scarbrtj

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Know the headline shocks the conscience a bit. But what is a rad onc? What do those in this "increasingly popular specialty" do? If a rad onc is a "physician who uses ionizing radiation (such as megavoltage X-rays or radionuclides) in the treatment of cancer," you absolutely do not have to do a rad onc residency to be a radiation oncologist. (But, hey ASTRO, real nice work on Urorads. You did great.) Now derms do more rad onc in the US than board certified rad oncs do. A 4 year rad onc residency is a "bad buy" if any other MD can do what we do without all the hassle of said rad onc residency.



 

RickyScott

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And of course, we can’t prescribe systemic therapy.
 
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FrostyHammer

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Can't believe anyone training at spots #150-195 think they'll be employed in 2025....
That's why it's worth making a list of the bottom of the bottom programs, because if a med student matches there then GOOD NIGHT
 
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seper

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ZAP-X is megavoltage so you'll need a RadOnc in all jurisdictions; however this IntraOp linac can fly under the radar?
 

RickyScott

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ZAP-X is megavoltage so you'll need a RadOnc in all jurisdictions; however this IntraOp linac can fly under the radar?
Is there a law that only a radonc can be authorized for mega voltage?
 
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medgator

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ZAP-X is megavoltage so you'll need a RadOnc in all jurisdictions; however this IntraOp linac can fly under the radar?
If natural source, would agree, but linacs don't fall under nrc regs.... CMS still says someone needed who knows what they are doing, zap-x still lowers the barrier for entry by non-ROs
 
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OTN

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Anyone been impacted by this out in practice?
Yes - one of the large dermatology practices bought an electronic brachytherapy machine and treats many patients with it. Average course is 17 fractions, and if you have more than one lesion he will treat one on one day, the other on the other day, etc, for 34 total days of treatment. Fraud.
 
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RadOncDoc21

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Yes - one of the large dermatology practices bought an electronic brachytherapy machine and treats many patients with it. Average course is 17 fractions, and if you have more than one lesion he will treat one on one day, the other on the other day, etc, for 34 total days of treatment. Fraud.
Choose wisely! Seems like they did.
 
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doctalaughs

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Dermatologist here. To be fair, I think it’s a very small minority of derm practices that do this sort of unethical stuff.

I treat thousands of skin cancers a year and probably have 3-5 that are significantly better candidates for Radiation rather than other modalities (maybe another 3-5 that need surgery and radiation after). I send those to you guys.
 
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scarbrtj

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Dermatologist here. To be fair, I think it’s a very small minority of derm practices that do this sort of unethical stuff. I treat thousands of skin cancers a year and probably have 3-5 that are significantly better candidates for Radiation rather than other modalities (maybe another 3-5 that need surgery and radiation after). I send those to you guys.

Ethical, or unethical. Who knows. It's not ethical for a radiation oncologist to give chemo in America but it is in many other countries.

But holy schnikes... RT utilization in skin cancer (the number one cancer diagnosis in America) is <<1%?!
 
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RickyScott

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Dermatologist here. To be fair, I think it’s a very small minority of derm practices that do this sort of unethical stuff.

I treat thousands of skin cancers a year and probably have 3-5 that are significantly better candidates for Radiation rather than other modalities (maybe another 3-5 that need surgery and radiation after). I send those to you guys.
Unless a skin cancer is very aggressive, 99.9% time derm is going to have similar outcomes delivering xrt after 3 hour class.
 
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Radiation volume for skin cancer is highly dependent on what latitude you practice at.

Department of Justice website has fraud cases decided against dermatologists who practice radiation therapy.
 

Reaganite

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Department of Justice website has fraud cases decided against dermatologists who practice radiation therapy.
The stuff I heard about and saw with dermrads during those days....I remember derms with multiple sites carrying 30+ on treatment at each site when the procedure was reimbursing 20k per patient...
 

TheWallnerus

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Department of Justice website has fraud cases decided against dermatologists who practice radiation therapy.
We need to notify the Department of Justice about all these radiation billing and coding advice articles the derms write about in their journals...

 

metallica81788

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Derms telling us how to code, MedOncs telling us when and how to do radiation... I specifically remember an Ortho in training who tried to dictate the field and dose on an HO...

Quad-boarded catfish indeed
 
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