Into the Valley of Death Rode the 600

[scarbrtj]

Rad onc has a "600" problem.

In five years, there will be 6,000 rad oncs in the U.S.
There will be six hundred thousand de novo new rad onc patients per year in the U.S. then.
This will equate to 600,000/6000= 100 new patients per rad onc per year.

To reiterate, about 100 new patients per rad onc, per year, in the U.S. in five years.
Two new patients per week.

No orgy of sources; I'll give one link and one link only.

Show I'm wrong.

#RadOncLightBrigade

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[Chartreuse Wombat]

I won't say you are wrong. But who cares.

DId your hear about the Zoom meeting "immersive educational experience planned for you" at ASTRO 2020. Early bird registration has been extended (never a good sign).

Enough negativity-I intend to help solve the "600 problem" by retiring in 2025. Thirty-two years is enough. I ran the gamut from external landmarks (yes, it's a thing) to 2D to 3D to IMRT and finally SBRT and oligo.

I can hear the young people now "OK boomer"

 

[StIGMA]

I'd be happy if we had 60 people who could work together to accomplish something of substance in this field.

 

[thecarbonionangle]

I'd be happy if we had 60 people who could work together to accomplish something of substance in this field.

if these 60 people are not working on taking radiation out of the equation because the best radiation is no radiation, you’re SOL

 

[Palex80]

Here Scarb, just for you...

 

[thecarbonionangle]

Better reference, you missed your chance to cite revelations!. Ladies and gentlemen, i give you the four horsemen of the Apocalypse: hypofractionation, disappearing indications, AI, reimbursement cuts. I will let you pick which colour horse represents which one. For it is written.

 

[ramsesthenice]

Better reference, you missed your chance to cite rebellations!. Ladies and gentlemen, i give you the four horsemen of the Apocalypse: hypofractionation, disappearing indications, AI, reimbursement cuts. I will let you pick which colour horse represents which one. For it is written.

Whichever it is I am sure it’s only a matter of time before someone posts a photoshop of Gustav Dorre’s Death on a Pale Horse with Paul Wallner’s face.

 

[thecarbonionangle]

Whichever it is I am sure it’s only a matter of time before someone posts a photoshop of Gustav Dorre’s Death on a Pale Horse with Paul Wallner’s face.

Must happen!

 

[RickyScott]

You can’t unf—k a pig. That’s why closing off all/100% of residencies will not solve the problem. And, why applicants who attend mskcc, Harvard etc will still see a lot of pain.

 

[Chartreuse Wombat]

I think supervision requirements should take the place of AI. Not sure that AI is that influential.

 

[Mandelin Rain]

I think supervision requirements should take the place of AI. Not sure that AI is that influential.

Not yet. Give it 10 years.

 

[Chartreuse Wombat]

 

[thecarbonionangle]

View attachment 316461

yes. So which one is which. Discuss. The darth sidious PW meme needs to be photoshopped as the creeping dark clothed man in the back. Sorta like the antichrist casting the plague on the world with the horses. I’d title the art piece “the breadlines are coming”

 

[Chartreuse Wombat]

yes. So which one is which. Discuss. The darth sidious PW meme needs to be photoshopped as the creeping dark clothed man in the back. Sorta like the antichrist casting the plague on the world with the horses. I’d title the art piece “the breadlines are coming”

White horse(Conquest)-Hypofractionation/SBRT (precise arrow and the white coincides with the "virtue" espoused by fraction shamers)
Red horse (War)-Reimbursement cuts (he has a sword after all)
Black horse (Pestilence)- Supervision requirements...ASTRO's hypocrisy on the issue is karma
Pale horse (Death)-Disappearing indications

 

[Gfunk6]

As I walk through the valley of the shadow of death
I take a look at my life and realize there's not much left
'Coz I've been applying for jobs for so long, that
Even Wallner thinks that my mind is gone

 

[Mandelin Rain]

As I walk through the valley of the shadow of death
I take a look at my life and realize there's not much left
'Coz I've been applying for jobs for so long, that
Even Wallner thinks that my mind is gone

And I never kissed an ass that did deserve it,
Me not treated like a punk? You know that's unheard of.

 

[Gfunk6]

You better watch how you're networkin', and where you're workin'
Or you and your homies might be lining the breadlines

 

[Mandelin Rain]

I hate fellowship, but I gotta, loc.
As all the jobs I find just go up in smoke, fool.

 

[Gfunk6]

I'm NOT the kinda RO the little residents wanna be like
On my knees in the night, sayin' prayers on the ASTRO jobs website

 

[evilbooyaa]

Been spendin' most our lives
Reachin' for academics' paradise
Been spendin' most our lives
Reachin' for academics' paradise
Keep spendin' all our lives
Hopin' for academics' paradise
Keep spendin' all our lives
Hopin' for academics' paradise

 

[medgator]

Tell me why are we so blind to see,
that reducing indications is true folly

 

[thecarbonionangle]

White horse(Conquest)-Hypofractionation/SBRT (precise arrow and the white coincides with the "virtue" espoused by fraction shamers)
Red horse (War)-Reimbursement cuts (he has a sword after all)
Black horse (Pestilence)- Supervision requirements...ASTRO's hypocrisy on the issue is karma
Pale horse (Death)-Disappearing indications

yup absolutely spot on.

 

[evilbooyaa]

yup absolutely spot on.

 

[Ray D. Ayshun]

This struck me as appropriate for this thread:



My fall back is that, "I'm a *cough*ic radiologist, I'd be happy to check ET tube placement"

 

[scarbrtj]

Didn’t realize I was surrounded by such slap knee funny liberal arts scholars.

 

[RickyScott]

You can’t unf—k a pig. That’s why closing off all/100% of residencies will not solve the problem. And, why applicants who attend mskcc, Harvard etc will still see a lot of pain.

Once a cup is full, it is in fact full. Going to a top program is going to have limited benefit. Most history PhD grads from Harvard dont get faculty jobs today out of the program (maybe in the 1970s and 80s). Unfortunately, for them, this applies across PhD disciplines) but in medicine, students can chose plenty of great specialties.

 

[RollTideRadOnc]

Scarb is correct (as he is about most things except for the phantom menace of low grade toxicity in prostate hypofractionation ).

doesn’t matter if it’s a 100 patients per year or 150. This is our future.

I propose it won’t ruin the field for everyone.

There will be those at academic motherships who do well and have good jobs for mediocre pay. Maybe 20 to 30% of us?

there will be those who are second class systems at academic satellites. Maybe another 20-30%?

there will then be those who are in marginal pp or employed positions

and then a class of itinerant docs traveling in wagons across the country, selling trinkets and doing locums