Rad Onc Twitter

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I can’t lay it all on him but the moment presented itself to Zeitman and he couldn’t have been more wrong and weak.

The “canary in the coal mine” essay was a disaster. We told him it didn’t matter if spots don’t fill in match - they’ll fill in SOAP. So it’s not even remotely a “solution.”

The weakness hiding behind phantom anti trust suits….

I think there’s a world where a really strong ASTRO (yes I know ASTRO not directly responsible for residency) leader ready to do the right thing even though chairs aren’t pushed the specialty in the right direction. Instead he poured gas on it.
 
sirspamalot said:
I remember when he was just barely fresh into being an Assistant Professor. Loved the sound of his own voice. Bootlicked his way right to the top.
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I really doubt he thought market could correct itself, but felt compelled not to predict demise of the specialty. One of first to recognize and publicize the problem.
 
Fpg1245 said:
I think the LDRT OA thing might take off before this does
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I agree. Stakes much higher here. For OA, I'm more than happy to participate in effective placebo.

This work is interesting, but good lord, that data. Look at how much the scores vary for a given patient with repeated administration of the test. Look at variance over time. This is not convincing.

We know from other work that MMS scores are highly variable and not useful for ascertaining progression of disease in Alzheimer disease.

jamanetwork.com

Variability in Annual Mini-Mental State Examination Score in Patients With Probable Alzheimer Disease

Objective To determine the variability in annual Mini-Mental State Examination scores of patients with Alzheimer disease enrolled in the Consortium to Establish a Registry for Alzheimer's Disease (CERAD).Patients A total of 372 patients with probable Alzheimer disease with 1 or more...
jamanetwork.com jamanetwork.com
 
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communitydoc13 said:
Yeah. Tough for anyone to be caught in a bubble of any sort. It means you have overestimated value somewhere and you are going to be taking losses.

When I think of the peak radonc bubble, I am OK with folks like me, who ended up in community jobs that they thought they were too good for, but have been paid fairly well and learned to live away from big cities.

It's the group of aspiring academics one tier down from the top 5-10 or so graduates per year that I wonder about. A group, that during peak radonc, could have called their academic trajectory in almost any other field, been given support and been expected to produce academically as opposed to clinically. I bet there was a good 10-12 year period there, where 30-50 graduating radonc residents per year had the academic bonifieds to make almost anyone in medicine blush, but were not looking forward to fruitful academic careers once they graduated.

Why has derm been different? Why hasn't there been a derm bubble?

I would say this. Derm always knew where their prestige came from. They knew it was about lifestyle and money, and they knew that to preserve these, controlling the supply/demand dynamic was critical.

While I'm sure derm aspirants had to put on a dog and pony show about about academic or community service aspirations, collectively everyone knew the real narrative. Derm is a field that you work hard to get into, so that you don't have to work so hard once you are in. It is prestigious only because the folks in the residency program are AOA/260+ types.

Radonc got carried away. Most importantly, leadership during peak radonc got carried away. They forgot the real narrative...that by and large, we radiate the medical oncologist's or surgeon's patients and don't take much call and radiation pays. They imagined that great and generalizable oncology knowledge would emerge from a very limited specialty, if they just acquired enough remarkable young talent. Many in leadership imagined themselves as great. A few were able to ingratiate themselves to the larger medical community and sail away. (Hahn, Deweese, etc)
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This right here. TRUTH.
 
communitydoc13 said:
.

While I'm sure derm aspirants had to put on a dog and pony show about about academic or community service aspirations, collectively everyone knew the real narrative. Derm is a field that you work hard to get into, so that you don't have to work so hard once you are in. It is prestigious only because the folks in the residency program are AOA/260+ types.
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Derm and gu have been great about regulating expansion, certainly the opposite of rad onc
 
With all the hospitals screaming bloody murder about how difficult their fiscal situation is in the wake of the pandemic -- this kind of change would be very disruptive. I think we'd see a lot of hospital closures, followed by docs reopening private practice.


I wonder if they'd ever get to a point where they just let the Rad Onc group buy the Linacs back. Doesn't seem likely. As long as they can profit off us, we're screwed.

Being in a CON state, I don't see the hospitals giving us up unless they fully go bankrupt and don't have a choice.
 
Juicy because the bloated hospital overhead cannot sustain smaller radonc practices and the private insurers will rachet down payments.. thus the bluff comes and will hospitals play hard or will the interlopers offer a cheaper alternative and take a chance to win the region.

Some good fightin' ahead if this happens. Otherwise, zzz status quo.. I'm guessing the AHA will prevent this site neutral stuff from becoming reality.
 
sirspamalot said:
Juicy because the bloated hospital overhead cannot sustain smaller radonc practices and the private insurers will rachet down payments.. thus the bluff comes and will hospitals play hard or will the interlopers offer a cheaper alternative and take a chance to win the region.

Some good fightin' ahead if this happens. Otherwise, zzz status quo.. I'm guessing the AHA will prevent this site neutral stuff from becoming reality.
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site neutral won’t have a huge impact on the big systems. Their prices will still largely be determined by market leverage with the insurers.
 
RadOncDoc21 said:
Lol, so what are they doing if there are no patients and she seems like a real tool to work with.
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Perhaps she can advocate on behalf of the hourly workers to corporate so that their not pressured to production-line patients, do a ****ty job reviewing setup images, and get out ASAP in order to save the hospital an extra $50 a day.
 
NotMattSpraker said:
Aww, its deleted. What did it say?
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It sounds like the OB/GYN resident who made the original post saw the parking spots close to the Radiation Oncology department at Loyola and assumed that they were there for the Physicians who were obviously too lazy to walk from where the other Physicians park.

Turns out it was actually patient parking for the convenience of people undergoing active treatment for cancer . . . whoops.
 
Gfunk6 said:
It sounds like the OB/GYN resident who made the original post saw the parking spots close to the Radiation Oncology department at Loyola and assumed that they were there for the Physicians who were obviously too lazy to walk from where the other Physicians park.

Turns out it was actually patient parking for the convenience of people undergoing active treatment for cancer . . . whoops.
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My residency certainly wasn't soul-crushing, but I don't recall being in the parking garage at 4. Wonder what she was doing there.
 




She apologizes that it was not her intention?
So, she actually meant it? 🤣🤣🤣
 


Please, discuss…

duck and cover documentary GIF by Kino Lorber
 
Scope creep/midlevels seems somewhat irrelevant to radiation oncology.

Please don't tell me you're teaching your APRN to see consults, contour, and evaluate plans. It's bad enough that some of us are teaching prospective students & surplus residents.

I'm happy to lead care teams consisting of AI language models and autoplanning neural networks.
 
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yesmaster said:
Scope creep/midlevels seems somewhat irrelevant to radiation oncology.

Please don't tell me you're teaching your APRN to see consults, contour, and evaluate plans. It's bad enough that some of us are teaching prospective students & surplus residents.

I'm happy to lead care teams consisting of AI language models and autoplanning neural networks.
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I have never worked with an NP or even seen an NP in “rad onc action.” But I see so many NPs on rad onc staff websites!
 
yesmaster said:
Scope creep/midlevels seems somewhat irrelevant to radiation oncology.

Please don't tell me you're teaching your APRN to see consults, contour, and evaluate plans. It's bad enough that some of us are teaching prospective students & surplus residents.

I'm happy to lead care teams consisting of AI language models and autoplanning neural networks.
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CMS claims records indicate mid-levels are definitely not irrelevant to Radiation Oncology...
 
Gfunk6 said:
View attachment 368589



Well, if the machine does all the work and humans are solely there for blame then I'd say we do have some things to worry about. 😵
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This loss of control… letting the “machine do all the work” and inverse optimize (“No more cord blocks for head and neck RT???”)… was super scary for old timers.
 
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