Where would you choose to live?

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You just have to explain it - in the community.

I just say "We used to do that, but we've found it doesn't change the outcome. It's a boomer thing" a smile and a wink. For those not fluent in radoncwimpese, it translates to, "I am the doctor, I will treat this patient Friday and be aware of them on the weekend. They will get their next treatment on Monday. This is not a negotiation."

In academics and certain centers, you're coming on an Saturday if you treat on Friday - why not take advantage of the cheap labor? Sucks to be them. Same with my old Banner job. Man, the referrings loved making us see patients on call (neurosurgeon said: "What do you mean, Monday? I'm here at the hospital. Come see the patient." They loved treating on weekends and my leadership agreed with them. My first Saturday on call, I went to 4 hospitals, saw 4 consults, continued treatment for 2 patients and started another 1. Worked 7a to 3.30p that day, drove 150 miles, with a break for lunch. For what?

I've said it before, if it's Friday and palliative, just give more on the first fraction. If doing 30 in 10, give 4-5 on day 1 and then <3 on the next 9 treatments. It's fine.

Or, just don't take call. We ended it here. It was not useful. If there is a something that urgent, they should be at a center with a neurosurgeon or IR that can do procedures (for SVC).

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I always question how we’re taught to give daily fractions, yet patients get to decide to take breaks and the issues regarding holidays and why we’re ok with giving 2-3 day breaks in between (looking at you Thanksgiving) but god forbid we can not start RT on a Friday! I came up with my own conclusion that it doesn’t matter. I think it’s more about the optics.

With all that said, I try to initiate RT “as soon as possible” of course only after steroids is given, a MRI is done and surgery says “no.” Fortunately, I’m 100% outpatient based so nothing is ever an emergency anymore.
Always found it funny that starting Thurs/Fri verboten, but finishing Monday/Tuesday just fine and dandy.
 
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Its all nonsense all the way down. Kind of like a workforce report from ASTRO. Epic "thou shalt" followed by muffled cries when the truth is revealed...that the "way it is" doesn't mean jack.
 
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