Stuff like
this is what I'm talking about:
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There's only ONE WAY this can happen. And that's if your institution is an unstoppable juggernaut, a cross between a mob boss and the Terminator.
And just to be even more confusing/nuanced: I actually think Penn/CHOP do great medicine! I'd go there! I'd send my family there!
But does Penn, or its peers, care AT ALL about this in terms of the levers and loopholes they will exploit to maximize profit?
No.
Will the behavior of Penn, Anderson, Mayo, Sloan - will it have an effect on our workforce?
Yes.
Supervision is the WRONG BATTLE.
Further, from a story that broke yesterday:
For those that don't know, Mayo offers the "MCCN":
They have, for years, offered this:
I'm sure we've all seen the rise in eConsults, independent of this.
The discussion of the overall societal impact rising costs of medicine is a totally different topic, and I don't think any of us want to go too far down this rabbit hole.
You're kidding, right?
You HAVE TO GO DOWN THIS RABBIT HOLE. This is all related.
I understand the easy logic here about "Direct Supervision means a RadOnc has to physically be present means more jobs".
That's not real. That's an illusion.
Do I think there's a chance that, if Virtual Direct is made permanent in 2025, there could be a handful of fewer jobs available in 2025-2030?
Maybe. I genuinely don't know.
But to see drastic changes to our workforce in a rapid timeline, one of two things need to happen:
1) Staffing of existing linacs needs to change.
2) New linacs need to be built.
#2 is basically off the table. Outside of Florida (lol), the CoN process is a huge roadblock to linac expansion.
Further, the capital-rich days of the last few years is gone. Interest rates are high. Purse strings are tight. Reimbursement is down. You're not going to see a flood of new linacs because...well that's not something that has ever happened, really.
For #1: Hospitals HATE CHANGE. There are a lot of downstream effects to a place that is used to having an on-site RadOnc for 30 years just...not having an onsite RadOnc anymore.
@drowsy12 - what do you mean "rise of Bridge"??? Does Bridge even have a clinical site yet? Maybe one is what I've heard? The probability they fail is quite high regardless of regulation.
I don't understand the points people are trying to make here.
What should ASTRO be doing? If they can't support supervision (which is beneficial to the large majority of us), what could they possibly support that people will listen to that will help the majority of RadOncs?
And why are there people here hoping for the worst possible outcome that will completely destroy the field?
Relentless.
Unstoppable.
Advocacy.
Blanket all media with pro-radiotherapy ads. Stories in print and digital. Television. Blogs. Podcasts.
Hire effective lobbyists.
ACRO already has one. Liberty Partners are beasts. Look what they did for 21C.
ROCR and Supervision are tilting windmills. The playbook already exists.
Lobby. PR. Lobby. PR. Lobby. PR.