ROCR

[sirspamalot]

That’s the real 750orGTFO

Still a W2 but your heart is in the right place. Your ASTRO dues aren't..

#defundASTRO

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Members don't see this ad.

 

[yesmaster]

If we could get meaningful change by funneling all private practice and community rad onc’s to a separate professional society, that lobbies payors, government, and acgme for our interests and not just proton pps-exempt chairpersons interests, that would be awfully swell. Does ACRO do that?

I do appreciate PRO and Red Journal access, strangely, their articles are often not included in ClinicalKey.

 

[sirspamalot]

If we could get meaningful change by funneling all private practice and community rad onc’s to a separate professional society, that lobbies payors, government, and acgme for our interests and not just proton pps-exempt chairpersons interests, that would be awfully swell. Does ACRO do that?

I do appreciate PRO and Red Journal access, strangely, their articles are often not included in ClinicalKey.

What's ClinicalKey do? I mean how does it help you vs sci-hub or pubmed or whatever?

Also yeah ACRO is helpful but the Proton Centers lean in there too so what. At least they defend pp interests. Don't always coordinate or even see eye to eye with ASTRO.

Unfortunately ACRO voice is much smaller than ASTRO yet often gets more done with greater impact. Every pp radonc should drop ASTRO and join ACRO.

Plus you can actually earn Fellowship as pp... unlike ASTRO...

 

[medgator]

What's ClinicalKey do? I mean how does it help you vs sci-hub or pubmed or whatever?

Also yeah ACRO is helpful but the Proton Centers lean in there too so what. At least they defend pp interests. Don't always coordinate or even see eye to eye with ASTRO.

Unfortunately ACRO voice is much smaller than ASTRO yet often gets more done with greater impact. Every pp radonc should drop ASTRO and join ACRO.

Plus you can actually earn Fellowship as pp... unlike ASTRO...

Free limoncello kit this month when you join too. ASTRO couldn't care less when you pay dues and they definitely didn't care when i didn't renew several years ago

 

[CaesarRO]

Free limoncello kit this month when you join too. ASTRO couldn't care less when you pay dues and they definitely didn't care when i didn't renew several years ago

As an existing ACRO member I'm bummed I can't get the limoncello kit

 

[Rad Onc SK]

Here is ASTRO PAC

View attachment 374274
Not sure why there are different numbers. I am not wise about giving money to pols

I have some experience here. I was the PAC chair for the 2010-16 election cycles, which is how numbers are reported. These are "hard dollars", which we can freely donate to candidates. There are automatic annual spends, such as Chairs for Ways and Means as well as key members of the doctor caucus. If you are a political junkie, 2016 (vs. 2012) is interesting. You expect to see a spike in PAC giving during a Presidential cycle but we didn't for that election.

 

[Rad Onc SK]

As an existing ACRO member I'm bummed I can't get the limoncello kit

Me too!

 

[Rad Onc SK]

Damn, not a bad gig at all.

Her compensation package is within range for the size of ASTRO. The compensation package is reviewed by the board with each contract renewal using an independent firm with benchmarking figures.

 

[Rad Onc SK]

If we could get meaningful change by funneling all private practice and community rad onc’s to a separate professional society, that lobbies payors, government, and acgme for our interests and not just proton pps-exempt chairpersons interests, that would be awfully swell. Does ACRO do that?

I do appreciate PRO and Red Journal access, strangely, their articles are often not included in ClinicalKey.

Good question. I love ACRO and what they do. Their volunteer leadership is amazing and their pipeline seems strong. I am a member myself.

ASTRO handles more "things". I think it's important that ACRO and ASTRO work together, along with ACR and ASCO.

There seems to be a push in this forum, at least by some, to watch ASTRO die. I don't think this is a great strategy, especially if you are younger and have 20+ years left in this field. I think the better strategy is to join, get engaged and become a leader. It's a volunteer-run society. Fix it from the inside. Rebuilding ASTRO would be very, very hard.

RO docs are still envied by other docs. We got so far out ahead when RBRVS went into effect in 1992 and we got another boost in the early to mid 2000's with IMRT (77418 and 77301). TBH, I don't see something like that coming down the pike anytime soon. We have been able to protect those codes, along with some from the 1990's, pretty well. ASTRO RUC is admired by other specialties. I know many people on this forum won't believe that, but it's true. ASTRO is the only society to send a team to each RUC, the last I checked. This is expensive. But it keeps us aware of the landscape and helps us build relationships.

 

[deleted1111261]

Her compensation package is within range for the size of ASTRO. The compensation package is reviewed by the board with each contract renewal using an independent firm with benchmarking figures.

That is a really dismissive answer, SK.

We are paying that salary, man. I don't care who they use to review the contract. The membership has been frustrated with the direction of the leadership for a long time. Criticism of her leads to being banned for serving. This sounds more like a dictatorship than a servant-leader.

A similarly small specialty (but larger than ours) - dermatology - Elizabeth Usher makes $660k. So, how are we in line? 90k less for the CEO of a larger specialty?

 

[Mandelin Rain]

A similarly small specialty (but larger than ours) - dermatology - Elizabeth Usher makes $660k. So, how are we in line? 90k less for the CEO of a larger specialty?

Derms prescribe a lot of radiation and make A LOT of money. Maybe we can roll into their society.

 

[RickyScott]

That is a really dismissive answer, SK.

We are paying that salary, man. I don't care who they use to review the contract. The membership has been frustrated with the direction of the leadership for a long time. Criticism of her leads to being banned for serving. This sounds more like a dictatorship than a servant-leader.

A similarly small specialty (but larger than ours) - dermatology - Elizabeth Usher makes $660k. So, how are we in line? 90k less for the CEO of a larger specialty?

The issue is not one of competence, but rather antagonism, that she actively works works against the best interests of her membership. I honestly feel that every day, she is trying to hurt me.

 

[TheWallnerus]

The issue is not one of competence, but rather antagonism, that she actively works works against the best interests of her membership. I honestly feel that every day, she is trying to hurt me.

I unhesitatingly agree

Urorads brouhaha really rubbed me wrong way if only because there had been times I had considered joining such a practice

No one warned me I was about to break all ethical and moral medical principles by deciding to let a urologist employ me instead of a large hospital or university

 

[communitydoc13]

Resource-based relative value scale - Wikipedia

en.wikipedia.org

Important read for anyone not familiar with RUCs and value setting. The link to RUC within this one is excellent, from the link:

Before the 1992 implementation of the Medicare fee schedule, physician payments were made under the "usual, customary and reasonable" payment model (a "charge-based" payment system).

All weird as hell of course. I am not convinced that RUCs acting as de-facto rate setters or CMS acting as de-jure rate setters do any calculations that are more meaningful than setting rates by "usual, customary and reasonable" standards. Clearly CMS (appropriately) has a will to pay less and RUCs are incentivized to preserve or increase payments. The government employs a lot of really smart boffins, who I'm sure believe that they can determine value analytically. While I'm not sure that this is possible ever, the whole RUC process certainly makes it impossible.

It is also true that we clearly pay too much for healthcare overall.

I do believe that within our specialty at least (probably many specialties), the narrative between CMS and these RUCs is largely that there are rogue and greedy private practice docs overcharging CMS and that this is what needs to be rooted out and not rewarded and is costing big money. Meanwhile, large institutions with enormous administrative overhead and economies of scale are exempted from much of the cost cutting (and often serve private patients disproportionately).

The critique here regarding ASTRO is relating payment to setting, picking winners within a field or encouraging high value for interventions only provided at large centers that really have very little value demonstrated in terms of outcomes. At some point, institutions become too large and all of us are hurt. There's got to be a curve out there somewhere relating value to institution size. It's not going to be monotonic.

Culturally, the FED is going to relate to Mayo or MD Anderson more than they are to private practice docs. They are also clearly valuing these larger places preferentially over smaller community hospitals. ASTRO seems to be willing to go along with this regarding therapeutic radiation (encouraging it even). It's a very bad calculation IMO.

 

[grenz]

The issue is not one of competence, but rather antagonism, that she actively works works against the best interests of her membership. I honestly feel that every day, she is trying to hurt me.

What? Criticism of the ASTRO CEO is literally something I’ve only heard SDN complain about in the last week.

 

[sirspamalot]

Her compensation package is within range for the size of ASTRO. The compensation package is reviewed by the board with each contract renewal using an independent firm with benchmarking figures.

This didn't age well even in the last 12 hours. I'm sorry but it seems that once inside the fold the corporate "we're sorry" language has already begun.

"But this time it's different" some in the crowd screamed "they hear us on SDN.. they care about pp.. they'll surely act!"

Narrator: They did not. Once again the masses had swallowed the bait. Out with the old in with the new. It made no difference. The wheel continued to grind pp into dust...

-----

The correct answer could have been: we hear you and believe it's time to improve the lot of pp and not just our PPS exempt Proton brethren. A new CEO competitive search will be undertaken and a new hire at market rate determined by a true independent 3rd party will be determined. We will emphasize the importance of pp in both our mission and action. We don't just hear you we are acting for your benefit. We will no longer support the position that PPS exempt centers should be disproportionately paid. We will focus on improving pp pay. We're sorry we've ignored you for years but we are ready to move forward with you.

 

[RadOncDoc21]

What? Criticism of the ASTRO CEO is literally something I’ve only heard SDN complain about in the last week.

That was by design… most company c-suites get paid well in secret.

 

[CaesarRO]

This didn't age well even in the last 12 hours. I'm sorry but it seems that once inside the fold the corporate "we're sorry" language has already begun.

"But this time it's different" some in the crowd screamed "they hear us on SDN.. they care about pp.. they'll surely act!"

Narrator: They did not. Once again the masses had swallowed the bait. Out with the old in with the new. It made no difference. The wheel continued to grind pp into dust...

-----

The correct answer could have been: we hear you and believe it's time to improve the lot of pp and not just our PPS exempt Proton brethren. A new CEO competitive search will be undertaken and a new hire at market rate determined by a true independent 3rd party will be determined. We will emphasize the importance of pp in both our mission and action. We don't just hear you we are acting for your benefit. We will no longer support the position that PPS exempt centers should be disproportionately paid. We will focus on improving PPS pay. We're sorry we've ignored you for years but we are ready to move forward with you.

As Simul said, somewhere above, I think it's important to remember what's within the scope of the ASTRO president and what's not. He just shared the mechanism by which her pay is set -- not whether he agrees with it or not. Frankly, I think it's too much for anyone to think a newly elected president-elect would publicly denounce a CEO and demand her pay be cut (... to what? Half of what it is now? -$90k to match derm? Why do we look at Derm in particular?)

CEO pay is an issue in this country and something I'm not happy about but to declare SK's election meaningless on day 1 over something like this is hyperbolic. Are there any examples out there of CEOs successfully having their pay reduced because of the outcry from their membership? More importantly -- is that really the most important thing for us as people who care about our field to be focusing on? Seems like a strange litmus test.

Change will be slow and incremental if it comes at all. I'm still grateful for the fact he is out here engaging. I don't expect him to check in daily, either.

 

[grenz]

That is a really dismissive answer, SK.

We are paying that salary, man. I don't care who they use to review the contract. The membership has been frustrated with the direction of the leadership for a long time. Criticism of her leads to being banned for serving. This sounds more like a dictatorship than a servant-leader.

Can you think of any institution that would readily hire/accept involvement from someone as publicly critical of it? I don’t see this as some exceptional reaction

 

[deleted1111261]

As Simul said, somewhere above, I think it's important to remember what's within the scope of the ASTRO president and what's not. He just shared the mechanism by which her pay is set -- not whether he agrees with it or not. Frankly, I think it's too much for anyone to think a newly elected president-elect would publicly denounce a CEO and demand her pay be cut (... to what? Half of what it is now? -$90k to match derm? Why do we look at Derm in particular?)

CEO pay is an issue in this country and something I'm not happy about but to declare SK's election meaningless on day 1 over something like this is hyperbolic. Are there any examples out there of CEOs successfully having their pay reduced because of the outcry from their membership? More importantly -- is that really the most important thing for us as people who care about our field to be focusing on? Seems like a strange litmus test.

I don't think you're talking to me - I am not a nihilist and I think new blood is a great opportunity. Change will be slow and incremental if it comes at all. I'm still grateful for the fact he is out here engaging. I don't expect him to check in daily, either.

Sameer is a thoughtful guy and he handles criticism well, and often times convinces me that I should take a different view of things.
This is not the same as CEO of a publicly traded company - that's why I'm more critical of it.

My point is that many of us think that $750k is a lot of money. Many of us think that the society does not serve us well.
If the only answer to this is - "well some benchmarking company said this is the number" - I think it doesn't really sit well.

I'm not saying to lower by any specific number. I was curious what other societies pay - Derm is still competitive and so it was just an example. I am certain IM society is paid more. If I have time later, I can look up some other small specialty societies.

 

[sirspamalot]

Sameer is a thoughtful guy and he handles criticism well, and often times convinces me that I should take a different view of things.
This is not the same as CEO of a publicly traded company - that's why I'm more critical of it.

My point is that many of us think that $750k is a lot of money. Many of us think that the society does not serve us well.
If the only answer to this is - "well some benchmarking company said this is the number" - I think it doesn't really sit well.

I'm not saying to lower by any specific number. I was curious what other societies pay - Derm is still competitive and so it was just an example. I am certain IM society is paid more. If I have time later, I can look up some other small specialty societies.

No sorry but we are absolutely going to speak up and say that the STATUS QUO MUST GO.

New CEO
New Mission
Immediate action

Are the proposed 2024 cuts not enough to motivate you? Pigs at the trough with too many residency slots? Do you like getting racked.. I just don't understand.

I refuse to become an ASTRO dues paying lackey as a pp until I get something of value beyond a printed copy of the red/white journal.

Vote with your dollars peeps.

Ps. I'll go out on a limb and predict that nothing meaningful will change in the next 5 years except I will have about 3.6k more retained net worth.

 

[communitydoc13]

RO docs are still envied by other docs. We got so far out ahead when RBRVS went into effect in 1992 and we got another boost in the early to mid 2000's with IMRT (77418 and 77301).

This is undoubtedly true. It has been a slide since.

Of course as @RickyScott has articulated many a time. It's the residency numbers stupid. Very few specialties pay for themselves with pro-fees.

Either meaningfully grow the field (more things to do, not more people) or shrink the field as indications decline and efficiency (in reasonable hands, not necessarily the academic behemoths) increases.

 

[RadOncDoc21]

I’m starting to sense political jargon and a real sense of needing to tone down my expectations regarding ASTRO and needed changes to be made.

 

[medgator]

Her compensation package is within range for the size of ASTRO. The compensation package is reviewed by the board with each contract renewal using an independent firm with benchmarking figures.

Towing the line. Can't make everyone happy all the time.

The bottom line is that radiation oncology is sick as a specialty. The question is do you want to follow the status quo at ASTRO, whose leadership and prominent members have turned rad onc into one of the least desirable specialties for US medical students when it was at the apex of desirability for US MDs not even a decade or two ago, or do you want to forge a new path that returns the specialty to where it used to command great respect and interest from medical students?

Many things need to be called out, changed and addressed before we hit even more icebergs. If you piss off established leadership, you're probably doing something right during your upcoming tenure imo @Rad Onc SK

 

[RickyScott]

This is undoubtedly true. It has been a slide since.

Of course as @RickyScott has articulated many a time. It's the residency numbers stupid. Very few specialties pay for themselves with pro-fees.

Either meaningfully grow the field (more things to do, not more people) or shrink the field as indications decline and efficiency (in reasonable hands, not necessarily the academic behemoths) increases.

CMS reimbursement is down significantly adjusted or unadjusted for inflation over the past 10 years, but large radonc departments are still earning more than ever due to price gouging from monopolistic leverage. Sure, they could have earned even more if cms reimbursement was stable and kept pace with inflation, just like they can earn more by deliberately oversupplying the market with residents.

Codes and reimbursement have become completely disconnected from salaries and the job market in the setting of widespread employment. As noted, the ROCR can improve reimbursement but will almost certainly hurt the job market/mobilty/salaries etc.

 

[NotMattSpraker]

There seems to be a push in this forum, at least by some, to watch ASTRO die. I don't think this is a great strategy, especially if you are younger and have 20+ years left in this field. I think the better strategy is to join, get engaged and become a leader. It's a volunteer-run society. Fix it from the inside. Rebuilding ASTRO would be very, very hard.

I was a highly engaged member and dropped my membership. I talked about this in the most recent Accelerators, which was intended in part to be feedback for ASTRO.

A person can be critical of ASTRO and even drop their membership and still root for them to live.

Volunteer-run societies listen to their volunteers and try to create a lot of value for them since the expectation is that they are giving you their time for free. If they really want to engage members and grow the base, ASTRO would do well to remember that membership is voluntary and there are other organizations to engage and become leaders.

I have so many friends that say they are "fixing it from the inside". Sorry, but I don't see it today. I'm always optimistic about the future though

 

[elementaryschooleconomics]

I agree with Sameer - the CEO salary is fair market value.

Which is by design, because it's an unbreakable defense - not only to member criticism, but in case the IRS or anyone else comes knocking.

I don't care about the number. It could be $1 or $10 million.

I care about the outcomes. This is overused but - are we better of today than we were ten years ago? 20 years ago?

We all know the answer is no.

You can say everyone meant well but...the road to hell is paved with good intentions.

 

[deleted1111261]

I agree with Sameer - the CEO salary is fair market value.

Which is by design, because it's an unbreakable defense - not only to member criticism, but in case the IRS or anyone else comes knocking.

I don't care about the number. It could be $1 or $10 million.

I care about the outcomes. This is overused but - are we better of today than we were ten years ago? 20 years ago?

We all know the answer is no.

You can say everyone meant well but...the road to hell is paved with good intentions.

Based on what, ESE?
What FMV is in place for society CEO?

Reason I'm being stickler is b/c they are literally making us leave money on table.

Easy when c-suite has no skin in the game* (yeah, i'm gonna use this a lot) and gets their salary whatever happens to us.

 

[medgator]

Good question. I love ACRO and what they do. Their volunteer leadership is amazing and their pipeline seems strong. I am a member myself.

ASTRO handles more "things". I think it's important that ACRO and ASTRO work together, along with ACR and ASCO.

There seems to be a push in this forum, at least by some, to watch ASTRO die. I don't think this is a great strategy, especially if you are younger and have 20+ years left in this field. I think the better strategy is to join, get engaged and become a leader. It's a volunteer-run society. Fix it from the inside. Rebuilding ASTRO would be very, very hard.

ASTRO and ASTRO PAC attacked private practice radiation oncology when they went after the In office ancillary exemption (IOAE) and urorads partnerships.

You were part of that effort then. Do you still stand by it? Why would anyone want be a part of an organization that was actively attacking their interests? 🤷‍♂️. In combination with flooding the market with unnecessary residents and residency programs and claiming anti trust for years rather than studying the issue, why would those of us in private practice ever trust ASTRO now? Not to mention the oversupply has really hurt everyone younger in training or out in practice, community/PP and academic alike

 

[RadOncDoc21]

I’ll say it.. Let’s just say whatever the number, we’re definitely not getting our money’s worth.

 

[elementaryschooleconomics]

Based on what, ESE?
What FMV is in place for society CEO?

This is actually a whole industry in and of itself. This argument/debate is repeated over and over and over again for any executive salary no matter if it's Lockheed Martin or Anthem.

Let me rephrase - for the primary professional society for a medical specialty, with a total "value" of $20-$30 million (depending on how assets are sliced up, revenue flux, investment performance, etc) a base salary of $400k-$500k with total comp of $700k-$800k for the CEO is a number the government won't send the FBI in for.

I'm not saying that I personally agree with this particular person, in this particular society, with this particular BOD, is "earning" this comp package - I'm saying that the position of CEO having a total comp package like this would in all likelihood withstand legal scrutiny.

 

[deleted1111261]

ASTRO and ASTRO PAC attacked private practice radiation oncology when they went after the In office ancillary exemption and urorads partnerships.

You were part of that effort then. Do you still stand by it? Why would anyone want be a part of an organization that was actively attacking their interests? 🤷‍♂️

There will never be an informative debate about this - I've spent some time chatting about it - and he's pretty certain that it was the right move. Most of us in the community will never agree. This was a problem for academic centers, not for most of us. The sensationalized it when it was hardly affecting the vast majority of us on the ground.

I would rather work for a physician owner (urologist) then under a department chair.

This got very out of hand when you had that Georgetown researcher publishing (Jean something?) all this stuff on UroRad and WSJ / NYT writing articles about it. So, ASTRO cared more about mainstream media than they did about the membership who didn't want us to spend capital on it.

You or whoever said - why would an organization pick on its own members? That is a very good question.

 

[deleted1111261]

This is actually a whole industry in and of itself. This argument/debate is repeated over and over and over again for any executive salary no matter if it's Lockheed Martin or Anthem.

Let me rephrase - for the primary professional society for a medical specialty, with a total "value" of $20-$30 million (depending on how assets are sliced up, revenue flux, investment performance, etc) a base salary of $400k-$500k with total comp of $700k-$800k for the CEO is a number the government won't send the FBI in for.

I'm not saying that I personally agree with this particular person, in this particular society, with this particular BOD, is "earning" this comp package - I'm saying that the position of CEO having a total comp package like this would in all likelihood withstand legal scrutiny.

Lockheed and Anthem are publicly traded companies. Different (to me).

Society is a "non-profit". Service. Etc. I'd love to see all the specialties and see the salaries. CHAT GPT?

 

[TheWallnerus]

What? Criticism of the ASTRO CEO is literally something I’ve only heard SDN complain about in the last week.

We have complained about ASTRO a lot (not addressing oversupply, gaslighting, proton favoritism, breast IMRT hatred that’s been hurting women, antitrust BS, totally against loss of direct supervision even for a country solo rad onc… and the weird APM fascinations going back almost a decade) and thus by proxy the CEO. That’s the way I always took it.

 

[RickyScott]

There will never be an informative debate about this - I've spent some time chatting about it - and he's pretty certain that it was the right move. Most of us in the community will never agree. This was a problem for academic centers, not for most of us. The sensationalized it when it was hardly affecting the vast majority of us on the ground.

I would rather work for a physician owner (urologist) then under a department chair.

This got very out of hand when you had that Georgetown researcher publishing (Jean something?) all this stuff on UroRad and WSJ / NYT writing articles about it. So, ASTRO cared more about mainstream media than they did about the membership who didn't want us to spend capital on it.

You or whoever said - why would an organization pick on its own members? That is a very good question.

urorads was affecting some of the big academic centers in several markets back then.

 

[TheWallnerus]

Sameer is a thoughtful guy and he handles criticism well, and often times convinces me that I should take a different view of things.
This is not the same as CEO of a publicly traded company - that's why I'm more critical of it.

My point is that many of us think that $750k is a lot of money. Many of us think that the society does not serve us well.
If the only answer to this is - "well some benchmarking company said this is the number" - I think it doesn't really sit well.

I'm not saying to lower by any specific number. I was curious what other societies pay - Derm is still competitive and so it was just an example. I am certain IM society is paid more. If I have time later, I can look up some other small specialty societies.

One way this is an apt comparison is the ASTRO CEO makes more than 50% of all rad oncs do, but more than 50% of derms make more than the derm society CEO. Don’t try to throw published data at me because I know this is true

 

[elementaryschooleconomics]

Lockheed and Anthem are publicly traded companies. Different (to me).

Society is a "non-profit". Service. Etc. I'd love to see all the specialties and see the salaries. CHAT GPT?

Pretty much the same for Peds - I'm sure they all will be in this range.

 

[TheWallnerus]

View attachment 374427

Pretty much the same for Peds - I'm sure they all will be in this range.

One way this is an apt comparison is the ASTRO CEO makes more than 50% of all rad oncs do, but more than 50% of derms make more than the derm society CEO. Don’t try to throw published data at me because I know this is true

My comparison will not work for peds!

 

[Neuronix]

urorads was affecting some of the big academic centers in several markets back then.

I remember my former chairs (all three of them) in residency bemoaning all the urorads in town.

My senior year the chair offered me a fellowship position.

Meanwhile, the urorads shop was looking to pay double what they were paying to assistant professors there.

Who is really out to get us as a specialty?

 

[TheWallnerus]

Maybe we could put the ASTRO CEO on pay for performance. Make the job value based. As long as the CEO meets certain metrics, has good reviews from the membership, completes wellness modules and listening tours that we may occasionally require, hits RVU (really visionary usefulness) targets, and provides direct supervision in her office space at least four days a week, 750K sounds OK.

 

[TheWallnerus]

I remember my former chairs (all three of them) in residency bemoaning all the urorads in town.

My senior year the chair offered me a fellowship position.

Meanwhile, the urorads shop was looking to pay double what they were paying to assistant professors there.

Who is really out to get us as a specialty?

Also what was just nuts (pardon the pun) is IMRT so much better for (most) patients than getting a prostatectomy. We had a whole specialty (urology) trying to go all in on the biggest advance in radiotherapy since Coutard and ASTRO gave them nothing but flung poop.

 

[Neuronix]

Also what was just nuts (pardon the pun) is IMRT so much better for (most) patients than getting a prostatectomy. We had a whole specialty (urology) trying to go all in on the biggest advance in radiotherapy since Coutard and ASTRO gave them nothing but flung poop.

In my neck of the woods the name of the game is robotic prostatectomy followed by IMRT. High risk is best risk. Double the billing.

 

[Mandelin Rain]

A society that should exist largely to actively push the utilization of radiation therapy, has routinely attacked it's own membership because they utilize radiation therapy.

 

[TheWallnerus]

A society that should exist largely to actively push the utilization of radiation therapy, has routinely attacked it's own membership because they utilize radiation therapy.

I love to find a psychological basis in a lot of human behavior, and this is the definition of neurotic. If you think of the med school and early life experiences of many of our elders (rad onc was NOT a top tier specialty when they joined rad onc… Eli Glatstein almost flunked out of med school!) it makes sense. When I was first coming up in rad onc there was a palpable but subtle jealousy I always sensed that academic rad onc had of very successful PP rad onc. That can weigh on one emotionally through the years.

 

[RickyScott]

I love to find a psychological basis in a lot of human behavior, and this is the definition of neurotic. If you think of the med school and early life experiences of many of our elders (rad onc was NOT a top tier specialty when they joined rad onc… Eli Glatstein almost flunked out of med school!) it makes sense. When I was first coming up in rad onc there was a palpable but subtle jealousy I always sensed that academic rad onc had of very successful PP rad onc. That can weigh on one emotionally through the years.

View attachment 374428

Totally agree. Its not trolling to point out that a lot of senior radoncs were at the bottom of their class, just a fact. and now history is repeating itself. Psychologically also explains their fetish for md PhDs.

 

[communitydoc13]

Its not trolling to point out that a lot of senior radoncs were at the bottom of their class

This may be factual, and the reference to jealousy of highly paid PP docs was definitely true in the 2000s, but the bottom dwellers advanced the field and the remarkably elite talent of the last 15-20 years has not quite made the same mark.

Why? Just more intrinsic opportunity for discovery (what have particle physicists done for us lately vs. pre-1980). Also, I have a theory that a little less competition (and less emphasis on productivity) leads to a much more meaningful academic product.

 

[deleted1111261]

This may be factual, and the reference to jealousy of highly paid PP docs was definitely true in the 2000s, but the bottom dwellers advanced the field and the remarkably elite talent of the last 15-20 years has not quite made the same mark.

Why? Just more intrinsic opportunity for discovery (what have particle physicists done for us lately vs. pre-1980). Also, I have a theory that a little less competition (and less emphasis on productivity) leads to a much more meaningful academic product.

This is true
We don’t need credentials to advance
We needed creative minds and risk takers

 

[TheWallnerus]

but the bottom dwellers advanced the field

I can make a great argument that a neurosurgeon is responsible for todays use of SRS SBRT and IMRT. Especially for IMRT believe it or not.

 

[thecarbonionangle]

The best thing to do is to let SK cook and to judge tenure based on that. Not even president yet.

 

[Rad Onc SK]

The best thing to do is to let SK cook and to judge tenure based on that. Not even president yet.

Thank you. I appreciate it.

And to go to a step further, I’m not on the board right now and I haven’t been for nearly five years.