Of course they don't.
How many rural centers are there in Canada?...which is a freaking rural country.
Their position (if somewhat tacit) is undoubtedly one in which they view centers that are potentially not staffed by docs every day as being centers that are not providing the highest level of care.
They almost certainly think that these centers should be shut down with XRT services provided by the nearest reasonably large center operating at a scale they are comfortable with.
Although, I suspect ASTRO would claim that their real position is that even rural patients deserve a doc on site everyday. In fact, they deserve a doc living in the community...and despite the perversion of the only doc in some of these communities being a radonc, this is better than none at all.
There is a darker narrative regarding whether urban academics and professionals in general care about rural people. This narrative has of course dramatically impacted our national discourse on all matters and is particularly important in the setting of our present electoral system.
But, for those not personally invested in these situations, a general cultural shift away from in-person supervision (once it is perceived as generally reasonable) will devastate the market.
I think some folks are looking at this in terms of personal behavior...they are wrong. Only a few individual docs will abuse a change in policy...as has already been shown.
I have no doubt that @elementaryschooleconomics and @MidwestRadOnc will remain conscientious docs who provide reasonable supervision under any regulatory environment.
However, medicine is largely corporate at this point (non-profits in medicine behave in a very corporate manner). That next merger or PSA with an academic place 100 miles away...doc comes down twice a week with virtual only all other days.
