My post from last Friday

[Rad Onc SK]

This is my 1st time on the board in 4 days. Clearly, I missed a lot! Yesterday at dinner, my kids told me I should take a look at the board today. They said a lot of people do not like me 😊 (they now are SDN “lurkers” – long story there)

I wanted to address some of the replies that came up from my Friday post. These were mischaracterizations of my intentions in posting the WaPo article. For some reason, a few posters decided to assume what I was trying to say. I was not trying to tell anybody how good we have it. I wanted to call attention to a very important article that got published in the Washington Post, one of this country’s most prominent newspapers. This article used a unique methodology and is going to be widely referenced by health policy wonks in Washington DC and beyond, whether we like it or not, whether we agree with it or not. I thought that physicians, radiation oncologists, in particular, should be aware of this article since we were specifically named. I thought posters in this forum would want to see the article. For what it is worth, I posted something similar on Twitter/”X” as to what I posted here on SDN.

Like many of you, I was surprised to see the rad onc salaries so high. I think the NBER study was cherry-picked. The average physician has a 30-year career but they chose, for most physicians, the peak 15 years. I had a chance to take a longer look at the paper. For those of you who chose to read it, I think the most important graph was Figure 1B, which showed that >20% of the total income is non-W-2 wages. It was great to see over 5000 comments on the Washington Post article, most of them pro-physician.

I am not planning on checking this site daily. If people expect a response from me within a day, on this board, they probably won’t get it. There are accounts here that post 60+ times a day. I won’t post 60 times in a year.

---

Members don't see this ad.

 

[evilbooyaa]

I am not planning on checking this site daily. If people expect a response from me within a day, on this board, they probably won’t get it. There are accounts here that post 60+ times a day. I won’t post 60 times in a year.

You're at 46 in 2 months. You'll probably hit 60...

It's hard to know why you post something if you don't post your opinion about it alongisde - if you had said - MAN look at this! it's super important, but like c'mon, it's so flawed, we don't make this much more on average! - you'd have likely gotten a bit of a different response.

There will be people who have an innate distrust of anyone who is or represents ASTROs interest. For any posters that are individually bothering you, feel free to put them on ignore so that you don't have to read their posts. Lord knows I've considered it myself for some of the folks I consider annoying AF on here. Unfortunately I can't so I can keep an eye on someone swan diving off the deep end.

 

[NotMattSpraker]

There will be people who have an innate distrust of anyone who is or represents ASTROs interest.

My fear of a charging lion is innate, my distrust of ASTRO is learned.

So many do not trust ASTRO because they do nothing to earn people's trust. Simple as that.

 

[elementaryschooleconomics]

In your defense, you absolutely never explicitly said "look how good we have it" on either SDN or Twitter.

I can only speak for myself, but I definitely assumed your intent on this one:

1) You have been elected to a visible, unique position within the major professional society ("unique" as in only one per year). To even seek such a position implies a desire to "be noticed". This is what "being noticed" entails.

2) You have been consistent in your "pro-establishment" stance, meaning you defend ASTRO in a way that can imply criticism but actually isn't. For example, you have often remarked on the perception that early career folks aren't becoming ASTRO members. Because even acknowledging this is novel (no one else "inside" ASTRO has ever said anything about this), it's easy to make the logical leap that you "agree" with their decision. But you've been clear about this too:

3) We're all human and we all have biases. Anything I say will usually be interpreted as "anti-ASTRO" which is both true and untrue. Anything you say will be interpreted as "pro-ASTRO", which is also both true and untrue. But many of us saw the Post article since it was published at 6AM on Friday morning. Your post was made 12 hours later.

While you were the first to post it here, there had already been a lot of discussion on Twitter. You were the only person to bring up that RadOnc was on the graph. Not only that, you spelled out the number, which is quite surprisingly high.

Not only that, you wrote this:

You literally say we're the third highest paid and work way less.

There was a substantial discussion in the thread you made about why this average salary was bad.

While I believe you're being truthful in that you don't check here regularly, you then Tweeted the same article over 24 hours later on Saturday night, after a lot of discussion had taken place here.

"NBER is respected and widely read" is a tacit endorsement of this salary number.

Now you come on here, SPECIFICALLY pointing out Figure 1B...but were Tweeting this Saturday night:

So again, you're not saying the number is skewed and not reflective of reality...you're saying the number is skewed because we're probably only making that much for a portion of our career?

And then you again endorse validity by describing the source?

And only now you're talking about Figure 1B and W2 wage, but you "skimmed it"?

Come on man, we're not THAT dumb.

Be better.

 

[Neuronix]

I am not planning on checking this site daily. If people expect a response from me within a day, on this board, they probably won’t get it. There are accounts here that post 60+ times a day. I won’t post 60 times in a year.

You have posted 46 times in less than 2 months. At this rate you will post 276 times this year.

 

[thecarbonionangle]

All i will say is come on you love sdn. You cant stay away. You will post far more than 60 times. Keep posting. It is a good thing.

 

[TheWallnerus]

All i will say is come on you love sdn. You cant stay away. You will post far more than 60 times. Keep posting. It is a good thing.

I hate rad onc SDN!

 

[Lamount]

To be fair, @Rad Onc SK posted an article that is relevant to our specialty.
Perhaps some here may be guilty of a wee bit too much overfitting in predicting his intentions.

Even if you aren’t a fan of ASTRO, having an open dialogue with its president could be useful.

@Rad Onc SK, it feels like many in the US (CMS, congress and med students inclusive) think that we are overvalued as a specialty… why do you think that is and what can be done to better demonstrate our value?

 

[CaesarRO]

I for one am very glad for the engagement. Agree or disagree, I think exchange of ideas is critical and while it's still very early you have my respect for engaging here at all.

I have zero expectation for volume of posts or frequency of checking in

 

[NotMattSpraker]

Even if you aren’t a fan of ASTRO, having an open dialogue with its president could be useful.

I see many, many individuals asking very reasonable questions of Sameer and ASTRO.

Please point me to the answers. That's what makes it a dialogue.

I talked about ASTRO's problems in a podcast episode I posted. The response to it has been overwhelming... from everyone except ASTRO.

ASTRO does not want open dialogue. Thats the problem.

 

[sirspamalot]

In your defense, you absolutely never explicitly said "look how good we have it" on either SDN or Twitter.

I can only speak for myself, but I definitely assumed your intent on this one:

1) You have been elected to a visible, unique position within the major professional society ("unique" as in only one per year). To even seek such a position implies a desire to "be noticed". This is what "being noticed" entails.

2) You have been consistent in your "pro-establishment" stance, meaning you defend ASTRO in a way that can imply criticism but actually isn't. For example, you have often remarked on the perception that early career folks aren't becoming ASTRO members. Because even acknowledging this is novel (no one else "inside" ASTRO has ever said anything about this), it's easy to make the logical leap that you "agree" with their decision. But you've been clear about this too:

View attachment 375421

3) We're all human and we all have biases. Anything I say will usually be interpreted as "anti-ASTRO" which is both true and untrue. Anything you say will be interpreted as "pro-ASTRO", which is also both true and untrue. But many of us saw the Post article since it was published at 6AM on Friday morning. Your post was made 12 hours later.

While you were the first to post it here, there had already been a lot of discussion on Twitter. You were the only person to bring up that RadOnc was on the graph. Not only that, you spelled out the number, which is quite surprisingly high.

Not only that, you wrote this:

View attachment 375426

You literally say we're the third highest paid and work way less.

There was a substantial discussion in the thread you made about why this average salary was bad.

While I believe you're being truthful in that you don't check here regularly, you then Tweeted the same article over 24 hours later on Saturday night, after a lot of discussion had taken place here.

View attachment 375427

"NBER is respected and widely read" is a tacit endorsement of this salary number.

Now you come on here, SPECIFICALLY pointing out Figure 1B...but were Tweeting this Saturday night:

View attachment 375428

So again, you're not saying the number is skewed and not reflective of reality...you're saying the number is skewed because we're probably only making that much for a portion of our career?

And then you again endorse validity by describing the source?

And only now you're talking about Figure 1B and W2 wage, but you "skimmed it"?

Come on man, we're not THAT dumb.

Be better.

Rekt. Rekt so hard. Do it again daddyo...lolol.

 

[sirspamalot]

You have posted 46 times in less than 2 months. At this rate you will post 276 times this year.

Oy vey.

Another one warped into the SDN wormhole..

Ps. Uh whats with the kids using the SDN account..

 

[NotMattSpraker]

Oy vey.

Another one warped into the SDN wormhole..

Ps. Uh whats with the kids using the SDN account..

#ASTROMath

 

[elementaryschooleconomics]

Even if you aren’t a fan of ASTRO, having an open dialogue with its president could be useful.

Agree or disagree, I think exchange of ideas is critical and while it's still very early you have my respect for engaging here at all.

Please point me to the answers. That's what makes it a dialogue.

Yeah...this is key. Before it went off the rails at the end there, there were multiple posts in that thread alone about the details of the NBER study. Also on his Twitter thread.

Like many of you, I was surprised to see the rad onc salaries so high. I think the NBER study was cherry-picked. The average physician has a 30-year career but they chose, for most physicians, the peak 15 years. I had a chance to take a longer look at the paper. For those of you who chose to read it, I think the most important graph was Figure 1B, which showed that >20% of the total income is non-W-2 wages. It was great to see over 5000 comments on the Washington Post article, most of them pro-physician.

This doesn't even reflect the discussion. The NBER report wasn't "cherry-picked", unless you mean the original headline of the newspaper article.

The NBER report is methodical and excellent. It's very clear how the $709,000 average was derived. It's just a number that has no meaning, other than a descriptive statistic with historical data.

I guess it's technically true that "greater than 20% of the total income is non-W2 wages" can be seen in Figure 1B, but that's not really...the point?

This is the point:

The Top 1% are many multiples higher in total income, with 85% derived from "non-labor" sources and 15% from labor.

Conversely, the 50th percentile make a paltry 8% of the total income from "non-labor" and 92% from labor.

"For those of you who chose to read it" -

Did you even read it?

 

[sirspamalot]

And you thought the new guy was different from the last guy.


#SHINY_NEW_WRAPPER

I think ASTRO needs to release a song showing why should all love and praise it.

Like these guys did for America...

youtu.be/P7JRvwfHFwo

 

[SneakyBooger]

I look forward to seeing ASTRO's rebuttal to this article.

 

[sirspamalot]

I look forward to seeing ASTRO's rebuttal to this article.

"We're sorry. We're very sorry.."

Etc.

 

[Mandelin Rain]

I see many, many individuals asking very reasonable questions of Sameer and ASTRO.

Please point me to the answers. That's what makes it a dialogue.

I talked about ASTRO's problems in a podcast episode I posted. The response to it has been overwhelming... from everyone except ASTRO.

ASTRO does not want open dialogue. Thats the problem.

Yes, 100%. I will say... Many of us are mainly here for the memes and lulz.

But at the center of this board is a core of incredibly intelligent, thoughtful, and engaged radiation oncologists who offer a different perspective than the old guard academics and special interests that have steered ASTRO to it's current course.

It would be a shame and missed opportunity if ASTRO and it's ambassadors were uninterested/unwilling/unable to sort through the (admitted) chaff that posters like myself provide, to find the cream that this board often produces. Moreover, it would be a similar missed opportunity, if that didn't lead to some organizational self reflection and course alteration. ASTRO can be a big tent serving all radiation oncologists or a small tent serving academic chair people and special interests. I think despite the bluster here, we'd all happily fall back in line if we felt it was the former.

 

[Mandelin Rain]

I feel like the tax discussion could be it's own off-topic thread.

 

[deleted1168505]

I feel like the tax discussion could be it's own off-topic thread.

Maybe not a good idea. The WaPo will sniff it out and engage in more finger-pointing at doctors. Overpaid AND tax-dodgers.

 

[evilbooyaa]

I feel like the tax discussion could be it's own off-topic thread.

Agreed. I have made it into its own thread in the business forum. All can continue to contribute there.

 

[doctalaughs]

The NBER report is methodical and excellent.

"For those of you who chose to read it" -

Did you even read it?

I finally skimmed the report.

My main issue is their definition of a “physician” and lack of median numbers broken down for each specialty rather than in aggregate.

If only 15% of income in the top 1% is derived from labor (seeing patients), are these really physicians? It’s like saying “car salesmen make an average of 1 million dollars a year” and including Elon Musk in the average.

This is obvious - even among the top 1% the median number is less than half of the mean (4m vs less than 2m). They should have excluded those seeing less than X patients or making more than X dollars, as clearly these aren’t primarily physicians.

But I would agree that the main problem is the over-simplification and clear “agenda” of the article interpreting the numbers.

 

[NotMattSpraker]

But I would agree that the main problem is the over-simplification and clear “agenda” of the article interpreting the numbers.

ASTRO should hire the author!

 

[sirspamalot]

ASTRO should hire the author!

When ASTRO speaks.. This is my response..

 

[sirspamalot]

I don't think SK will ever come back to SDN.

"Change my mind"

 

[OTN]

 

[elementaryschooleconomics]

"You mean I can't just do things without being questioned? I'm out! On RO Hub I can ask Anne to delete the things I don't like. In real life, I can't even get people fired!"

 

[OTN]

"You mean I can't just do things without being questioned? I'm out! On RO Hub I can ask Anne to delete the things I don't like. In real life, I can't even get people fired!"

"But I sure will try!"

 

[elementaryschooleconomics]

Dear friends -

Have you considered bringing nonsense internet disagreements into real life?

 

[sirspamalot]

Always a good idea to FAFO it right off the interwebs into your job security.