SBRT vs IMRT for prostate - rad onc is all about money...

[SneakyBooger]

I find this video very unprofessional and erroneous in the statements made. It is very disappointing to see rad onc's again portrayed by others as motivated solely by money. Furthermore, the video recommends patients pay out of pocket for a test that has no supporting data and is not FDA approved. "Malpracticy"

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[medgator]

"cryotherapy" options if radiation toxic based on an FDA non approved test. Quacks.

A lot of companies in that status will often let patients get it done for free. Like decipher etc

 

[elementaryschooleconomics]

 

[SneakyBooger]

I look forward to ASTRO's reply to this video.

 

[deleted1111261]

“When we are talking toxicity, we are also talking about side effects”

 

[deleted1111261]

Well, that was impressive. How many lies can you pack into one video?

 

[sirspamalot]

Well, that was impressive. How many lies can you pack into one video?

Negative non profitable comments will.... Be deleted.

Bwaaahaahha unreal. Why the F is this Medonc clown talking about anything xrt and anyone listening is beyond me.

STFU you quack!

 

[OTN]

Fella needs to take his terrible tie and head back to the community college where his educational career started.

 

[Gfunk6]

I find this video very unprofessional and erroneous in the statements made. It is very disappointing to see rad onc's again portrayed by others as motivated solely by money. Furthermore, the video recommends patients pay out of pocket for a test that has no supporting data and is not FDA approved. "Malpracticy"

I disagree - I think he was sufficiently nuanced. He said finances are a factor in decision making and I think that is accurate.

44 fraction IMRT ~ $35,000
5 fraction SBRT ~ $15,000
44 fraction protons ~ $70,000+

Proton centers pull this crap all the time and I always tell patients who are considering protons for prostate cancer treatment this. You and I both know that if reimbursement were identical across all modalities, all of a sudden IMRT utliization would plummet.

On the other hand, paying $500 out of pocket for a non-Medicare covered test is a dubious value proposition at best.

 

[TheWallnerus]

I find this video very unprofessional and erroneous in the statements made. It is very disappointing to see rad onc's again portrayed by others as motivated solely by money. Furthermore, the video recommends patients pay out of pocket for a test that has no supporting data and is not FDA approved. "Malpracticy"

I guess it’s ok to dichotomize SBRT as not being IMRT for the lay public. But scientifically I low key hate it. I high key hate trying to blindly discuss cost by saying “slow radiation” is more costly than “fast radiation.”

 

[TheWallnerus]

I disagree - I think he was sufficiently nuanced. He said finances are a factor in decision making and I think that is accurate.

44 fraction IMRT ~ $35,000
5 fraction SBRT ~ $15,000
44 fraction protons ~ $70,000+

Proton centers pull this crap all the time and I always tell patients who are considering protons for prostate cancer treatment this. You and I both know that if reimbursement were identical across all modalities, all of a sudden IMRT utliization would plummet.

On the other hand, paying $500 out of pocket for a non-Medicare covered test is a dubious value proposition at best.

Those values are only roughly ok for Medicare

Depending on insurance, some places will get 60K for SBRT but freestanding guy in town will get $25K for 45 fraction IMRT. Price transparency etc.

 

[OTN]

I disagree - I think he was sufficiently nuanced. He said finances are a factor in decision making and I think that is accurate.

44 fraction IMRT ~ $35,000
5 fraction SBRT ~ $15,000
44 fraction protons ~ $70,000+

Proton centers pull this crap all the time and I always tell patients who are considering protons for prostate cancer treatment this. You and I both know that if reimbursement were identical across all modalities, all of a sudden IMRT utliization would plummet.

On the other hand, paying $500 out of pocket for a non-Medicare covered test is a dubious value proposition at best.

I take offense to this random man saying finances are a factor in my decision-making. I tell patients up front that we are paid less for SBRT vs fractionated treatment and then turn right around and recommend SBRT for the vast majority of my intermediate-risk patients.

I don't place the SpaceOAR, because despite what Dr. Terrible Tie McCommunity College says the data is pretty obvious that it does nothing but increase procedural risk. I would make more money placing the SpaceOAR. I am also up front about this with patients. Just because this guy, with his unapproved molecular test, clearly uses finances to impact his medical decision-making, it doesn't mean the rest of us do. Rant over.

 

[deleted1111261]

I take offense to this random man saying finances are a factor in my decision-making. I tell patients up front that we are paid less for SBRT vs fractionated treatment and then turn right around and recommend SBRT for the vast majority of my intermediate-risk patients.

I don't place the SpaceOAR, because despite what Dr. Terrible Tie McCommunity College says the data is pretty obvious that it does nothing but increase procedural risk. I would make more money placing the SpaceOAR. I am also up front about this with patients. Just because this guy, with his unapproved molecular test, clearly uses finances to impact his medical decision-making, it doesn't mean the rest of us do. Rant over.

This is ethical medicine
Give them all options that are recommended by guidelines. Don’t recommend wasteful procedures.

 

[sirspamalot]

No gel. No SBRT. No fiducials. No protons. F right off with that nonsense.

 

[evilbooyaa]

This guy is a med onc and a moran. It's like asking a Rad Onc to discuss intricacies of medical oncology. Sure, we could do it, but we probably shouldn't be in a patient facing video/situation.

PCRI should be ashamed that they couldn't find a RO to discuss the recs of SBRT/IMRT. Hell, I'm sure I or OTN would be happy to discuss it for ya'll!

Y'know, if we weren't worried about the whole anonymity thing... but that's for another thread.

 

[TheWallnerus]

This guy is a med onc and a moran. It's like asking a Rad Onc to discuss intricacies of medical oncology. Sure, we could do it, but we probably shouldn't be in a patient facing video/situation.

PCRI should be ashamed that they couldn't find a RO to discuss the recs of SBRT/IMRT. Hell, I'm sure I or OTN would be happy to discuss it for ya'll!

Y'know, if we weren't worried about the whole anonymity thing... but that's for another thread.

Is this the same guy that started that weird color scale for prostate cancer. “Teal” stage etc?

 

[TheWallnerus]

Rough back of envelope Medicare based reimbursement amounts for 45 and 28 fraction IMRT and SBRT. National payment rate amounts.

 

[sirspamalot]

MPFS I assume.

HOPPS is muchas betteras.

 

[Reaganite]

He's annoying...always tries to steal patients or change plans. I can't absolutely corroborate this, but at some point I heard he had worked out a deal with a brachy guy and would try to redirect patients who had already seen other radoncs to "his guy."

 

[sirspamalot]

Anyone want to send him a box, c/o SDN?

 

[Fpg1245]

Anyone want to send him a box, c/o SDN?

Is that even legal?

 

[Fpg1245]

Rough back of envelope Medicare based reimbursement amounts for 45 and 28 fraction IMRT and SBRT. National payment rate amounts. View attachment 375458View attachment 375460

Which is why 45 till I die

 

[sirspamalot]

Is that even legal?

Is this legal?​

Yes and we've been in business since 2007. Sending an anonymous non-hazardous package through the US Postal Service is indeed legal. Please review our legal page for more information.