Rad Onc Twitter

[Palex80]

doesn’t spratt push protons ?

I would say, he likes protons.
But not for prostate.

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[Palex80]

I bet we all use IMRT 100 percent of the time, what is the level one evidence that it is superior to non IMRT methods.

 

[medgator]

I love to poke fun as much as the next guy, especially to deflate hypocrisy or pomposity. But my dad used to start meetings sometimes with “one of these days we all need to get together and be honest.” Whenever we use IMRT (a “device” I’d argue, as would CPT 77338) for prostate cancer, and I bet we all use IMRT 100 percent of the time, what is the level one evidence that it is superior to non IMRT methods.

Fair but look at the financial delta between IMRT and 3d. Protons vs IMRT far greater with no evidence to support superiority

 

[OTN]

What is Proton Therapy? - Innovations & Benefits of Proton Therapy for Cancer Treatment | University Hospitals

Learn the difference between proton therapy and radiation therapy, the benefits of this advanced cancer treatment and more. The University Hospitals Proton Therapy Center is ready to create targeted treatments for you or your loved one to give you optimal chances for success.

www.uhhospitals.org

Prostate mentioned

 

[RickyScott]

Dan is probably charging most insurances 5-10x cms rates and has satellites throughout the metro. He is playing the same game. Its ok to charge prices 10x that of a small community hospital for same services, but somehow problematic to hype a shiny new robot.

 

[drowsy12]

Dan is probably charging most insurances 5-10x cms rates and has satellites throughout the metro. He is playing the same game. Its ok to charge prices 10x that of a small community hospital for same services, but somehow problematic to hype a shiny new robot.

‘dan’ as if he has anything to do with that let’s be real

 

[medgator]

‘dan’ as if he has anything to do with that let’s be real

Still happening on his watch. Where does the buck stop? Not the chairman?

 

[drowsy12]

Still happening on his watch. Where does the buck stop? Not the chairman?

come on. you think a chairman sets up hospital based prices with insurance companies? lol?

 

[OTN]

Even if you didn't build the glass house in which you live, it is not a good idea to throw stones from it

 

[RickyScott]

‘dan’ as if he has anything to do with that let’s be real

He is a real go-getter. No doubt, he is growing his department by capturing patients from nearby community centers so to receive high priced care under the university umbrella.

 

[drowsy12]

Even if you didn't build the glass house in which you live, it is not a good idea to throw stones from it

What a strange stretch of apples and oranges.

I don’t even like spratt but you guys are just being weird.

 

[A_DeMichele]

chair got nothing to do with negotiated rates

 

[Chartreuse Wombat]

chair got nothing to do with negotiated rates

No but chair knows how to keep the C-suite happy. Corporate medicine in action.

 

[drowsy12]

 

[Ray D. Ayshun]

Med school boom? I'm not sure what that was, or when. It looks like we graduate <30,000 MDs and DOs yearly in the US. I'm all for emphasizing that medicine is not what you think or hope it might be but having 2+ times as many applicants as spots only seems like those dreams that were unrealistic in the first place might be over. Maybe my math is wrong/I'm missing something.

 

[thesauce]

Med school boom? I'm not sure what that was, or when. It looks like we graduate <30,000 MDs and DOs yearly in the US. I'm all for emphasizing that medicine is not what you think or hope it might be but having 2+ times as many applicants as spots only seems like those dreams that were unrealistic in the first place might be over. Maybe my math is wrong/I'm missing something.

Half of applicants are getting in. I thought it used to be 1/4th?

 

[fiji128]

Half of applicants are getting in. I thought it used to be 1/4th?

I think it was around 1/3 15 or 20 years ago.

 

[OTN]

Covid boom then went back to normal

 

[fiji128]

According to a quick search there are about 30,000 UD MD/DO medical school positions offered per year and 43,000 residency positions in the match. Seems like we still need a lot more US Med school positions to open up.

 

[Bequerel]

According to a quick search there are about 30,000 UD MD/DO medical school positions offered per year and 43,000 residency positions in the match. Seems like we still need a lot more US Med school positions to open up.

Should be 42,900 residency positions if our residency programs could get it together!

 

[evilbooyaa]

Dan is probably charging most insurances 5-10x cms rates and has satellites throughout the metro. He is playing the same game. Its ok to charge prices 10x that of a small community hospital for same services, but somehow problematic to hype a shiny new robot.

‘dan’ as if he has anything to do with that let’s be real

Agree with drowsy. Seriously, this is a moving of the goal posts from some of you guys. Why you so obsessed w/ Dan Spratt?

Yes academics and hospital systems get to charge more. This was happening before Spratt became chair and is completely unrelated to him existing.

It started with 'doesn't Spratt push protons'?

The answer was 'no, he's actually pretty conservative in regards to benefits and criticizes protons especially for prostate more than the average Rad Onc who is in a position of power. He criticizes them DESPITE having access to a proton machine at his facility, which is a significant rarity (generally those who are pro protons for prostate work for a proton center, generally those who are against protons for prostate work at a center that does NOT have protons)'

Then, there was a search about a portion of a UH website that is about proton cancer mentions the world prostate, and thus immediately the worst is assumed. Here is the FULL EXCERPT, bold my emphasis:

"Protons are most successful in treating solid tumors with well-defined borders that have not spread to other areas of the body. As such, proton therapy is most often used for tumors of the brain, head, neck, lungs and spine, although it can also treat eye melanoma, pituitary gland tumors, prostate cancer and a number of other contained cancers. Proton therapy can be combined with other forms of radiation and chemotherapy and can even be used as a follow-up treatment to surgery to help eradicate cancer from the surrounding tissues."

So yes, proton therapy CAN be used to treat prostate cancer. Sure, it doesn't say whether it should or it shouldn't, but proton therapy can clearly be used to treat prostate cancer (even though IMO it shouldn't because there's no benefit to an individual patient and harm on a global scale).

I'm not saying Dan Spratt is amazing either, but, when it comes to prostate cancer, he is, IMO, at least consistent. He argues against non evidence based things and claims, regardless of who is making money off of it.

 

[Radonky]

Agree with drowsy. Seriously, this is a moving of the goal posts from some of you guys. Why you so obsessed w/ Dan Spratt?

Yes academics and hospital systems get to charge more. This was happening before Spratt became chair and is completely unrelated to him existing.

It started with 'doesn't Spratt push protons'?

The answer was 'no, he's actually pretty conservative in regards to benefits and criticizes protons especially for prostate more than the average Rad Onc who is in a position of power. He criticizes them DESPITE having access to a proton machine at his facility, which is a significant rarity (generally those who are pro protons for prostate work for a proton center, generally those who are against protons for prostate work at a center that does NOT have protons)'

Then, there was a search about a portion of a UH website that is about proton cancer mentions the world prostate, and thus immediately the worst is assumed. Here is the FULL EXCERPT, bold my emphasis:

"Protons are most successful in treating solid tumors with well-defined borders that have not spread to other areas of the body. As such, proton therapy is most often used for tumors of the brain, head, neck, lungs and spine, although it can also treat eye melanoma, pituitary gland tumors, prostate cancer and a number of other contained cancers. Proton therapy can be combined with other forms of radiation and chemotherapy and can even be used as a follow-up treatment to surgery to help eradicate cancer from the surrounding tissues."

So yes, proton therapy CAN be used to treat prostate cancer. Sure, it doesn't say whether it should or it shouldn't, but proton therapy can clearly be used to treat prostate cancer (even though IMO it shouldn't because there's no benefit to an individual patient and harm on a global scale).

I'm not saying Dan Spratt is amazing either, but, when it comes to prostate cancer, he is, IMO, at least consistent. He argues against non evidence based things and claims, regardless of who is making money off of it.

Agree. Typical behavior from the condiments lobby