Rad Onc Twitter

[Mandelin Rain]

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Doing a Couple minute video to promote/describe your publication/yourself would be by far the best part of being an author in any journal, including the ijrobp. Many of us have done it. It sucks. Being able to “buzz the tower” in spoken word would be great.

Chirag, of course, has a point. The process itself is ridiculous. But as Sue stated, we can walk and chew gum.

Finally, and most importantly, as Simul points out; this is deck chairs on the Titanic stuff.

 

[jondunn]

 

[jondunn]

 

[elementaryschooleconomics]

 

[medgator]

View attachment 353469

Was going to say... She probably just needs to get an APP like KO for all that extra bird time

 

[medgator]

 

[jondunn]

I disagree.

ASTRO represents large price gouging systems, period.

it's no surprise. like Congress - money talks.

 

[medgator]

I disagree.

ASTRO represents large price gouging systems, period.

it's no surprise. like Congress - money talks.

Hence the kid gloves for protons and going hardcore against breast IMRT over the years

 

[jondunn]

 

[Mandelin Rain]

There are some harsh truths being dropped by and then in return on these academic types.

Yes, our specialty is becoming a throughput technician specialty (gross). Yes, it’s all about market share. But it’s also about the size of the thumb that’s already on the scale in your favor.

If you have a PPS exemption, of course you’ll be fine. You’ll just charge more, wait out the centers that can’t, and take their patients. That model doesn’t work for the other 90% out there. It’s also not some morally superior approach that’s benefiting the patient-population-at-large. It’s reducing options, reducing access, raising costs, and saddling cancer patient with the other issues that come with centralization.

 

[jondunn]

 

[medgator]

Higher rates Makes sense in that context and are totally justified














/s

 

[Mandelin Rain]

Becoming “IR with XRays (or protons)” isn’t the way forward for this specialty. It’s the death of it.

Just fold it back into a fellowship of diagnostic rads already.

 

[jondunn]

If Anthony Paravatti thinks anything he’s doing now has anything with MSK being a “destination site”, his ego is out of control. The winners and losers were picked long ago. The suits at the winning places decided it was time to make it rain.


I can’t emphasize this enough. We draw circles. VERY similar circles for most of us. Patients shouldn’t have to travel across the country to find a circle drawer.

He’s not at MSK, he’s a private practice doc

 

[Mandelin Rain]

He’s not at MSK, he’s a private practice doc

Whoops. I retract my statement about that dude. Google told me Kettering and I failed to investigate further. 🙁

Give me that L.

I stand by my point about winners and losers being picked a long time ago, though. As you stated, large systems. Many of which started as small systems but had the will to start ruining medicine when it became clear hospital based price gouging were the path to profit.

 

[jondunn]

I stand by my point about winners and losers being picked a long time ago, though. As you stated, large systems. Many of which started as small systems but had the will to start ruining medicine when it became clear hospital based price gouging were the path to profit.

yes. 99 percent of what gets talked about here boils to this. salary, job market, autonomy, costs, etc.

 

[RadOncDoc21]

yes. 99 percent of what gets talked about here boils to this. salary, job market, autonomy, costs, etc.

1% biryani.

 

[RickyScott]

I

Becoming “IR with XRays (or protons)” isn’t the way forward for this specialty. It’s the death of it.

Just fold it back into a fellowship of diagnostic rads already.

couldnt have said it better; especially for those trained in era where we were told that we are the most knowledgeable oncologists.

 

[RickyScott]

Every year UPENN has a retreat for the 20 something medical directors of their various satellites. Although they call it a “retreat”, there are no meditation or team building exercsises. Directors are basically expected to list their competitors and threats. They then spend hours discussing strategies to counter the competition. Nonprofit.

 

[deleted1111261]

Every year UPENN has a retreat for the 20 something medical directors of their various satellites. Although they call it a “retreat”, there are no meditation or team building exercsises. Directors are basically expected to list their competitors and threats. They then spend hours discussing strategies to counter the competition. Nonprofit.

Lol. I think sounds better and more useful than mindfulness training!

 

[jondunn]

Every year UPENN has a retreat for the 20 something medical directors of their various satellites. Although they call it a “retreat”, there are no meditation or team building exercsises. Directors are basically expected to list their competitors and threats. They then spend hours discussing strategies to counter the competition. Nonprofit.

The Brian Lally Method

 

[RickyScott]

The Brian Lally Method

He is a good guy, but would love to hear what he has to say about the retreats. Degreee of Corporatization here is incredible.

 

[radoncftw]

The elephant in the room. Corporatization of the large academic center. It has literally metastasized everywhere. In my neck of the woods, the large academic center literally built satellites right next to the community practice sites in every direction.

On another note Mudit posted that harvard satellite near him still doing 9 weeks for prostate. I'll let jon dunn post that tweet. that is absurd though. maybe harvard satellite should be choosing wisely.

 

[RadOncDoc21]

I am starting to think that maybe we should do away with ABR board certification if we truly believe rad oncs are not taught the same way or somehow either improve by being affiliated with a large system or lose their skills once they start in private practice but somehow gain all competence again if they start working at a University.

 

[TheWallnerus]

I am starting to think that maybe we should do away with ABR board certification if we truly believe rad oncs are not taught the same way or somehow either improve by being affiliated with a large system or lose their skills once they start in private practice but somehow gain all competence again if they start working at a University.

Between working for the university and having Evicore choosing the style and amount of radiation...

Rad onc residencies, who needs 'em?

 

[jondunn]

back in my day, the famous saying was 'There's the right way, the wrong way, and the MDACC way'

now there are so many more ways - The ABR way, The Evicore way, The NCCN way, The Econtour way.....

 

[radoncftw]

back in my day, the famous saying was 'There's the right way, the wrong way, and the MDACC way'

now there are so many more ways - The ABR way, The Evicore way, The NCCN way, The Econtour way.....

take all disease site attendings at MDACC. Have them each contour a case. Compare contours. publish in red j.

 

[Ray D. Ayshun]

take all disease site attendings at MDACC. Have them each contour a case. Compare contours. publish in red j.

Tbh, id enjoy that paper if it included the thoughts that went into their contours etc. That's actually a paper I could use. Some underpowered trial designed to get the desired outcome on a secondary endpoint? No, thanks.

 

[RickyScott]

Tbh, id enjoy that paper if it included the thoughts that went into their contours etc. That's actually a paper I could use. Some underpowered trial designed to get the desired outcome on a secondary endpoint? No, thanks.

The problem with this kind of literature is that while contours can vary in the axial plane, the plans come out quite similar. Plan is dictated more by avoidance structures than by what is contoured.

 

[radoncftw]

The problem with this kind of literature is that while contours can vary in the axial plane, the plans come out quite similar. Plan is dictated more by avoidance structures than by what is contoured.

this is true. in the end it is a wash.
makes me feel more comfortable as a PGY-5 when attending changes a few a ditzels on my contours.

 

[seper]

RadOnc attendings are essentially techs? Well, there are no news here

 

[jondunn]

If there ever was a nonsensical tweet -

 

[TheWallnerus]

If there ever was a nonsensical tweet -

Ron D and sense go together like tuna fish and cigarettes

 

[jondunn]

if I was Andrew chang I would be mortified my name was associated with this in public

I’m sure he did it for a nice payday and felt he was just hurting a corporation (lol who cares right?!) but this is some terrible terrible **** that sets a bad precedent

 

[grenz]

if I was Andrew chang I would be mortified my name was associated with this in public

I’m sure he did it for a nice payday and felt he was just hurting a corporation (lol who cares right?!) but this is some terrible terrible **** that sets a bad precedent

These massive punitive damages often get reversed on appeal right?

WCB's FTS case is singled out by Law 360 as among "The Biggest Injury Verdict Reductions Of 2020" | Wright Close & Barger, LLP

www.wrightclosebarger.com

 

[grenz]

if I was Andrew chang I would be mortified my name was associated with this in public

I’m sure he did it for a nice payday and felt he was just hurting a corporation (lol who cares right?!) but this is some terrible terrible **** that sets a bad precedent

Gross. There are now lawyers specializing in proton therapy lawsuits

Proton Therapy Insurance Denial

Attorneys for proton therapy insurance denial. Call us if your doctors have prescribed proton therapy, but Insurance company denied the claim

www.debofsky.com

 

[jondunn]

effing disgusting

also - they may have more clients if they expand their client base to IMRT denials, but the whole thing is gross.

 

[grenz]

effing disgusting

also - they may have more clients if they expand their client base to IMRT denials, but the whole thing is gross.

We really need partiqol to report out soon. Radcomp will take much longer.

Some private insurers are changing their policies to cover protons if patient is on a cooperative group RCT. Hopefully that will accelerate accrual on to other trials

 

[SubserviantToABR]

If there ever was a nonsensical tweet -

Ron DiGiaimo is another grifter in our field. I've met him a few times over the years, and he preys on young residents to try to get them to use his companies when they're out in practice. It's shameful.

 

[thecarbonionangle]

Ron DiGiaimo is another grifter in our field. I've met him a few times over the years, and he preys on young residents to try to get them to use his companies when they're out in practice. It's shameful.

If our field is full of grifters and conmen, doesn’t this mean he is just an average guy in our field?

 

[radiaterMike]

I wouldn’t say he’s in our field. Nor that clown Jordan Johnson. They are just acting to extract money from our field.

 

[deleted1111261]

In private practice, we used a billing company called United. They were pretty good, limited grift, as far as I knew.

 

[RickyScott]

I wouldn’t say he’s in our field. Nor that clown Jordan Johnson. They are just acting to extract money from our field.

Jordan was and continues to be very helpful in exposing prices/gouging.

 

[jondunn]

If our field is full of grifters and conmen, doesn’t this mean he is just an average guy in our field?

@thecarbonionangle - what's your favorite rad onc grift?

 

[jondunn]

 

[deleted1111261]

And soon after, Brian Kavanaugh calls Chirag sexist. This field is absolute bull****. Editor of red journal needs former Astro president to call him names rather than engage with the conversation.

 

[thecarbonionangle]

People like BK were always going to dissapoint. “Leaders” will “lead”. BK calls CS a sexist and if this is true (which is so not) why shouldn't BK be cancelled as racist? You see it goes both ways. You want a brown guy to stay in his lane. Times have changed BK!!! Plantation and sweet tea ain’t it now buddy!

 

[jondunn]

BK must be getting some of that sweet sweet red journal cash

He reminds me of one of the VIPs from Squid Game

 

[Neuronix]

And soon after, Brian Kavanaugh calls Chirag sexist. This field is absolute bull****. Editor of red journal needs former Astro president to call him names rather than engage with the conversation.

Please share tweet. I can't find it. I'm bad at twitter.

 

[thecarbonionangle]

BK must be getting some of that sweet sweet red journal cash

He reminds me of one of the VIPs from Squid Game

When the bottomline and profiteering is threatened, anything goes