Rad Onc Twitter

[communitydoc13]

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It would be really awesome for medicine if people agreed it was advocacy not research, and then medical schools valued advocacy like they value bench or clinical research. We might have more action and less papers. I think that would be great for all.

Love this.

I value DEI in that I believe these things are intrinsically valuable to institutions and society. No study will convince me that I should not value DEI. Just as no study is going to convince many self described "classical liberals" that they should be concerned about social justice.

As physicians we should be concerned about disparities in outcomes, but there are many initiatives, without any need for study, that would likely immediately improve disparities, such as providing affordable health care for all. Of course, once these initiatives are taken, we can make them subject to meaningful study and we should.

Retrospective DEI research is just as bad as retrospective clinical research. The results are always of uncertain significance and are preferentially published when they fit a certain narrative.

But check this out. A prospective study of a DEI intervention.

https://www.pnas.org/doi/10.1073/pnas.1816076116

Is there a perception that DEI researchers are preferentially promoted/valued in academia? If so, this itself could be studied. Not sure if it's worth the time. Maybe this is some of what people are complaining about.

 

[OTN]

Love this.

I value DEI in that I believe these things are intrinsically valuable to institutions and society. No study will convince me that I should not value DEI. Just as no study is going to convince many self described "classical liberals" that they should be concerned about social justice.

As physicians we should be concerned about disparities in outcomes, but there are many initiatives, without any need for study, that would likely immediately improve disparities, such as providing affordable health care for all. Of course, once these initiatives are taken, we can make them subject to meaningful study and we should.

Retrospective DEI research is just as bad as retrospective clinical research. The results are always of uncertain significance and are preferentially published when they fit a certain narrative.

But check this out. A prospective study of a DEI intervention.

https://www.pnas.org/doi/10.1073/pnas.1816076116

Is there a perception that DEI researchers are preferentially promoted/valued in academia? If so, this itself could be studied. Not sure if it's worth the time. Maybe this is some of what people are complaining about.

I'm complaining that a disproportionate (in my opinion, I know) amount of time, effort, and energy is being spent by radonc academicians on DEI initiatives rather than asking important clinical questions for our field.

 

[Fpg1245]

I am so glad I got into pissing matches with universities and large hospital systems during review over take-it-or-leave-it contracts and didn't end up working there. My lawyer basically said this is the most ridiculous nonsense I have ever seen, why would you sign this. Oh well, ma'am, let me tell you about all the perks of working for these mega institutions...

The only advantage being you get to work. Other than that not seeing much

 

[Fpg1245]

Was going to write the same thing but you put it much more eleoquently. Propents of dei would contest even the notion of falsification as racism.

I mean Kant was white…so clearly it’s a racist concept

 

[communitydoc13]

I'm complaining that a disproportionate (in my opinion, I know) amount of time, effort, and energy is being spent by radonc academicians on DEI initiatives rather than asking important clinical questions for our field.

Maybe radonc is particularly susceptible to this? I mean, in a field where there is not a tie in to the synthesis of new therapeutics, important clinical questions tend to focus on how do we do less of what we do.

Is there too much DEI research by medonc academicians or are they busy trying out new therapeutics?

 

[RadOncMegatron]

I mean Kant was white…so clearly it’s a racist concept

Popper? Both white males so doesnt make a difference

Also, I believe two other white males (*need fact check) Irwin PRESS and Rod GANEY out of their white privilege and unconscious bias are forcing their Press-Ganey scores upon the URMs of healthcare. I bet white males score higher thus their systemically racist and oppressive scoring system must be stopped! 😆

 

[deleted1116990]

The only advantage being you get to work. Other than that not seeing much

Until you become slightly disagreeable about anything then they force you out by cutting your pay and making you miserable.

After having this happen multiple times I have learned the recruiting process is basically screening to select sheepish applicants who will allow themselves to pushed around by admin. They might negotiate with you a little on salary as that is still somewhat expected (for now), but as soon as you start trying to modify the contract terms to specify having control over things like clinic schedule and coverage and remove things that punish the physician (or "provider" as they will forcefully correct you when you use that word) for leaving or limiting the hospital's ability to change terms in the future, they will rescind the offer. Often with an explanation of how shocked they were that you went from a friendly person everyone loved on the interview to a disagreeable a-hole who didn't trust them enough to blindly sign a 20 page contract without asking questions. The employer recognizes that if you do anything but smile and shower them with praise for the opportunity, you will be someone who won't just lay down and allow themselves to be walked all over later on.

This game only works as long as there is a very heavy supply-demand imbalance and significant artificial barriers to practicing independently.

 

[Fpg1245]

Popper? Both white males so doesnt make a difference

Also, I believe two other white males (*need fact check) Irwin PRESS and Rod GANEY out of their white privilege and unconscious bias are forcing their Press-Ganey scores upon the URMs of healthcare. I bet white males score higher thus their systemically racist and oppressive scoring system must be stopped! 😆

Thank you. I was mistaken it is popper

 

[TheWallnerus]

It would be really awesome for medicine if people agreed it was advocacy not research, and then medical schools valued advocacy like they value bench or clinical research. We might have more action and less papers. I think that would be great for all.

exactly.

 

[TheWallnerus]

I mean Kant was white…so clearly it’s a racist concept

I Kant even

 

[NotMattSpraker]

exactly.

My favorite DEI study. We need more of this, and more featuring of this kind of work. This was an oral at ASTRO, but not on the big stage. If protons or a drug showed this kind of survival improvement...

DEFINE_ME

I worked on both "systems interventions" and more classic clinical trial type work at my old academic job and it was immediately clear what was supported and what was not. It's hard to do more than database studies without support from institutions, societies, and journals.

Anecdotal experience of course.

 

[Ubba]

My favorite DEI study. We need more of this, and more featuring of this kind of work. This was an oral at ASTRO, but not on the big stage. If protons or a drug showed this kind of survival improvement...

DEFINE_ME

I worked on both "systems interventions" and more classic clinical trial type work at my old academic job and it was immediately clear what was supported and what was not. It's hard to do more than database studies without support from institutions, societies, and journals.

Anecdotal experience of course.

These "disparity" studies (almost) never seem to stratify by income/wealth level. Which is almost certain to be the real discriminant in outcomes. But I don't think academics get the warm-and-fuzzies when it's just a matter of helping out the poor. There isn't a fashionable slogan or acronym for that.

 

[RickyScott]

These "disparity" studies (almost) never seem to stratify by income/wealth level. Which is almost certain to be the real discriminant in outcomes. But I don't think academics get the warm-and-fuzzies when it's just a matter of helping out the poor. There isn't a fashionable slogan or acronym for that.

Kind of an awkward issue to address, but can a wealthy south American ashkenazi Jew appropriate the “hispanic” label to champion DEI. Should Elon Musk be able to play up his background as an African American? When it comes to DEI advocates in radiation oncology, there are definitely some carpetbaggers jumping on this for careerist reasons.

 

[deleted1111261]

I’m also very skeptical about much of this, but it is almost always the case that Black patients have a lower SES when it comes to health care and this is still a real problem. Lower SES patients have many barriers.

Suneja’s work on this is pretty compelling- it takes on average 3 weeks later to start IMRT in black patients compared to non-Hispanics whites. There are many reasons for this, but it’s not simply racism. Structural barriers for the poor, difficulty with dealing with insurance companies, etc - come with poverty. And, in America, Black patients tend to be significantly poorer.

 

[RadRadRad]

Distract the masses with race, gender, etc while the main issue is economic

 

[medgator]

Distract the masses with race, gender, immigration, etc while the main issue is economic

Ftfy

 

[RickyScott]

I’m also very skeptical about much of this, but it is almost always the case that Black patients have a lower SES when it comes to health care and this is still a real problem. Lower SES patients have many barriers.

Suneja’s work on this is pretty compelling- it takes on average 3 weeks later to start IMRT in black patients compared to non-Hispanics whites. There are many reasons for this, but it’s not simply racism. Structural barriers for the poor, difficulty with dealing with insurance companies, etc - come with poverty. And, in America, Black patients tend to be significantly poorer.

I’m also very skeptical about much of this, but it is almost always the case that Black patients have a lower SES when it comes to health care and this is still a real problem. Lower SES patients have many barriers.

Suneja’s work on this is pretty compelling- it takes on average 3 weeks later to start IMRT in black patients compared to non-Hispanics whites. There are many reasons for this, but it’s not simply racism. Structural barriers for the poor, difficulty with dealing with insurance companies, etc - come with poverty. And, in America, Black patients tend to be significantly poorer.

having worked in a lower social economic setting, I can also add that patients often put off their simulation longer than I would like as well as require transportation services. I can’t tell you the amount of times, someone came in with a painful bone met, and I found out from the secretary that the pt scheduled their sim a week and a half later.

 

[Ubba]

I’m also very skeptical about much of this, but it is almost always the case that Black patients have a lower SES when it comes to health care and this is still a real problem. Lower SES patients have many barriers.

Suneja’s work on this is pretty compelling- it takes on average 3 weeks later to start IMRT in black patients compared to non-Hispanics whites. There are many reasons for this, but it’s not simply racism. Structural barriers for the poor, difficulty with dealing with insurance companies, etc - come with poverty. And, in America, Black patients tend to be significantly poorer.

Let's assume that this is the case. We should be highlighting outcome disparities for poor pts rather than pts of particular racial groups. If the subsequent rising tide of care happens to boost the boats of a particular group, fine, but at least the effort won't be alienating 50+% of the country in the process.

 

[RickyScott]

Let's assume that this is the case. We should be highlighting outcome disparities for poor pts rather than pts of particular racial groups. If the subsequent rising tide of care happens to boost the boats of a particular group, fine, but at least the effort won't be alienating 50+% of the country in the process.

We should also encourage centers like mskcc and mdacc to treat black pts. Cadillac insurance requirements are effectively recapitulating the grandfather laws of southern states.

 

[Ubba]

We should also encourage centers like mskcc and mdacc to treat black pts. Cadillac insurance requirements are effectively recapitulating the grandfather laws of southern states.

The implication of your post is that such requirements are placed deliberately by centers like Sloan and MDACC to avoid provision of care to black pts.

 

[RickyScott]

The implication of your post is that such requirements are placed deliberately by centers like Sloan and MDACC to avoid provision of care to black pts.

I just think they should treat black patients. Is that too much to ask for taxpayer supported institutions that recieve hundreds of milllions in gov handouts.

 

[medgator]

The implication of your post is that such requirements are placed deliberately by centers like Sloan and MDACC to avoid provision of care to black pts.

Would imagine many of the insurances/payors excluded from their collective networks cover many minority lives. Why screw around with Medicare HMOs and Medicaid when you have international VIPs flying in paying suitcases full cash for treatment?

 

[RadRadRad]

The implication of your post is that such requirements are placed deliberately by centers like Sloan and MDACC to avoid provision of care to black pts.

Appalling implication
Should have implied they don’t want to treat poor people even if they have insurance but not great insurance
However on the flip side the insurers with **** reimbursement need some pressure to pay a reasonable rate

 

[medgator]

Appalling implication
Should have implied they don’t want to treat poor people even if they have insurance but not great insurance
However on the flip side the insurers with **** reimbursement need some pressure to pay a reasonable rate

Close to Medicare isn't even enough for some of these places. If you only have the ability to treat X number of patients, financially, the best decision is treat the X patients which are paying you more than Medicare

Mayo Clinic says denying non-contract Medicare Advantage patients access is not about money

Feb. 15—ROCHESTER — Mayo Clinic explains its decision to not treat out-of network Medicare Advantage patients is solely about "capacity" versus lower reimbursement rates. "Mayo simply does not have enough capacity to serve an ever-increasing number of patients. Mayo needs to be good stewards...

finance.yahoo.com

 

[Palex80]

 

[PhineasGageRadOnc]

Long time lurker, first time poster. Saw this gem on a text thread with friends from residency -- looks like Lou Potters trying to take out Amar Kishan

 

[medgator]

Long time lurker, first time poster. Saw this gem on a text thread with friends from residency -- looks like Lou Potters trying to take out Amar Kishan



View attachment 360242

Keeping things in perspective. Potters response is the perfect example of being ratio'd on Twitter. Amar reportedly disclosed COIs so not sure what LP is trying to get at here?

Here's what being ratioed on Twitter actually means

What does ratioed mean on Twitter? Here's the meaning of the viral phrase.

www.popbuzz.com

 

[Fpg1245]

Keeping things in perspective. Potters response is the perfect example of being ratio'd on Twitter. Amar reportedly disclosed COIs so not sure what LP is trying to get at here?

Here's what being ratioed on Twitter actually means

What does ratioed mean on Twitter? Here's the meaning of the viral phrase.

www.popbuzz.com

Looks like non profit explorer strikes again. I don’t think he had to black out the other names. Could have just pointed to him.

 

[RickyScott]

Looks like non profit explorer strikes again. I don’t think he had to black out the other names. Could have just pointed to him.

Potters salary is not appropriate.

 

[Fpg1245]

Potters salary is not appropriate.

Totally irrelevant.

 

[medgator]

Potters salary is not appropriate.

Not appropriate to be discussed or not appropriate for his position and workload?

 

[RickyScott]

Totally irrelevant.

I disagree. Amars salary probably sucks - Mikey sucks up all the o2-and ucla pay is not enough to afford a house where he works.(even a shole like Culver City is 1 mill+ despite the nations worst taxes) Maybe he needs a side hustle to afford a roof over his head. incongruous criticism when you have an unjustified salary 5x that of amars. Maybe if guys like Lou hadn’t destroyed the field with overexpansion, junior attendings would have less conflicts

 

[deleted1111261]

It’s not relevant to the argument at hand, but it’s always fun to point out how insane the comp structure is at academic centers. Amar works twice as hard and produces twice as much and gets paid half.

 

[TheWallnerus]

It’s not relevant to the argument at hand, but it’s always fun to point out how insane the comp structure is at academic centers. Amar works twice as hard and produces twice as much and gets paid half.

If he makes half as much as Lou still pretty good!

 

[RickyScott]

If he makes half as much as Lou still pretty good!

I think that was lous 2018/19 salary. Probably has hit 2 mill+ by now. I bet amars salary is an order of magnitude less than the annual returns of mike Steinbergs Tens of millions he pocketed from selling all those centers.

 

[deleted1116990]

How does this guy literally get paid 2-3X of every other chair? Multiple standard deviations off. What does he bring to the table to be able to negotiate a deal like that? Plebs like us try and negotiate clinic schedule or a few extra days of PTO, let alone salary. and the chairs and admins tell us to take a hike, how dare you even ask.

 

[radiadouken]

Long time lurker, first time poster. Saw this gem on a text thread with friends from residency -- looks like Lou Potters trying to take out Amar Kishan



View attachment 360242

Wow… completely inappropriate, but especially coming from a chair

 

[Doctorer]

How does this guy literally get paid 2-3X of every other chair? Multiple standard deviations off. What does he bring to the table to be able to negotiate a deal like that? Plebs like us try and negotiate clinic schedule or a few extra days of PTO, let alone salary. and the chairs and admins tell us to take a hike, how dare you even ask.

Anecdotally, I feel there's been a decent amount of junior-ish people bailing on academics the last year or two.

 

[deleted1116990]

Anecdotally, I feel there's been a decent amount of junior-ish people bailing on academics the last year or two.

No big deal. They are actively training a bunch of IMGs, DOs, washouts from other fields, midcareer physicians. etc that private practices will not hire. All of whom want to work in or near big cities (where the universities are).

 

[TheWallnerus]

Anecdotally, I feel there's been a decent amount of junior-ish people bailing on academics the last year or two.

Les jeux sont faits. Translation: The game is up.

Ferris Bueller's Day Off (1986) clip with quote Les jeux sont faits. Translation: The game is up. Yarn is the best search for video clips by quote. Find the exact moment in a TV show, movie, or music video you want to share. Easily move forward or backward to get to the perfect clip.

memes.getyarn.io

 

[deleted1111261]

Boomer on boomer violence. Love to see it.

 

[evilbooyaa]

Wonder if Potters and Steinberg staged this so as to avoid all the other difficult to swallow pills coming in ERAS this year.

 

[RickyScott]

Boomer on boomer violence. Love to see it.

Who has the bigger bank account? Mike only earns 1 mill per year but probably got paid 10s of millions for centers he sold. Both are really bad for this field.

 

[TheWallnerus]

Wonder if Potters and Steinberg staged this so as to avoid all the other difficult to swallow pills coming in ERAS this year.

False flag?!

 

[NotMattSpraker]

Anecdotally, I feel there's been a decent amount of junior-ish people bailing on academics the last year or two.

I blame SDN. It is the only reasonable explanation.

 

[medgator]

I blame SDN. It is the only reasonable explanation.

Ok Jake!

 

[TheWallnerus]

I blame SDN. It is the only reasonable explanation.

No please keep it straight

Dr Parikh tweets have cause young academics to go non academic

SDN is only responsible for tanking the match

 

[Fpg1245]

Boomer on boomer violence. Love to see it.

It’s really pathetic to watch. Other than that ASCO blow up in the prostate section last year.

Watching the big rich people and their squabbles, they feel the need to be express every opinion without a filter.

 

[Ray D. Ayshun]

Ok Jake!

Jake actually seems like an interesting guy doing interesting stuff. He isn't a radiation oncologist though.

 

[Palex80]

It’s not relevant to the argument at hand, but it’s always fun to point out how insane the comp structure is at academic centers. Amar works twice as hard and produces twice as much and gets paid half.

That sounds almost like...