Transcription of Dr. Parikh's speech

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Neuronix

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Thank you. Speaking for the community: I didn’t leave ASTRO; ASTRO left me.

There’s a trust issue between big rad onc and little rad onc. Big rad onc is the academic chairmen, the ASTRO leadership, the ABR, the editors of our journals, the people charging five to seven times the rates that the community and freestanding centers charge. Some of you on this panel are big rad onc.

We didn’t like it when you ignored Chirag Shah’s warnings in 2013. We really didn’t like your responses to him. Because unlike him, you weren’t data driven or thoughtful, you were selfish. We had chairmen saying: “we need more residents to drive faculty salaries down.” Now what Chirag said, it may have come to fruition.

We didn’t like it when you ignored Ben Smith’s analysis in 2016 that modeled the oversupply. This was based on new information about hypofractionation, stereotactic treatments, omission of radiation, and surveillance. Why didn’t we have this discussion back then? Why wasn’t this discussed at ASTRO’s annual meeting—or should I call it the Varian and proton industry trade show? We didn’t like it that you doubled the number of residents without input from stakeholders.

We didn’t like it when you failed forty percent of the residents in 2018 and then shouted “Anghoff, Anghoff” out of one side of your mouth and “the residents are poor quality” out of the other side of your mouth. Mudit, Ana, Trevor, me--we wrote a paper showing that this was patently false. We’re still waiting for an apology from you two, and you know who I’m talking about.

This same board grandfathered people in who have no business contouring simple IMRT plans, yet are allowed to practice outdated medicine.

We’re upset that you bring politics into every aspect of our being, instead of focusing on advocacy for cancer patients and cancer physicians. Why are we getting involved in congressional bickering and angering our members who just want an advocacy group that advocates for cancer care? We want a break from the culture wars.

We don’t want chairmen that write editorials clumsily and incorrectly writing about cancel culture. Just in case you aren’t clear, cancel culture doesn’t mean people are being mean to me on the internet, please stop. What, are we in elementary school?

We don’t like when you say women and minorities as one word. Women have been historically excluded for one set of reasons; minorities have been excluded for another. We don’t like it when you say you have to lower standards to include them. You made those standards. They’re terrible standards. They need to be changed to make us all better.

We didn’t like it when you tell breastfeeding mothers that they should come back next year for their exam instead of accommodating them.

We don’t like when you tell us it’s unsafe for someone to work from home supervising patient care, expertly aligning CBCTs, contouring head and neck plans, feeding the baby, and then finishing the telemedicine consult. But it’s safe to have some semi-retired person who doesn’t know what a CBCT is babysit a linac and charge full freight.

Little rad onc—we want truth, we want accountability. Little rad onc wants you to start choosing wisely. Oh, who is little rad onc? It’s rad oncs like me that treat patients. You know, the eighty percent of us out there in the community taking care of people. What do we want? We want big rad onc to stop pissing on our leg and telling us it’s raining. We want you to clean up this mess, tell us you’re sorry, and tell us how you’re going to make things right. Thank you.

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