Recent content by thesauce

*cough* ANY community cancer center

You cannot be serious. A single skin CA exclusion is not worth this entire dumpster-fire of a bill meant to drive more cases to the higher cost centers and destroy private practices in the process. This is just step 1. You will take a huge cut upfront and then cuts will continue from there as...

They wouldn't. This is gaslighting. It's called a negative externality - someone making/proposing a change in which another party pays the cost of it. It is frankly wrong and I have much less respect for Michalski for this. Anyone supporting this should insist they be included. Include...

For those willing to fight it, could you send an email to [email protected]? I'll get a conference call set up

I am interested in a lot of these answers as well, and a lobbyist can probably find some of this out, but in the end a lot of this is probably unknowable or out of our control. Getting someone to champion for us is not.

You’re not wrong. What’s going to happen with this is that CMS will start to pay a flat 20-40k per fraction, because everything will be 1 or 2 fractions. That is not going to fly for long.

Supporting shorter courses for ALL indications

I found a pretty good lobbyist that would be willing to fight against this. Would others be willing to chip in?

Yeah. There is an inflection point.

Unfortunately, these lines are entirely blurred. There is an agenda and that agenda does, if even subconsciously (let’s hope so), skew results. I know for a fact it skews the chances of publication. Try and open a standard-fractionation dose-escalation study. I know someone who had it turned...

Evidence-based medicine is not intuitive. If all we had to do was what made sense, we wouldn’t have had to go to school for 13 years.

I have no problem doing 5 or 28 if they are fully informed - it’s their body. But they have to be informed and few choose a more toxic treatment in exchange for a short-term convenience. Some do and I’ll respect their wishes.

Every one of these studies I’ve seen show a numerically higher toxicity with hypofrac, but the p value is not <0.05. Could just be statistical manipulation (using whatever test works) to say it’s non-inferior. I mean, what are the chances that they all have numerically higher toxicity in the...

No. Hypofrac has been entirely pushed by the large academic centers with lots or resources and the best insurance contracts imaginable so they can make even more money by drawing patients away from community centers by offering more toxic treatments and not telling patients these risks.

401(k) up to the match. That’s free money. Then Roth. Then honestly just enjoy the rest.