Advanced Practice Radiation Therapist

[Sheldor]

https://www.redjournal.org/article/S0360-3016(23)00450-9/fulltext

I don't have Red Journal access, what's this all about? What would this APRT do?

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[Gfunk6]

See this thread for discussion: Advanced practice providers in priv. prac. radiation oncology

 

[thecarbonionangle]

since the job market is great and clearly there arent enough rad oncs, everybody knows this!, we must train more people to take over what we do.

 

[Sheldor]

See this thread for discussion: Advanced practice providers in priv. prac. radiation oncology

That's different though, this is a path for RTT's to do... something advanced? Not clear what. Simul just had a tweet thread about it, maybe he'll weigh in here too

 

[Fpg1245]

This is a travesty. And Neha? The one who was so concerned about JM problems years ago. You can’t trust academia to solve your problems.

 

[Gfunk6]

Here is an actual quote from this article:

There is a concern about increasing service demand due to physician shortages and an increased number of patients requiring care; thus, the social factors must be accounted for in determining the need for an APRT to practice within the Radiation Oncology service. The number of unmatched residency positions in radiation oncology residency programs rose to 19% in 2020.45 Literature indicates this shortage is attributed to decreasing interest and awareness of radiation oncology and will be a problem for future delivery services demanding all stakeholders address this issue.46

This is such incredibly flawed reasoning that I am at a loss. In 2023 does anyone think there will be a SHORTAGE of Rad Oncs?

 

[Fpg1245]

Here is an actual quote from this article:



This is such incredibly flawed reasoning that I am at a loss. In 2023 does anyone think there will be a SHORTAGE of Rad Oncs?

We have just lost cabin pressure

 

[thecarbonionangle]

Medical student, even if russian FMG, if you are reading/hearing!, do not go into rad onc!

 

[medgator]

Here is an actual quote from this article:



This is such incredibly flawed reasoning that I am at a loss. In 2023 does anyone think there will be a SHORTAGE of Rad Oncs?

Neha should be ashamed

 

[BobbyHeenan]

The real reason *adjusts tin foil hat*

They want a future where the rad onc is at the mothership on Zoom, and some mid level or APRT runs the clinic/linac in the rural/suburban center with a big *insert academic center* logo on the front.

 

[thecarbonionangle]

The real reason *adjusts tin foil hat*

They want a future where the rad onc is at the mothership on Zoom, and some mid level or APRT runs the clinic/linac in the rural/suburban center with a big *insert academic center* logo on the front.

Tinfoil hat musing: None of them want to go to the “satellites” which are sometimes in undesirable, unsafe, far places. They swallowed up PPs and turned 1M jobs into “academic” pay. They took that money from PP and siphoned it into the evil tentacles of the mothership but they don’t want to put in the work.
These are decisions purely based on what is best for THEM, rather than the good of the field. “Leaders” will continue to dig the hell pit deeper.

 

[Fpg1245]

Tinfoil hat musing: None of them want to go to the “satellites” which are sometimes in undesirable, unsafe, far places. They swallowed up PPs and turned 1M jobs into “academic” pay. They took that money from PP and siphoned it into the evil tentacles of the mothership but they don’t want to put in the work.
These are decisions purely based on what is best for THEM, rather than the good of the field. “Leaders” will continue to dig the hell pit deeper.

They want to eliminate physicians from the delivery altogether. Have a few specialists doing token review using made up MLPs and AI while the criminal health orgs they work for pocket the cash and lobby CMS to keep their reimbursements high.

 

[Gfunk6]

The real reason *adjusts tin foil hat*

They want a future where the rad onc is at the mothership on Zoom, and some mid level or APRT runs the clinic/linac in the rural/suburban center with a big *insert academic center* logo on the front.

That's all folks, we can close this thread now. BobbyHeenan just said the quiet part out loud.

 

[elementaryschooleconomics]

So...

Sure seems to me like the gap this is filling is the residency expansion gap.

Residents were the cheapest way to generate revenue and minimize faculty work. The brakes slammed on that option.

Mid levels? Batter up.

 

[Sheldor]

So...

Sure seems to me like the gap this is filling is the residency expansion gap.

Residents were the cheapest way to generate revenue and minimize faculty work. The brakes slammed on that option.

Mid levels? Batter up.

I guess I'm confused though because what would a mid-level radiation therapist even do? They don't have any medicine training per-say, very odd

 

[elementaryschooleconomics]

I guess I'm confused though because what would a mid-level radiation therapist even do? They don't have any medicine training per-say, very odd

The question is - what can't they do?

Meaning, while we work in a regulated environment, there's still a lot of latitude. Depending on the state, RTTs (and mid-levels created from RTTs) can start lines for IVs. They can run a linac and diagnostic equipment, which nurses can't do.

While they can't "prescribe" in some senses, depending in the institution/state, you can create pre-approved order sets that could be used.

But most importantly - they can answer phones and complete documentation, so the "higher-ups" don't have to.

When you're at a giant academic center, especially a PPS-exempt center, it doesn't matter if they can drop E/M codes or not.

 

[deleted1111261]

The article literally says nothing. It’s amazing what gets published these days

 

[NotMattSpraker]

Here is an actual quote from this article:



This is such incredibly flawed reasoning that I am at a loss. In 2023 does anyone think there will be a SHORTAGE of Rad Oncs?

Genuine question. Are the reviewers and editors of IJROBP doing any work these days? Or do they just click through the articles and send them for pub?

 

[salubalu]

I believe it’s time for more competition in the publication field. Time for independent groups to come out and pay people for their work and pay reviewers for their work!

 

[elementaryschooleconomics]

Genuine question. Are the reviewers and editors of IJROBP doing any work these days? Or do they just click through the articles and send them for pub?

No need for reviewers, just people who can click a mouse.

This is fascinating - good catch @Gfunk6. I recently was in a meeting where this exact same line of reasoning was used, as in, "Match is bad therefore shortage coming".

I let it go, because it was directed by someone more senior than me to the C-suite level about our individual situation (thus not affecting wider issues), but I was perplexed as to how he arrived at this conclusion.

It appears this is not a unique phenomenon.

FOR THE PEOPLE STRUGGLING WITH ECONOMICS, NO, THE POOR PERFORMANCE OF RADIATION ONCOLOGY IN THE MATCH DOES NOT MEAN THERE'S A LOOMING SHORTAGE. YOUR LOGIC IS BAD AND YOU SHOULD FEEL BAD.

 

[NotMattSpraker]

I believe it’s time for more competition in the publication field. Time for independent groups to come out and pay people for their work and pay reviewers for their work!

We are piloting a project that is exactly this, all the info is in this thread:

 

[Fpg1245]

No need for reviewers, just people who can click a mouse.

This is fascinating - good catch @Gfunk6. I recently was in a meeting where this exact same line of reasoning was used, as in, "Match is bad therefore shortage coming".

I let it go, because it was directed by someone more senior than me to the C-suite level about our individual situation (thus not affecting wider issues), but I was perplexed as to how he arrived at this conclusion.

It appears this is not a unique phenomenon.

FOR THE PEOPLE STRUGGLING WITH ECONOMICS, NO, THE POOR PERFORMANCE OF RADIATION ONCOLOGY IN THE MATCH DOES NOT MEAN THERE'S A LOOMING SHORTAGE. YOUR LOGIC IS BAD AND YOU SHOULD FEEL BAD.

Academics arent dumb. Maybe they just avoid inconvenient conclusions as long as they can.

Yuo will physcially have to walk them through every false conclusion they could draw from this before they accept the obvious that they are overtraining and it needs to stop.

Until then, they will delay this conclusion by gaslighting med students and publishing nonsense.

 

[salubalu]

We are piloting a project that is exactly this, all the info is in this thread:

Would love to help if you need any. Frustrated by the current state of medicine and rad onc and I think things like this can help cause change.

 

[TheWallnerus]

Here is an actual quote from this article:



This is such incredibly flawed reasoning that I am at a loss. In 2023 does anyone think there will be a SHORTAGE of Rad Oncs?

And just because people aren’t matching in the match, we are still ultimately accepting in about the same number of rad oncs per year. Match rate is mostly superfluous in rad onc vis a vis ultimate per year rad onc production rate. A bad match rate means a shortage of GOOD rad oncs one day, not a shortage of rad oncs.

 

[medgator]

Genuine question. Are the reviewers and editors of IJROBP doing any work these days? Or do they just click through the articles and send them for pub?

@sueyom ???

 

[deleted1111261]

Would love to help if you need any. Frustrated by the current state of medicine and rad onc and I think things like this can help cause change.

Send your piece to me
[email protected]

 

[Chartreuse Wombat]

And our next president of ASTRO...yippee

 

[NotMattSpraker]

@sueyom ???

This is a "clinical investigation" published in an ASTRO journal with authors from ASTRO, ASRT, and the Radiation Therapy Association of New York State, Inc. It contains many controversial statements that are not cited, and I could have sworn that IJROBP just published that our supply and demand were balanced. The limitations section is 3 sentences long and ends with:

As a result, this research could be missing more specific practice aspects of the APRT model that could be relevant to this project.

Haha yea, I'd say so.

My question for Dr. Yom would be: is there any discussion among ASTRO EICs about the crisis we are facing in academic publishing?

 

[sirspamalot]

(Raises hand)

The one who was so concerned about JM problems years ago.

What is/are JM problems? Because if heard by someone who went to WashU this might have a different meaning than you intended..