Certainly did have to buy into the practice however, which does entail risk and an investment for which one would expect a ROI.

Also never said I was into "pull yourself up by the bootstraps" and I certainly realize the benefits I received from my family, for which I am very thankful.

0/2. Want to keep playing?
 
jondunn said:
Let’s get one thing straight OTN - you didn’t take any great financial risk lol.

Something tells me you’re big into ‘pull yourself up by the bootstraps’ mentality
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You think people that are partnered into technical practices now got in for free? You seem like a big Bernie bro, bro
 
Everyone is not employed until they are. They’ll come for me and they’ll come for you. I’m certain there are multiple large hospital systems that have you circled out for the picking, as they do me.


This discussion becomes less and less relevant every day
 
The reality is the doctor is the most important part of the rad onc practice. If you fill your pratice with crappy doctors, patient end up going other place.

Administration really think we are easily replaced. It takes years to make a successful practice and only weeks to months to completely decimate it.
 
udrag14 said:
The reality is the doctor is the most important part of the rad onc practice. If you fill your pratice with crappy doctors, patient end up going other place.

Administration really think we are easily replaced. It takes years to make a successful practice and only weeks to months to completely decimate it.
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Agree. That said, I’ve found it’s way easier for an admin to replace you than it is for an admin to decimate (using strict definition of the word) a practice.
 
udrag14 said:
The reality is the doctor is the most important part of the rad onc practice. If you fill your pratice with crappy doctors, patient end up going other place.
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crappy how?

if they are friendly/nice/approachable but terrible at what they are doing radiation wise, the patients will still like the doc
 
udrag14 said:
The reality is the doctor is the most important part of the rad onc practice. If you fill your pratice with crappy doctors, patient end up going other place.

Administration really think we are easily replaced. It takes years to make a successful practice and only weeks to months to completely decimate it.
Click to expand...
Makes me sad that you're wrong. Neither admin nor patients know the difference between a great rad onc vs a crappy rad onc. Neither do probably 90% of our colleagues in other specialties. And that's being generous.
 
jondunn said:
crappy how?

if they are friendly/nice/approachable but terrible at what they are doing radiation wise, the patients will still like the doc
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It is INCREDIBLY hard for non-RadOncs to know who is "crappy" and who is not.

Sure, if you've got a doc burning a hole in the chest with 125 Gy, or melting pelvises routinely, that's one thing.

But if you've got someone who can get the radiation in the ballpark of the correct anatomy, and give a dose of radiation that's within a realm of reasonable, and at least talk the talk in a halfway coherent manner - I can 100% guarantee you that doc will have a 30+ year career.

The fact that I can 100% guarantee that brings me more sadness than I can possibly express.
 
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temujim said:
Makes me sad that you're wrong. Neither admin nor patients know the difference between a great rad onc vs a crappy rad onc. Neither do probably 90% of our colleagues in other specialties. And that's being generous.
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I don't even know if I'M crappy.
 
elementaryschooleconomics said:
Heck, you could literally be the best doc on the planet - but if your Dosimetrist is meh, and your therapists are phoning it in, it doesn't matter at all.
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And because most rad oncs work for someone else, good luck getting rid of them. But then even my buddies in the business world say it takes them 1-2 years to get rid of non-performing employees.
 
temujim said:
And because most rad oncs work for someone else, good luck getting rid of them. But then even my buddies in the business world say it takes them 1-2 years to get rid of non-performing employees.
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The Mendoza line of every rad onc in a group should be recorded and assiduously followed
 
elementaryschooleconomics said:
It is INCREDIBLY hard for non-RadOncs to know who is "crappy" and who is not.

Sure, if you've got a doc burning a hole in the chest with 125 Gy, or melting pelvises routinely, that's one thing.

But if you've got someone who can get the radiation in the ballpark of the correct anatomy, and give a dose of radiation that's within a realm of reasonable, and at least talk the talk in a halfway coherent manner - I can 100% guarantee you that doc will have a 30+ year career.

The fact that I can 100% guarantee that brings me more sadness than I can possibly express.
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fully agree. and many rad oncs know this as well and capitalize on it. move the meat, get them through and billed as fast as possible, don't even bother trying. draw huge, don't miss, toxicity is someone else's problem......
 
jondunn said:
fully agree. and many rad oncs know this as well and capitalize on it. move the meat, get them through and billed as fast as possible, don't even bother trying. draw huge, don't miss, toxicity is someone else's problem......
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Works great until word gets out unless you're in a captive market... Eventually people figure out who not to send to
 
jondunn said:
crappy how?

if they are friendly/nice/approachable but terrible at what they are doing radiation wise, the patients will still like the doc
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Friendly doctos usually do well. However, we have very interesting personalities in rad onc. The rad onc coming to non desirable locations aren't always top tier.
 
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udrag14 said:
Friendly doctos usually do well. However, we have very interesting personalities in rad onc. The rad onc coming to non desirable locations aren't top tier.
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That’s true
 
medgator said:
Works great until word gets out unless you're in a captive market... Eventually people figure out who not to send to
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Recently asked an admin about how to measure quality of a rad onc in the context of metrics/incentives. Was taken on a roundabout of the first two "A"s of private practice.

Honestly I think most colleagues outside rad onc shrug and say that's radiation. Melt a few mandibles or something outrageous as ESE mentioned will shift referral patterns but otherwise... nah.
 
temujim said:
Definitely batting above that line in trivia not previously known to me. Kudos.
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Had to always stay above our group's Mendoza line in one practice I was in; which essentially was if you were the lowest producer you couldn't go less than 20% lower than the person above you in terms of collections or your time was numbered. Mendoza lines can be arbitrarily decided.
 
Not a tweet but this has become de facto news thread. This one is….weird.

www.medscape.com

Wake Forest Cancer Center Director Fired, Advisory Board Resigns

The director, Boris Pasche, MD, was fired one day after the National Cancer Institute renewed its funding for the center; the entire external advisory board has resigned.
www.medscape.com www.medscape.com

You can pretty much guess at what happened, but it won’t make you love modern day medicine anymore.
 
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Mandelin Rain said:
Not a tweet but this has become de facto news thread. This one is….weird.

www.medscape.com

Wake Forest Cancer Center Director Fired, Advisory Board Resigns

The director, Boris Pasche, MD, was fired one day after the National Cancer Institute renewed its funding for the center; the entire external advisory board has resigned.
www.medscape.com www.medscape.com

You can pretty much guess at what happened, but it won’t make you love modern day medicine anymore.
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I can’t guess.. what happened ?
 
Yeah I’m curious as well
 
Charlotte-based Atrium Health acquired Wake Forest University Health Sciences and Wake Forest Baptist Medical Center on 10/9/2020. (Didn't realize a university system could be bought out like that). The two cancer centers are currently in the process of merging into one mega system.

The Wake Forest cancer director, Boris Pasche, obtained a NCI renewal notice, dated 2/9/2022 and he was then let go or fired on 2/10/2022. The 15 members of Wake Forest Baptist Comprehensive Cancer Center's external advisory board (EAB) then resigned on 2/18/2022. EABs serve at the pleasure of the center director so they basically resigned in protest. A. William Blackstock, Jr., was named interim director. He is the chair of Radiation Oncology at Wake Forest.

Most importantly, on 2/25/2022 it was reported that Wake Forest Baptist Medical Center reported a 93.1% increase in excess revenue to $362.5 million for the quarter that ended Dec. 31.

Nowhere can I find any explanation as to why Boris Pasche was fired. So it is hard to guess what exactly happened and why.
 
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fiji128 said:
Charlotte-based Atrium Health acquired Wake Forest University Health Sciences and Wake Forest Baptist Medical Center on 10/9/2020. (Didn't realize a university system could be bought out like that). The two cancer centers are currently in the process of merging into one mega system.

The Wake Forest cancer director, Boris Pasche, obtained a NCI renewal notice, dated 2/9/2022 and he was then let go or fired on 2/10/2022. The 15 members of Wake Forest Baptist Comprehensive Cancer Center's external advisory board (EAB) then resigned on 2/18/2022. EABs serve at the pleasure of the center director so they basically resigned in protest. A. William Blackstock, Jr., was named interim director. He is the chair of Radiation Oncology at Wake Forest.

Most importantly, on 2/25/2022 it was reported that Wake Forest Baptist Medical Center reported a 93.1% increase in excess revenue to $362.5 million for the quarter that ended Dec. 31.

Nowhere can I find any explanation as to why Boris Pasche was fired. So it is hard to guess what exactly happened and why.
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Atrium buys Wake for the name. I'd guess that Pasche's academic vision was not compatible with Atrium Health's corporate goals. The fact they fired him 1 day after securing NCI designation and grants, indicates he was used exclusively for that purpose.

I'm not implying anything more sinister than that.
 
jondunn said:
Wow. Don’t mess with SERO I guess

That’s some shady shady ****.
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Everything is now under an Atrium Health Wake Forest Baptist umbrella with the Dr. Blackstock (chair of Wake Rad Onc) as the combined entity cancer center director. That can't be a positive development for SERO (who mainly cover Atrium Health sites). Will there be pressure for replacing SERO coverage with cheaper employed Wake Forest "academics"?
 
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fiji128 said:
Everything is now under an Atrium Health Wake Forest Baptist umbrella with the Dr. Blackstock (chair of Wake Rad Onc) as the combined entity cancer center director. That can't be a positive development for SERO (who mainly cover Atrium Health sites). Will there be pressure for replacing SERO coverage with cheaper employed Wake Forest "academics" coverage?
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SERO is HUGE. Have to be at least twice as big as Wake in terms of clinical (money making) docs. Additionally, "their" system just bought Wake and fired the director. Not the other way around. They're in the driver's seat.

They now get the name and more favorable insurance contracting. I'm sure they'll keep whoever they want at Wake, and the rest will be let go. Lot's of PhDs at Wake. I'd quietly start looking.

No doubt though, new hires will be brought on as academic junior faculty.
 
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Looks like SERO is living their best life, flush with cash right now!

 
SERO maybe huge but they are not Atrium Health. My guess is cooperate will go with whatever arrangements generates the most profits.
 
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fiji128 said:
SERO maybe huge but they are not Atrium Health. My guess is cooperate will go with whatever arrangements generates the most profits.
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If they are doing a joint venture proton center with the system, I'm guessing they are pretty secure.
 
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SERO truly does have a monopoly in Charlotte and surrounding areas… too bad they only start you off at 250k/yr.
 
RadOncDoc21 said:
SERO truly does have a monopoly in Charlotte and surrounding areas… too bad they only start you off at 250k/yr.
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youll make plenty, plenty more once partner. they're not worried about those associate years.
 
Mandelin Rain said:
Look for rapid expansion of Wake's residency program.
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Yup almost guaranteed. Private groups starting fellowships, some private groups truing to start “residencies”, and private groups expanding residencies for cheap labour is the present and future folks!
 
fiji128 said:
Everything is now under an Atrium Health Wake Forest Baptist umbrella with the Dr. Blackstock (chair of Wake Rad Onc) as the combined entity cancer center director. That can't be a positive development for SERO (who mainly cover Atrium Health sites). Will there be pressure for replacing SERO coverage with cheaper employed Wake Forest "academics"?
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Would love to see it!
 
thecarbonionangle said:
Honestly any of these so called “elite” practices, i could care less for. Reeks of douchebaggery to me. Not surprising they love cheap labour like INOVA.
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Sero has reputation as being very fair and transparent with their new docs (unless things have changed recently). It is a relative king path to full technical partnership but they are upfront about that. The workload used to be balanced by a fairly strict formula. If your site became low on patients you might have to rotate to a different site one day a week to keep workload balanced between docs.
 
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