PP offer - please advise

[medgator]

Is this a training era thing? Why do you refuse to use 4D? It doesn’t make sense. Old dogs can learn new tricks!

So when you do 4DCT on your glottics, how do the waveforms look when they swallow?

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[jondunn]

So when you do 4DCT on your glottics, how do the waveforms look when they swallow?

for you to even make this joke shows me that you are out of your element

 

[TheWallnerus]

Ok someone explain 4DCT on the glottis. I tried not to say anything but I am sticking my… neck out.

 

[jondunn]

Ok someone explain 4DCT on the glottis. I tried not to say anything but I am sticking my… neck out.

its a medgator strawman. no one does that.

 

[medgator]

its a medgator strawman. no one does that.

Seriously dude, try to keep up:

PP offer - please advise

I am currently a hospital employee, a few years out BC. I work in a small town (no prior connections here, no family, etc). The practice is good with new machines, good support staff, good morale among department, I do a lot of SBRT/SRS/IMRT. I am paid well at MGMA median. I recently met with a...

forums.studentdoctor.net

 

[deleted1111261]

Seriously dude, try to keep up:

PP offer - please advise

I am currently a hospital employee, a few years out BC. I work in a small town (no prior connections here, no family, etc). The practice is good with new machines, good support staff, good morale among department, I do a lot of SBRT/SRS/IMRT. I am paid well at MGMA median. I recently met with a...

forums.studentdoctor.net

that guy was being sarcastic…

 

[medgator]

that guy was being sarcastic…

Obviously.... But he got my drift and came up with the "strawman" @jondunn

 

[Ray D. Ayshun]

Did I hear that representatives of jondunn and medgator are meeting in Istanbul today?

 

[elementaryschooleconomics]

Did I hear that representatives of jondunn and medgator are meeting in Istanbul today?

I heard KHE was just hired as the mediator!

Now, I can't tell if he's a W2 or 1099 mediator, but here's 36 items you need to consider when deciding between the two...

 

[deleted1111261]

They met in Istanbul, over a pot of rich Turkish coffee. Gator, wearing his usual t-shirt and nothing else (commonly referred to as 'shirtcocking' or "Winnie The Pooh-ing") had a sheepish ****-eating grin plastered on his face. Dunn, appeared visibly angry while popping laxatives like one would pop Tic Tacs. The mediator was KHE88, who was allowed to come off of his traveling mobile linac by his partner (who's kidding who, his boss), Todd Scarborough. KHE88, as we all know, was made of money. But we found out that was to be taken literally. His DNA from a recent 23 and Me test revealed that he was 4% USD. The mediation started with recriminations and accusations ...

 

[Ray D. Ayshun]

They met in Istanbul, over a pot of rich Turkish coffee. Gator, wearing his usual t-shirt and nothing else (commonly referred to as 'shirtcocking' or "Winnie The Pooh-ing") had a sheepish ****-eating grin plastered on his face. Dunn, appeared visibly angry while popping laxatives like one would pop Tic Tacs. The mediator was KHE88, who was allowed to come off of his traveling mobile linac by his partner (who's kidding who, his boss), Todd Scarborough. KHE88, as we all know, was made of money. But we found out that was to be taken literally. His DNA from a recent 23 and Me test revealed that he was 4% USD. The mediation started with recriminations and accusations ...

Well written. Are you saying the 'E' in KHE stands for Erdogan? I always kinda wondered.

 

[medgator]

I heard KHE was just hired as the mediator!

.

Not sure that's the most unbiased choice....

 

[Mandelin Rain]

Not sure that's the most unbiased choice....

He'd probably hate you both evenly.

 

[Lamount]

Perhaps an armistice...

4D for H&N -no
4D for lung (you know, that thing that actually creates respiratory motion) -yes

Agree?

 

[jondunn]

Perhaps an armistice...

4D for H&N -no
4D for lung (you know, that thing that actually creates respiratory motion) -yes

Agree?

No one is on the other side of this issue other than medgator

 

[CurbYourExpectations]

They met in Istanbul, over a pot of rich Turkish coffee. Gator, wearing his usual t-shirt and nothing else (commonly referred to as 'shirtcocking' or "Winnie The Pooh-ing") had a sheepish ****-eating grin plastered on his face. Dunn, appeared visibly angry while popping laxatives like one would pop Tic Tacs. The mediator was KHE88, who was allowed to come off of his traveling mobile linac by his partner (who's kidding who, his boss), Todd Scarborough. KHE88, as we all know, was made of money. But we found out that was to be taken literally. His DNA from a recent 23 and Me test revealed that he was 4% USD. The mediation started with recriminations and accusations ...

Simul is prepping his pay per read fanfic career for when the job market collapses.

This is the season for healing. And I'm here for it.

 

[elementaryschooleconomics]

I mean, TECHNICALLY, unless your CTSIM is instantaneous, all scans are 4D. You're always working off an AIP whether you want to or not.

With 2.5mm slice thickness and 20-30 seconds for a sim scan to complete, what we're looking at is just an estimation of reality. Your TPS is just doing some math to slap colors on your AIP and tricks you into thinking you "know" what dose the patient is getting.

You don't know. Nobody knows. We're all just an imagination of ourselves.

Here's Tom with the weather.

 

[RadOncDoc21]

I mean, TECHNICALLY, unless your CTSIM is instantaneous, all scans are 4D. You're always working off an AIP whether you want to or not.

With 2.5mm slice thickness and 20-30 seconds for a sim scan to complete, what we're looking at is just an estimation of reality. Your TPS is just doing some math to slap colors on your AIP and tricks you into thinking you "know" what dose the patient is getting.

You don't know. Nobody knows. We're all just an imagination of ourselves.

Here's Tom with the weather.

 

[thecarbonionangle]

I mean, TECHNICALLY, unless your CTSIM is instantaneous, all scans are 4D. You're always working off an AIP whether you want to or not.

With 2.5mm slice thickness and 20-30 seconds for a sim scan to complete, what we're looking at is just an estimation of reality. Your TPS is just doing some math to slap colors on your AIP and tricks you into thinking you "know" what dose the patient is getting.

You don't know. Nobody knows. We're all just an imagination of ourselves.

Here's Tom with the weather.

Gator a visionary? Many saying it

 

[Lamount]

I mean, TECHNICALLY, unless your CTSIM is instantaneous, all scans are 4D. You're always working off an AIP whether you want to or not.

With 2.5mm slice thickness and 20-30 seconds for a sim scan to complete, what we're looking at is just an estimation of reality. Your TPS is just doing some math to slap colors on your AIP and tricks you into thinking you "know" what dose the patient is getting.

You don't know. Nobody knows. We're all just an imagination of ourselves.

Here's Tom with the weather.

AT LEAST 4D.

11D if you take M theory into account

 

[Ray D. Ayshun]

Back to the op, where is this job and where do I send my updated cv? I'm okay not 4ding my larynx

 

[jondunn]

I don’t 4D stage 1 glottic but you’re ****ing insane if you aren’t doing 4D on your nasopharynx cases

 

[RickyScott]

Ny/NJ ?

 

[thecarbonionangle]

I don’t 4D stage 1 glottic but you’re ****ing insane if you aren’t doing 4D on your nasopharynx cases

You really dont wanna miss clivus, posterior third of maxillary sinus/nasal choana, foramen ovale/rotundum, etc.

 

[jondunn]

You really dont wanna miss clivus, posterior third of maxillary sinus/nasal choana, foramen ovale/rotundum, etc.

had an old boomer partner of mine have a marginal miss in vidian when they didnt use 4D

 

[elementaryschooleconomics]

You really dont wanna miss clivus, posterior third of maxillary sinus/nasal choana, foramen ovale/rotundum, etc.

You don't put Calypso beacons in the clivus?

Amateur. I'm a true Master of the Beam, I put two beacons in the clivus and lodge one in the hypoglossal canal for triangulation.

Then I hydrodissect the fossa of Rosenmuller to reduce my temporal lobe dmax. I still haven't TECHNICALLY shown a significant improvement in patient reported tox, but there's a trend in the odds ratio, and my temporal lobe DVH is highly significantly better with my PEG-based spacer.

 

[RadOncDoc21]

You don't put Calypso beacons in the clivus?

Amateur. I'm a true Master of the Beam, I put two beacons in the clivus and lodge one in the hypoglossal canal for triangulation.

Then I hydrodissect the fossa of Rosenmuller to reduce my temporal lobe dmax. I still haven't TECHNICALLY shown a significant improvement in patient reported tox, but there's a trend in the odds ratio, and my temporal lobe DVH is highly significantly better with my PEG-based spacer.

View attachment 352593

I use DIBH, rectal ballons and space OAR.of course 2 CBCT’s during treatment with calypso and 5 beacons. My partner likes to do daily MRI’s with adaptive planning between arcs.

 

[elementaryschooleconomics]

I use DIBH, rectal ballons and space OAR.of course 2 CBCT’s during treatment with calypso and 5 beacons. My partner likes to do daily MRI’s with adaptive planning between arcs.

 

[Mandelin Rain]

I mean, TECHNICALLY, unless your CTSIM is instantaneous, all scans are 4D. You're always working off an AIP whether you want to or not.

With 2.5mm slice thickness and 20-30 seconds for a sim scan to complete, what we're looking at is just an estimation of reality. Your TPS is just doing some math to slap colors on your AIP and tricks you into thinking you "know" what dose the patient is getting.

You don't know. Nobody knows. We're all just an imagination of ourselves.

Here's Tom with the weather.

There was a couple weeks where our 4D rig was down.

We slowed the pitch down on the sim and just did a really slow free breathing scan to generate a "MIP". Didn't do any SBRT cases this way, but worked well enough for other lungs. I find I'm infrequently changing volumes based on 4D with typical bulky Stage III disease anyway. Small volume Stage III is a different story, particularly in lower lobe, but those are few and far between in my clinic.

 

[medgator]

I find I'm infrequently changing volumes based on 4D with typical bulky Stage III disease anyway. Small volume Stage III is a different story, particularly in lower lobe, but those are few and far between in my clinic.

!!!!!!!