The Accelerators Podcast

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host Dr. Clifford Hudis, medical oncologist and CEO of the American Society of Clinical Oncology. 

We discuss a wide range of topics surrounding organizational leadership. While we examined the topic through a physician's lens, anyone that works in healthcare will love this conversation! 

Leadership coaching, physician-led healthcare organizations, remote work and virtual care, engaging law makers and the public, and more! 

Learn from one of oncology's best physician leaders. 

Here are some other things we discussed during the show:

• Hudis on the Healthcare Unfiltered Podcast (audio only, video)
• Dying and Living in the Neighborhood by Probhjat Singh
• ASCO Resources Webpage and Leadership Development Programs
• ESTRO Foundations of Leadership in Radiation Oncology
• ASAE, The Center for Association Leadership
• Why Work Sucks and How to Fix It by Cali Ressler and Jody Thompson
• Common Sense Oncology
• The Accelerators Podcast -  "The Emporor Is Just Wearing Underwear" with CSO leaders Drs. Booth and Goodman 
• Oncology Unscripted Podcast with Katie, Julie, and Matt
• Hughes et al., Lumpectomy Plus Tamoxifen With or Withoutt Irradiation in Women Age 70 or Older

The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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In this episode, The Accelerators (Drs. Matt Spraker and Simul Parikh) host Mary Calys, DPT, a lymphedema physical therapist, and Katelyn Nees. They are the Senior Clinical Specialist and Senior Market Development Director for Tactile Medical, respectively.

Mary and Katelyn update our medical knowledge on the etiology and management of lymphedema with a special focus on breast and head & neck cancers.

Do not miss the awesome resources they provided for this show: a high-quality slide deck, clinician resources for lymphedema management in breast and head and neck cancers, and data supporting pneumatic compression.

We cover definitions, screening for symptoms, advanced measurements, and comprehensive management. We also cover the randomized data supporting the use of Flexitouch Plus, an advanced pneumatic compression device to treat lymphedema at home.

Finally, we cover the process of prescribing Flexitouch in clinic and Matt and Simul share their experiences with clinical use. 

We hope you enjoy this practical #MedEd episode as much as we enjoyed making it!

Here are some other things we discussed during the show:

•  Lymphology Association of North America - Find a Therapist
• American Physical Therapy Association - Find a Physical Therapist

Editor's Note: The Accelerators Podcast was compensated for this episode and Tactile Medical participated in planning the content. Matt and Simul are not compensated by the company for the clinical use of Tactile products, they just really like them! The discussions in this episode are the opinions of the participants and are not clinical, billing, or coding advice. We encourage you to contact your friendly local Tactile Medical representative or visit tactilemedical.com for more information.

Please see our website for complete information on our past and current sponsors.

The Accelerators Podcast is a Photon Media production. 

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At the end of last year, Dr. Jason Beckta published a docu-podcast about clinical supervision of radiotherapy services (parts one, two, and three). The series covers supervision terms, legal precedent, and dispels the misinformation shared by conflicted parties. 

In this episode, The Accelerators (Drs. Matt Spraker and Simul Parikh) join up with Jason to interview the famous Dr. Todd Scarbrough, the radiation oncologist at the center of supervision lore.

Todd shares his story and we discuss many aspects of supervision policy. 

Here are some links to things discussed in the show:

• TAP Episode with Simul, Jason, and Todd from ACRO 2022
• Jarvis et al., Initial Clinical Experience of Cherenkov Imaging in External Beam Radiation Therapy Identifies Opportunities to Improve Treatment Delivery
• Price et al., Washington University in St. Louis experience with remote SBRT coverage and adaptive radiotherapy coverage

The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host early career radiation oncologists Drs. Austin Sim, Anna Paulsson, and Avinash Chaurasia to discuss... early career (EC) issues in radiation oncology!

It's no secret that this is a passion topic for TAP. One of our first episodes dished out practical tips for new attendings (and new residents), and we've since given an independent voice to our EC peers on a wide range of topics: boards, starting families, finding your place in community medicine, and more.

We've been watching the work of friends-of-the-show Austin, Anna, and Avinash in this space throughout the last year.

They are among founding members of the nascent ASTRO Early Career Committee, a new group created to "represent the needs of radiation oncologists and physicists who are eight years or fewer out of training."

Listen in as we discuss all the things they are working on and their ideas for the future!

Don't miss the ECC resource website (members only) as well as their open suggestion box!

The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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It's another Accelerators journal club with Dr. Simul Parikh!

In this episode Simul reviews a recent industry sponsored publication in Advances in Radiation Oncology.

Image guidance improves freedom from recurrence rate after superficial radiation therapy for non-melanoma skin cancer

The article retrospectively compares patients with skin cancer treated with image-guided superficial radiotherapy to other previously published cohorts. Such a definitive title for a retrospective study! Well, there is more to the story. 

Simul discusses the article's methods, results, and adds important context for the message communicated by this paper. Edward Bernays would be proud.

Here are some links to things discussed in the show:

• The Sensus SRT-100+, a superficial radiotherapy machine
• SkinCure Oncology, funder of this study

The Accelerators Podcast is a production of Photon Media, a division of the Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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The Accelerators (Drs. Matt Spraker and Simul Parikh) discuss critique versus negativity, why Simul quit social media, Student Doctor Network, and engaging in discourse about Radiation Oncology.

This episode is a companion to an episode we recorded in December, but Matt initially decided to hold it back. The episode is a strong, journal club style critique of payer policy article published by the IJROBP that we feel should be retracted.

We encourage you to listen to our "almost lost" episode and additionally read Mark Storey's amazing rebuttal to the IJROBP publication.  

Here we discuss how this contributed to Simul leaving social media, why we initially held back the episode, critique, misanthropy, and our mission for open discussion in Radiation Oncology. 

Here are some links to things we discuss in the episode:

• SDN Thread "Screenshotting Simul"
• A Wikipedia article on Preference Falsification
• Out.Of.The.Basement podcast on the ASTRO "collaboration letter" and propaganda
• Edward Bernays, an American pioneer in public relations and propaganda

The Accelerators Podcast is a production of Photon Media, a division of Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

Update 12/17/24: Simul is back online with a new substack, check it out here.

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For the first time ever, a lost episode has been found!

The Accelerators (Drs. Matt Spraker and Simul Parikh) recorded a "reaction" episode to a brief report published in December 2023 in the IJROBP shortly after it published.

The article demonstrates that freestanding departments have been slightly slower to implement hypofractionation for treatment of breast and prostate cancers that hospital-based departments. The authors argue that this burdens the healthcare system and propose ROCR as an incentive to drive increased use of these techniques.

In this episode, we discuss this article in detail and share our opinion that the authors examined this issue in a very disingenuous way.

Yet, if you holistically analyze this issue, the data does not support the author's argument.

Is the goal to help readers understand the complexities of our system or were data curated to support implementation of ROCR policy? You'll have to ask the authors. 

Here are some resources we feel are important complements to this episode:

• Out.Of.The.Basement podcast on the ASTRO "collaboration letter" and propaganda
• Out.Of.The.Basement podcast, a rural doctor's thoughts on The ASTRO President speaking at "The President's Cancer Panel"
• Out.Of.The.Basement podcast, on unaddressed significant conflicts of interest among ROCR authors
• Mark Storey's rebuttal to the IJROBP article

The Accelerators Podcast is a production of Photon Media, a division of Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host new Associate Executive Director for Radiation Oncology at The American Board of Radiology (ABR), Dr. Michael Yunes! 

Mike is a community radiation oncologist in Springfield, MA and long time volunteer for the ABR. The transition to his leadership comes after a turbulent period for the Rad Onc board. Communication around the 2018 score anomalies dragged trainee confidence in the ABR to new lows and, soon after, COVID forced the board to complete a rapid redesign of testing. 

More than 5 years later, there are exciting signals of change. The "Orals 2.0" platform seems very well received by examiners and examinees and the board has voted to ramp up the clinical relevance of the qualifying exams in Rad Onc.

Most importantly, Mike is all about transparency and communication. His door is always open, so we invited ourselves in and recorded a podcast. 

We discuss all things Initial Cert: the successful move to virtual oral boards, the written boards and clinical relevance, Angoff'ing, and "crisis management" and communication. 

We close the episode with Simul's lightning round.  Lobster, wine, informatics, 3D printing for benign radiotherapy, Mike's got hobbies!

We hope you enjoy what we hope is the first of many fruitful conversations. 

Physician training and evaluation is a topic near and dear to our hearts; here are some prior episodes from our group related to the ABR.

• TAP, Beckta interviews Matt about boards
• Out.Of.The.Basement, Beckta covers the contentious 2018 ABR initial certification results

Here are some other resources discussed in the episode:

• Beriwal et al., Interdisciplinary debate on the physics test content
• Golden, United States Radiation Oncology Curriculum Development: The Tail is Wagging the Dog
• Warwzuta et al., The rise of negative portrayals of radiation oncology: A textual analysis of media news
• Chimney Rock Winery, a Yunes' family favorite
• See Mike's blog in ABR The Beam

The Accelerators Podcast is a production of Photon Media, a division of Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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Welcome to MattPAC*, a new Accelerators pilot concept!

Radiation Oncologist Dr. Matt Spraker aims to introduce important healthcare policy concepts rooted in current events. Each show is designed to be efficient with your time and inspire you to get engaged with advocacy in around 30 minutes. 

In MattPAC #1, Matt covers quality payment programs (QPP). QPPs aim to incentivize "High Quality Care" by adjusting a portion of physician's pay according to performance on quality indicators, measures of healthcare quality. 

We'll discuss the rich history of care quality improvement in radiation medicine and examine how Medicare has approached the QPP with Merit-based Incentive Payment System (MIPS). After, we examine practice accreditation, the QPP approach proposed in ASTRO's ROCR and close with a brainstorm of a better QPP. 

Here are some good resources for further reading on these topics:

• Albert and Das reviews, Quality Assessment in Oncology and Quality Indicators in Radiation Oncology
• MedPAC report, Examining MACRA implementation and the road ahead
• MedPAC report, Moving beyond the MIPs
• GAO Report, Provider Performance and Experiences under the Merit-based Incentive Payment System
• Patel et al., Oncologist Participation and Performance in the Merit-Based Incentive Payment System
• Luh, Radiation Oncology Alternative Payment Model's Impact on Small and Rural Practices
• Jones et al., Merit-Based Incentive Payment System (MIPS) Participation in Radiation Oncology Practices — A Simple Survey
• Chera et al., Improving Quality of Patient Care by Improving Daily Practice of Radiation Oncology
• Coia and Hanks, Quality Assessment in the USA: How the Patterns of Care Study Has Made a Difference 
• Hanks et al., Patters of Care Studies: Past, Present, and Future
• Visit the CMS QPP page for a lot of info: check your participation status, MIPs guides, APMs, and more
• ASTRO ROCR FAQ page

The Accelerators Podcast is a production of Photon Media, a division of Cold Light Legacy Company.

*MattPAC is not a political action committee, it's just a cute name. If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.

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The Accelerators (Drs. Matt Spraker and Simul Parikh) host the lung cancer legend, Brendon Stiles, MD. He is a Professor of Oncology, Medicine, and Thoracic Surgery at Montfiore and Albert Einstein College of Medicine.

We discuss all things lung cancer: early stage, locally advanced, staging, quality, and more.

The episode is capped with Simul's Lighting Round. Good luck Brendon!

We hope you enjoy this #MedEd instant classic!

Here are (almost?) all the studies and materials we mentioned during the show:

• Brendon's "Old Slide" on patient selection and operability
• Lobar or Sublobar Resection for Peripheral Stage IA Non–Small-Cell Lung Cancer (CALGB 140503)
• Stereotactic ablative radiotherapy with or without immunotherapy for early-stage or isolated lung parenchymal recurrent node-negative non-small-cell lung cancer (I-SABR)
• Stereotactic ablative radiotherapy versus lobectomy for operable stage I non-small-cell lung cancer: a pooled analysis of two randomised trials (STARS-ROSEL)
• Measuring the Integration of Stereotactic Ablative Radiotherapy Plus Surgery for Early-Stage Non–Small Cell Lung Cancer (MISSILE)
• Stereotactic ABlative Radiotherapy Before Resection to AvoId Delay for Early-Stage LunG Cancer or OligomEts During the COVID-19 Pandemic (SABR-BRIDGE)
• Five-Year Survival Outcomes From the PACIFIC Trial: Durvalumab After Chemoradiotherapy in Stage III Non–Small-Cell Lung Cancer
• Phase II Study of Accelerated High-Dose Radiation Therapy with Concurrent Chemotherapy for Patients With Limited Small-Cell Lung Cancer (RTOG 0239)
• Randomized Phase II Study of Preoperative Chemoradiotherapy ± Panitumumab Followed by Consolidation Chemotherapy in Potentially Operable Locally Advanced (Stage IIIa, N2+) Non-Small Cell Lung Cancer (RTOG 0839)
• Neoadjuvant Nivolumab plus Chemotherapy in Resectable Lung Cancer (CheckMate 816)
• Pacific-2 Press Release, AstraZeneca
• Study of Durvalumab Given With Chemoradiation Therapy in Patients With Unresectable Non-small Cell Lung Cancer (MDT-BRIDGE, in progress)
• Society of Thoracic Surgeons quality initiatives

The Accelerators Podcast is a production of Photon Media, a division of Cold Light Legacy Company.

If you'd like to support our efforts, please visit the Cold Light Legacy Company to learn more.