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A sprawling mix of real-world education, armchair journalism, and scientific exploration, all anchored in Radiation Medicine. The Establishment has locked information behind Towering Ivory Walls: consider us Nuclear Robin Hood, stealing from the rich to give to the poor; gadflies forcing radioactive truth into the spotlight. Out of the Basement is produced by Photon Media, a project from the 501(c)(3) nonprofit Cold Light Legacy. Of course, none of this is medical, legal, or financial advice. Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

Jason Beckta, MD, PhD


    • Mar 17, 2025 LATEST EPISODE
    • monthly NEW EPISODES
    • 47m AVG DURATION
    • 48 EPISODES


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    Latest episodes from out.of.the.basement / radiation.medicine

    ROCR Reloaded: The Clock's Ticking on Radiation Oncology

    Play Episode Listen Later Mar 17, 2025 48:04


    ROCR is back. From accreditation traps to Congressional risks, this episode breaks down the data and delivers six bold fixes to save patient access. Tune in to hear why time's running out for Radiation Oncology's underdogs.OOTB is produced by Photon Media.Contact: jason@becktamd.com

    Slow Motion Crash: How the AMA, Medical Professional Societies, and Flawed (Secret) Methodology Are Driving Radiation Oncology Off a Cliff

    Play Episode Listen Later Mar 5, 2025 47:49


    Strap in for a wild ride through the Medicare mess threatening radiation oncology in 2026. From a bizarre AMA survey that thinks we're just radiology's quirky cousin, to ASTRO's head-scratching distractions, we break down the...break down?Recorded at midnight in the Vermont Mountain Basements™, this episode unpacks the Byzantine world of CPT codes, RVUs, and a 40% practice expense gut punch that could turn off the lights. OOTB is produced by Photon Media.Contact: jason@becktamd.com

    Pediatric nasopharyngeal brachytherapy: a radioactive relic and the harmful myths surrounding it.

    Play Episode Listen Later Oct 27, 2024 57:47


    In this episode, we step into a historical hornet's nest, examining the controversial legacy of nasopharyngeal radium treatments once used for ear infections and adenoid issues in children. We unravel the convoluted data on radiation and cancer risks, hypothesizing about the academic intrigue behind a much-cited 2001 Hopkins study. Most importantly, we question how narratives - especially "radiation equals danger" narratives - shape research and publication. Join us for a thought-provoking dive into the world of radiation medicine, statistical hijinks, and the pressures of scientific storytelling. *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@becktamd.com --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Threshold of Deception: Stretching the Truth of Radiation Safety

    Play Episode Listen Later Oct 20, 2024 78:15


    Let's takes a deep dive into the flawed foundations of the Linear No-Threshold (LNT) model, a theory that has shaped radiation regulations for decades. We'll unravel the history of "radiophobia" and explore how fear of radiation, scientific ego, and regulatory inertia cemented the LNT model into public policy. The episode touches on the controversial decisions of Nobel laureate Hermann Muller, who may have let ambition and ideology steer his interpretation of radiation science. In visiting the...questionable...handling of contradicting evidence, we see parallels to modern scientific dogma and the need for transparency. An episode sure to leave you rethinking everything you thought you knew about radiation. *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@becktamd.com --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    ROCR's magical trickle-down equity economics

    Play Episode Listen Later Jul 3, 2024 16:59


    I've got a big HEART - can I have $500 too? *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    RVU University (RVUU): The origin of modern Medicare reimbursement, Chevron deference, and ROCR

    Play Episode Listen Later Jul 1, 2024 41:22


    After the journal evidently had to rediscover, patent, and rebuild the printing press, my ROCR "Letter to the Editor" was finally published: https://t.co/dGKHQJoMQD To accompany and expand upon this content, we'll start with framing the entire conversation with a simple "why do we care"? Since the Supreme Court was feeling feisty and surprisingly overturned Chevron deference, we also discuss how in the world that has anything to do with ROCR. Don't you just love summer?? *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    High Yield LDRT for OA - Everything Under the Sun (Xstrahl Miniseries Capstone)

    Play Episode Listen Later May 29, 2024 56:01


    Ever found yourself thinking, "Man, I wish there was a single podcast episode that summarized all the most helpful and practical information on low-dose radiotherapy for osteoarthritis"? Well, good news! This episode is your ultimate guide to understanding the science, clinical efficacy, and practicalities of LDRT. We're distilling the highlights of the entire “Xstrahl Miniseries” into one convenient digital treasure trove. Perfect for those looking to expand their modern practice with a treatment that's been in use for over a century, this capstone experience explores how LDRT can revolutionize not just OA management, but the entire field of Radiation Medicine in America. Specific highlights include tips on charming skeptical patients and colleagues, as well as navigating the labyrinthine world of insurance claims. Jam those earbuds into your external acoustic meatuses and discover why LDRT might just be the best-kept secret in Radiation Medicine…because who doesn't love a good underdog story? *** High Yield - Mechanisms of Action in LDRT for Osteoarthritis https://doi.org/10.6084/m9.figshare.25918756 *** Brought to you in part by Xstrahl, modern manufacturers of orthovoltage devices.  Visit them at ⁠⁠⁠⁠⁠https://xstrahl.com/⁠⁠⁠⁠⁠ *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    The Nuclear Scare Scam - Galen Winsor (also known as "that physicist who ate uranium in the 1980s")

    Play Episode Listen Later May 18, 2024 91:29


    Recently, a video of a physicist eating uranium while delivering a lecture appeared on my social media feed. While I ignored it once or twice, THE ALGORITHM knows me better than I know myself, and I eventually watched it. However, the short clip contained no information, and I couldn't tell the context of why someone would do this, let alone if it was even real. Turns out…it's very real. This is the full, unedited version of “The Nuclear Scare Scam”, a talk delivered by a man named Galen Winsor in 1985. The “uranium eating” takes place around the 1 hour 12 minute mark. Galen Winsor was a nuclear physicist who served in the Navy during World War II, returning home to help design and operate the first nuclear power plant in Hanford, WA – and many power plants thereafter. Winsor dismantles the exaggerated fears surrounding nuclear energy, revealing how strategic disinformation and vested interests have perpetuated a culture of radiophobia in America. Through personal anecdotes and historical context, he argues that the dangers of low-level radiation have been blown out of proportion. He critiques the overly cautious regulations driven by economic and political agendas, suggesting that these fears were deliberately cultivated to hinder the growth of atomic technology. Winsor makes some…potentially controversial points in this talk. Most notably, his opinion on Three Mile Island. Currently, I am neither supporting nor condemning any of his spicier ideas – that's for future episodes. But: in the 1980s, Winsor traveled across America giving this same talk 77 times - and thus snacked on uranium dust 77 times. Winsor did eventually die… ...in 2008, at the age of 86, more than 20 years after “The Nuclear Scare Scam” was recorded. It's hard to argue with the results. *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Those "negative" randomized control trials everyone likes to cite and say "LDRT doesn't work" are really, really bad (Radiotherapy for Arthritis: The Miniseries)

    Play Episode Listen Later Apr 16, 2024 18:01


    Episode Four (part...one?) of the “Real World LDRT” miniseries (sponsored by Xstrahl) gets more into the evidence behind LDRT. Specifically, the two RCTs out of the Netherlands published a few years back showing that LDRT had no benefit in osteoarthritis. So...couple small problems with that. Namely, the trials had less than 30 patients in each arm, used too high of a dose, used only half the standard treatment, and...oh, yeah. In the LDRT arm in one of the trials, 2/3rds of the patients had >5/10 pain for >15/30 days per month despite analgesics/therapy for >5 years. That's VERY severe pain, by any definition. ...and: One of the primary outcome criteria was "greater than 50% relative improvement in pain/function AND >20 points in absolute improvement" on their specific measurement tool. ...and: "...both studies were powered to detect a large effect of low-dose radiation therapy. Using the primary outcome, allowing for a 15% dropout rate, [they] aimed to include 27 patients per group, assuming an expected difference of 40% in the proportion of responders between the low-dose radiation therapy and sham intervention groups, 80% power and 5% α level, and that 40% of the sham intervention group would be responders..." Is there any intervention on Planet Earth that would show a positive signal with a design like this? Please. Please. Please stop citing these trials. *** Brought to you in part by Xstrahl, modern manufacturers of orthovoltage devices. Visit them at ⁠⁠⁠⁠https://xstrahl.com/⁠⁠⁠⁠ *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Who watches the watchers? The April 2024 town hall on Radiation Oncology's white whale: SUPERVISION

    Play Episode Listen Later Apr 15, 2024 108:02


    On April 5th, 2024, ASTRO held an actual, honest-to-goodness "town hall" style virtual meeting with ~200 members of the Radiation Oncology community showing up to make their voices heard. Yowza. There's a reason this took me over a week to make and clocks in at almost two hours. Buckle up for a very special Cold Light episode as we "watch the watchers" and explore the topic of virtual supervision discussed in a virtual meeting. *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    LDRT Coding and Billing (Radiotherapy for Arthritis: The Miniseries)

    Play Episode Listen Later Apr 8, 2024 32:33


    Episode Three of the “Real World LDRT” miniseries (sponsored by Xstrahl) is everyone's favorite topic: coding and billing! [insert the sounds of a gleeful studio audience here] The secret sauce is to remember you can bill it like normal (ideally, 2D or "complex isodose"). The radiotherapy CPT codes are disease agnostic (no, they're not just for cancer - heard that one before). But importantly - as doctors primarily treating cancer, we don't realize how massive the burden of osteoarthritis is for the American population. The even more secret sauce? LDRT is, by far, the most economical treatment option to both the patient, and the healthcare system as a whole. Remember: 3 Gy in 6-every-other-day fractions, assess at 12 weeks, and deliver a second identical course if necessary/desired. It really is that easy. *** Brought to you in part by Xstrahl, modern manufacturers of orthovoltage devices. Visit them at ⁠⁠⁠https://xstrahl.com/⁠⁠⁠ *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Radiotherapy for Arthritis: The Miniseries (Episode Two - How to Get Your First Patient, Setup, and Treatment Planning)

    Play Episode Listen Later Apr 4, 2024 42:22


    Episode Two of the “Real World LDRT” miniseries (sponsored by Xstrahl) is all "meat and potatoes", as the kids used to say (back when FDR was president). I start with a high-level overview of the laboratory evidence for LDRT, followed by how to get your first patient and what you say to them when they ask "how does this work??" Hint: it's like NSAIDs and prednisone, just a different pathway. We then explore my favorite CTSIM setups and target volumes/PTVs. Remember: 3 Gy in 6-every-other-day fractions, assess at 12 weeks, and deliver a second identical course if necessary/desired. It really is that easy. Find the presentation/slides for this episode at: Beckta, Jason (2024). Getting started with radiation therapy for arthritis - mechanisms, getting your first patients, setups, treatment planning. https://doi.org/10.6084/m9.figshare.25546417.v1 *** Brought to you in part by Xstrahl, modern manufacturers of orthovoltage devices. Visit them at ⁠⁠https://xstrahl.com/⁠⁠ *** OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Radiotherapy for Arthritis: The Miniseries (Episode One, Part Two - Radiophobia and Secondary Malignancy)

    Play Episode Listen Later Mar 21, 2024 54:01


    Episode One, Part Two of the “Real World LDRT” miniseries (sponsored by Xstrahl) circles back to the 1940s and the extraordinary flaws of the "linear no threshold" (LNT) model of radiation risk. We explore backroom deals, handshake science, corporate greed, regulatory capture, hormesis, OSHA violations, putting radium in the throats of 2.5 million children...you know, the regular, everyday stuff. Why? Because a common hesitation to deploying LDRT for arthritis is the risk of the treatment itself causing cancer. Spoiler alert: there has never been a case of secondary malignancy from therapeutic radiation below a magical threshold dose. And LDRT stays below that threshold. Don't believe me? That's why this miniseries exists! Relevant papers and sources at ⁠http://u.pc.cd/OhN⁠ Brought to you in part by Xstrahl, modern manufacturers of orthovoltage devices. Visit them at ⁠https://xstrahl.com/⁠ OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Radiotherapy for Arthritis: The Miniseries (Episode One, Part One - LDRT Predates the Airplane)

    Play Episode Listen Later Mar 18, 2024 23:50


    Kicking off the “Real World LDRT” miniseries sponsored by Xstrahl, Episode One/Part One takes us all the way back to 1895 and Wilhelm Roentgen aiming his newly discovered “X-rays” at his wife's hand. Within 3 years, radiotherapy was treating arthritic conditions in Europe before coming to America in 1906. By 1930, the scientific literature contained more than 6,000 patients treated by LDRT for arthritis (and other degenerative inflammatory conditions) - with orthovoltage techniques accounting for most (if not all) reports. Today, a common concern preventing the use of radiotherapy for arthritis in every practice in America is the alleged “lack of evidence”...an odd complaint for one of the only therapies in use for ~125 years with tens of thousands of patients experiencing excellent outcomes. Don't believe me? That's why this miniseries exists! Brought to you in part by Xstrahl, modern manufacturers of orthovoltage devices. Visit them at https://xstrahl.com/ OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Coalition of the Willing - ROCR, Bacon, Eggs, and Freud's nephew.

    Play Episode Listen Later Jan 15, 2024 28:22


    On January 9th, 2024, a blog post announced some groups were interested in protecting Medicare reimbursement. Neat. OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Frame 122: evidence-based medicine and other fairy tales I used to believe in. Can I buy magic beans with Venmo?

    Play Episode Listen Later Jan 1, 2024 80:37


    "If we are to have any hope of advancing rational beliefs against the riptide of myside bias, primitive intuitions, and mythological thinking, we must safeguard the credibility of these institutions. Experts such as public health officials should be prepared to show their work rather than deliver pronouncements ex cathedra. Fallibility should be acknowledged: we all start out ignorant about everything, and whenever changing evidence calls for changing advice, that should be touted as a readiness to learn rather than stifled as a concession of weakness." - Reason To Believe, January 2023 OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    The Trilogy of Radiation Supervision: Welcome to Modernity

    Play Episode Listen Later Dec 5, 2023 83:56


    Finally. The time has come to discuss "the changes". On November 1st, 2019, CMS announced that hospital outpatient procedures would be moving to "General Supervision". Of course, this broke our dogma, which...well, we don't deal with that well. Then, the PHE brought us "virtual direct supervision" with real-time A/V communication. In Episode Three of the Supervision Series, we cover the switch from direct to general, the specious argument that "IGRT is diagnostic", the specious argument that "you can't bill for professional work done off-campus", and the final two supervision cases in Radiation Medicine: the Maryland case (settled for...$300,000) and a previously unknown Kentucky case (technically ongoing, but the judge was kind enough to write lengthy opinions pre-emptively agreeing with everything I've ever said). OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Supervision Strikes Back: Target Tumors, Not Yourself (and other scare tactics).

    Play Episode Listen Later Nov 28, 2023 81:55


    In Part One, we discussed definitions...for an hour. A literal hour. Yowza. Now, we're going to talk about the consequences. Specifically, the qui tam ("whistleblower") cases, and my (least) favorite journalist Walt B. over there at that newspaper in NYC. This is definitely going to take at least one more episode, so...enjoy Part Two of "I want to speak to your supervisor"! OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    I want to speak to your direct supervisor! Not your general supervisor! Wait...there's a difference?

    Play Episode Listen Later Nov 26, 2023 65:57


    Ah, the enigmatic topic of supervision in Radiation Medicine. Are we beholden to direct supervision? General supervision? Virtual direct supervision through the use of real-time audio/visual communication? Is there are problem with site of service? "Incident to" billing? Does anyone really know? Rather than create another 10-hour monolith, this episode is Part One of...well at least two episodes, exploring one of the most controversial topics in our field. OOTB, produced by Photon Media, is made possible by Cold Light Legacy, a 501(c)(3) nonprofit that thrives on community support. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Small Market, Big Heart: Considering the Radiation Medicine Maldistribution Problem.

    Play Episode Listen Later Nov 22, 2023 34:49


    Have you ever heard the phrase "there's not a supply problem, there's a distribution problem"? Did you grow up in an urban area, go to school in an urban area, perhaps train and practice in an urban area? Have you ever held your head up a little higher talking about how you're a "specialist at the main campus" when trying to get records from an "outside hospital"? In this special Thanksgiving episode inspired by listening to my Photon Friends interview David Chang, we "pierce the veil" on being in the "small market". OOTB is produced by Photon Media, a project of the 501(c)(3) nonprofit Cold Light Legacy. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Towards a shared history: Simone's Maxims for (academic) medicine.

    Play Episode Listen Later Nov 6, 2023 35:44


    It's easy to forget how quickly things are forgotten. The zeitgeist of the Medicine World feels shared when you're in med school and residency, and there's an assumption that it will always be the way you remember it. Of course, this is not true, and it can quickly lead to folks "talking past each other". If you're a resident, med student, or just an observer: do you hear the phrase "an institution cannot love you back" and are confused as to why it seems like you're supposed to know what that means? This episode is for you! OOTB is produced by Photon Media, a project of the 501(c)(3) nonprofit Cold Light Legacy. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Cognitive Dissonance in Radiation Oncology: ERAS-tional emergent properties of a complex system.

    Play Episode Listen Later Oct 30, 2023 53:06


    The NRMP did their weird thing where they release "preliminary" Match application statistics which...I don't quite understand why they do that, but whatever. I originally planned on exclusively talking about emergent properties and mental frameworks around paradox without bringing up our RadOnc baggage, but alas, the universe doesn't care about plans. For the slides with all the various details and statistics and citations: http://u.pc.cd/TGs7 OOTB is produced by Photon Media, a project of the 501(c)(3) nonprofit Cold Light Legacy. jason@coldlight.org --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Conflicts on Conflicts on Conflicts on Conflicts - The Final 15

    Play Episode Listen Later Oct 16, 2023 13:05


    The previous episode on this story clocks in at 2 hours and...14 minutes and 55 seconds. It's insanely dense, and I left out many, many details. This is the final 15 minutes, which will hopefully convince you to stick through the full episode. The link to the slides is below! From the humid swamps of Florida to the halls of legislation, discover how this bizarre saga has implications for us all. https://doi.org/10.6084/m9.figshare.24312775.v1 --- Out of the Basement is produced by Photon Media, a project from the 501(c)(3) nonprofit Cold Light Legacy. coldlight.org | @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Conflicts of Interest: 21C, Humana, DOJ, HHS, Abandoned Patents, GenesisCare, Accuray, Expert Testimony, Antitrust Immunity, ASTRO and...ROCR.

    Play Episode Listen Later Oct 16, 2023 134:55


    This wasn't what I set out to make. This wasn't the story I expected to tell. In 2012, 21st Century Oncology and Humana created an alternative payment model that appears to be the inspiration for ROCR. As both the 21C/Humana and ASTRO/ROCR models share the same author(s), it's strange we haven't heard about it. From the humid swamps of Florida to the halls of legislation, discover how this bizarre saga has implications for us all. https://doi.org/10.6084/m9.figshare.24312775.v1 --- Out of the Basement is produced by Photon Media, a project from the 501(c)(3) nonprofit Cold Light Legacy. coldlight.org | @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Chicken Little Strikes Back: only 16% of graduating Radiation Oncologists think the job market is bad?

    Play Episode Listen Later Oct 1, 2023 38:01


    What if I told you that...I agree with the 2023 ARRO survey results presented at this year's San Diego conference? What if I told you that the survey supports my Red Journal "Letter to the Editor" about the Workforce Study? How in the world am I not changing my opinion on the oversupply issue despite personally experiencing the benefits of the current job market? Am I writing these descriptions like a Buzzfeed article now? --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    ASTRO to Biden: "we're incentivizing shortening the overall duration of therapy...because it's easier to stay away from home for a week than it is for 8 weeks."

    Play Episode Listen Later Sep 8, 2023 36:25


    - ASTRO President, discussing ROCR, during the Advisors to the President [Biden] on the National Cancer Program meeting, 9-7-2023 The inaugural "President's Cancer Panel" meeting took place recently and boy...that was something. Lots of concern over rural cancer care - from people not engaged in rural cancer care. Coincidentally, I am actually involved in rural cancer care. Join me for another riveting "reaction"-style episode on...federal policy regarding national Healthcare concerns! --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Bill of Health: is ROCR a Legislation Lifeline or Liability?

    Play Episode Listen Later Jul 22, 2023 61:55


    On Friday at 4PM, the first "live" presentation of the alternative payment model "ROCR" took place. Though questions were not actively fielded from attendees, several concerns that have been brought up since the ROCR announcement were discussed. This special Basement episode breaks new ground with a "reaction"-style commentary on the ASTRO Town Hall. A discussion on the discussion...does this count as a meta-analysis? --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    The Code Bundling Conundrum: A Medicare Misadventure (starring 77301, ASTRO, AMAC, public record emails, conspiracy theories, and copy/paste)

    Play Episode Listen Later Jul 17, 2023 60:39


    In this episode, we unravel the intriguing story of a 2015 correspondence that pulls back the curtain of medical billing. Prepare to be riveted about everyone's favorite topic: CPT code bundling. How and why does the government consider "CT Simulation" (77280-77290) a part of "IMRT Treatment Planning" (77301)? Was it always like this? Does everyone agree and is everyone happy? Just kidding - we all know no one is happy. Crucial to this episode are the following two PDF files on the government's website: Email Letter to CMS: https://downloads.regulations.gov/CMS-2015-0075-0285/attachment_1.pdf Email Attachment to CMS: https://downloads.regulations.gov/CMS-2015-0075-0285/attachment_2.pdf --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    RVU-U: Private Practice Physician Primer - what the heck is a W2 employee? Or a professional services agreement? Academic satellite?

    Play Episode Listen Later Jul 14, 2023 17:56


    In this era of massive consolidation, it is incredibly confusing to discuss the different ways doctors can practice medicine in America. In discussing payment reforms, supply, professional vs technical fees, and so on - are we talking the same language? This episode aims, in extremely general, broad strokes, to define the "other" ways to practice medicine, beyond "academic faculty at a medical school's main campus". From being employed at a community hospital to being private practice at an academic hospital, join me on a whirlwind tour of jobs! --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    RVU-U: What are these "wRVU targets" or "average RVU" things I keep hearing about?

    Play Episode Listen Later Jul 7, 2023 16:58


    The theme of 2023, between workforce studies and payment models, is everyone's favorite: the RVU. Who's got 'em? Who needs 'em? Does it matter? Do we care? Join me in digital nerd town for a general overview of yearly metrics! --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Reflections on ROCR as a doctor: these are some ASTROnomical predictions

    Play Episode Listen Later Jun 29, 2023 21:11


    For years, the "white whale" of Medicare reimbursement has created many "Captain Ahab" impressions among policymakers and professional societies. In a movie script written in the style of George A. Romero, the Radiation Oncology Case Rate Program (ROCR) was unexpectedly published on June 28th, generating significant buzz among the RadOnc (RadMed) community. The model projects $212 million dollars in savings for CMS over a 5-year period but...how? On this "hot take" episode of OOTB, we discuss how one private consulting firm uses the data from another private consulting firm to make some...interesting...economic forecasts. --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Answering the Answering Call: RVU-U and Radiopharmaceuticals

    Play Episode Listen Later Jun 25, 2023 33:50


    Who knew that using liquid radiation could be so complicated and confusing? --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    RVU-U: "On beam" overview

    Play Episode Listen Later Jun 24, 2023 14:32


    What does it mean to talk about "on beam" numbers in a Radiation Oncology clinic? --- Earn free CME for this episode: https://earnc.me/E9XHPi www.becktamd.com www.photonmedia.org Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    The syllogism of supply/demand economics in Radiation Oncology, historical patterns of care studies, # of linacs in America, "big mood"

    Play Episode Listen Later Apr 12, 2023 42:50


    What has prevented open and in-depth analysis of the RadOnc workforce over the last decade? To paraphrase Fight Club - you are not your job. Does the 2023 ASTRO/HMA study make sense in terms of the existing data? Do we even know how many linear accelerators there are in America? Spoiler alert: we do (sort of) know! Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    History of RadOnc: what do people mean when they talk about the "2018 exams"?

    Play Episode Listen Later Mar 19, 2023 88:59


    On a recent, LIVE episode of The Accelerators, the question of "what happened to RadOnc" was answered, in part, by referencing the unusually high failure rate of board certification exams. It has now been 5 years since those events, and medical students/junior residents are unlikely to know "the story". This is my version of a documentary/editorial on "the 2018 exams", which starts with a 2012 CNN report, exam restructuring, NRMP reports, ARRO letters, PRO papers - all of it. Though impossible for me to tell the story utterly objectively, I have tried to include all major milestones should folks feel inclined to "check my sources". Then, in a twist worthy of M. Night Shyamalan, I discuss why hitting this "rock bottom" has brought out some of the most inspiring people our field has, and why I think there's a bright light at the end of this tunnel. It's easy to lose hope, but remember the ACROpolis and...Rome wasn't built in a day. ***ERRATA*** I realized after uploading this that the "trending downward" paper was published prior to the 2018 exams. I'll leave this as-is, because my error demonstrates the purpose of this project. Relevant papers: https://doi.org/10.1148/radiol.12120251 https://doi.org/10.1016/j.prro.2020.04.010 https://doi.org/10.1016/j.prro.2018.03.005 https://doi.org/10.1016/j.ijrobp.2018.12.046 http://dx.doi.org/10.1016/j.ijrobp.2013.05.027 https://doi.org/10.1016/j.prro.2018.04.005 https://doi.org/10.1016/j.prro.2018.04.005 Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    Season 2: RadOnc Workforce - "Economic Modeling Strikes Back"

    Play Episode Listen Later Mar 12, 2023 43:04


    Crawling Out of the Basement for the first time in 2023 with The Accelerators, The Todd, and Birkenstock Beckta (now based on the set of Super Troopers, looking for Bernie's mittens). The ASTRO Workforce Taskforce paper, the final version, dropped last Wednesday. In terms of "ambitious projects", forecasting supply and demand is akin to eating not one but TWO elephants. We discuss almost exclusively the concept of supply, hiring consultants, and the folly of forecasting the past instead of just, you know, using data. --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #12: ASTRO '22 workforce interim analysis "hot take" - armchair healthcare economics.

    Play Episode Listen Later Oct 24, 2022 21:19


    Join me as I meld prior ASTRO abstracts, Red Journal publications, CMS Medicare Part B data, and phone pics of slides live-Tweeted from San Antonio...to discuss the job market. No, I don't have "regular" hobbies, why do you ask? Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #11: Secrets of the physician job interview...ASTRO speed dating and the hidden curriculum.

    Play Episode Listen Later Oct 16, 2022 30:29


    My Twitter feed is an explosion of posts about airports and hotels and registrations and...it's that time of year again. The ASTRO conference. Which means senior residents gearing up for the legendary "ASTRO Job Interview" marathon. Employers are gearing up for new grad prospecting and "the arbitrage of talent". This episode is 30 minutes of advice I wish I could give to my younger self on the first day of med school. 15 years of painful lessons. One podcast. Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #10: BEAM-IT...a new way to write outpatient notes. All aboard the learning train with CPT codes, E&M documentation, time-based billing, wRVUs - nonstop fun!

    Play Episode Listen Later Oct 14, 2022 31:34


    You're a doctor, not a writer! Stop pretending your consult note needs to cite the PACIFIC trial and join me to talk about Evaluation and Management CPT codes, wRVUs, time-based billing, and how I write my notes: BEAM-IT. The most innovative acronym in medicine. Here are the slides/figures from the episode https://figshare.com/articles/figure/BEAM-IT/21334053?file=37860630 https://figshare.com/articles/figure/BEAM-IT/21334053?file=37860627 --- Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #9: The mystery of how doctors get paid, cracking the code of the "RVU", and the start of the MBA series (Medicine Business Acumen...or Anguish)

    Play Episode Listen Later Oct 6, 2022 21:29


    General societal opinion says doctors + $$ = bad. This attitude means non-clinicians command American healthcare. Ignoring the business of medicine doesn't mean we've taken the ethical highroad. It means we have surrendered an essential component of caring for the sick. I want to learn more about the nuts and bolts of the Healthcare Machine. Do you? Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #8: Why did low-dose radiation therapy for arthritis disappear in America? Scientific careers, Nobel prizes, Rockefeller, Eisenhower, and egos.

    Play Episode Listen Later Sep 19, 2022 47:21


    In the first half of the 20th century, radiation therapy was used for a huge range of medical maladies. X-rays cut the mortality of gas gangrene from 50% to 5% and treated skin manifestations of lupus as early as 1905. Then American culture shifted, and the fear of atomic power chased radiotherapy to the dark basement of hospitals, the pages of comic books, and political crises detailed on the evening news. How did we get here? The story is more absurd than I ever imagined. Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #7: Exposing the Lotion Conspiracy - Myths of Radiation Medicine

    Play Episode Listen Later Sep 15, 2022 18:26


    Have you or someone you know been exposed to the insidious claim that any lotion, cream, or topical agent left on the skin before radiation treatment can have a bolus effect? You may be entitled to compensation. Basement Brothers, Attorneys at Law, have filed a class action lawsuit... Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #6: How can you start doing low-dose radiotherapy for arthritis in your practice?

    Play Episode Listen Later Sep 9, 2022 54:22


    Yes, it really is as simple as it sounds. Yes, it really is popular worldwide because of the results. Yes, you can start doing it...tomorrow. On the heels of Austin Dove's wonderful webinar, Matt Spraker (our favorite Basement Buddy) and I do a "curbside consult" on starting to use low-dose radiotherapy (LDRT) for osteoarthritis in his practice...and maybe yours? Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #5: IGRT and me; part three.

    Play Episode Listen Later Sep 1, 2022 33:47


    The final installment of another long conversation about IGRT. Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #4: You think you know IGRT, but you have no idea [IGRT choices/part two].

    Play Episode Listen Later Aug 27, 2022 33:34


    Continuing on with our practical discussion regarding IGRT choice, immobilization, so on and so forth. Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #3: I bet no one taught you IGRT in residency [IGRT choices/part one].

    Play Episode Listen Later Aug 18, 2022 32:52


    Matt Spraker returns for a PowerPoint-fueled romp through IGRT choices. Slides are on Twitter and FigShare: https://figshare.com/articles/figure/IGRT_Slide_1/20493393 https://figshare.com/articles/figure/IGRT_S2/20506833 Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #2: RadOnc job secrets; doctor contracts; (linear) accelerate your life [part two].

    Play Episode Listen Later Aug 10, 2022 69:33


    Matt and I talk again. Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

    #1: What are the secrets of the elusive "RadOnc job"; contracts; work; and life [part one].

    Play Episode Listen Later Jul 29, 2022 57:47


    Matt Spraker joins us to talk about details of what an actual attending job in Radiation Medicine looks like, RVUs, medical director roles, etc. Earn free CME by reflecting on the content of this episode: https://earnc.me/E9XHPi www.becktamd.com Twitter: @drbeckta --- Support this podcast: https://podcasters.spotify.com/pod/show/radmed/support

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