The Accelerators Podcast

The Accelerators

Oncology News and Views from Photon Media. For more info, please visit photonmedia.org.

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Episodes

On Lymphedema and Treatment with Mary and Katelyn from Tactile Medical
Apr 9 2024
On Lymphedema and Treatment with Mary and Katelyn from Tactile Medical
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 TherapistAmerican Physical Therapy Association - Find a Physical TherapistEditor'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.
“A Recent Article in the Red Journal”: A Rad Onc Policy Journal Club
Feb 13 2024
“A Recent Article in the Red Journal”: A Rad Onc Policy Journal Club
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 propagandaOut.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 authorsMark Storey's rebuttal to the IJROBP articleThe 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.
“Squatting Under the Table Feeding Them Answers”: In Conversation With Mike Yunes of the ABR
Feb 7 2024
“Squatting Under the Table Feeding Them Answers”: In Conversation With Mike Yunes of the ABR
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 boardsOut.Of.The.Basement, Beckta covers the contentious 2018 ABR initial certification resultsHere are some other resources discussed in the episode:Beriwal et al., Interdisciplinary debate on the physics test contentGolden, United States Radiation Oncology Curriculum Development: The Tail is Wagging the DogWarwzuta et al., The rise of negative portrayals of radiation oncology: A textual analysis of media newsChimney Rock Winery, a Yunes' family favoriteSee Mike's blog in ABR The BeamThe 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.
MattPAC #2: Quality Payment Programs and Accreditation
Jan 29 2024
MattPAC #2: Quality Payment Programs and Accreditation
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 OncologyMedPAC report, Examining MACRA implementation and the road aheadMedPAC report, Moving beyond the MIPsGAO Report, Provider Performance and Experiences under the Merit-based Incentive Payment SystemPatel et al., Oncologist Participation and Performance in the Merit-Based Incentive Payment SystemLuh, Radiation Oncology Alternative Payment Model's Impact on Small and Rural PracticesJones et al., Merit-Based Incentive Payment System (MIPS) Participation in Radiation Oncology Practices — A Simple SurveyChera et al., Improving Quality of Patient Care by Improving Daily Practice of Radiation OncologyCoia 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 FutureVisit the CMS QPP page for a lot of info: check your participation status, MIPs guides, APMs, and moreASTRO ROCR FAQ pageThe 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.
“I’m Gonna Put My Helmet on First”: On Lung Cancer Surgery With Brendon Stiles
Dec 5 2023
“I’m Gonna Put My Helmet on First”: On Lung Cancer Surgery With Brendon Stiles
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 operabilityLobar 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 CancerPhase 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, AstraZenecaStudy of Durvalumab Given With Chemoradiation Therapy in Patients With Unresectable Non-small Cell Lung Cancer (MDT-BRIDGE, in progress)Society of Thoracic Surgeons quality initiativesThe 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.
“Have You Been to Oscar’s?”: Neurocognition and Radiation Toxicity With Jona
Nov 14 2023
“Have You Been to Oscar’s?”: Neurocognition and Radiation Toxicity With Jona
The Accelerators (Drs. Matt Spraker and Simul Parikh) host radiation oncologists Dr. Jona Hattangadi-Gluth and PGY-5 resident Dr. Austin Hopper. Jona is a central nervous system malignancies expert, co-lead of the Central Nervous System Disease Team and Associate Professor of Radiation Oncology at UC San Diego. In this episode, we discuss Jona's lab's work in understanding the link between brain tumors, radiation (and other) treatments, and neurocognitive toxicity. We start by discussing Austin's recently presented work that developed an normal tissue complication probability (NTCP) model for radiation dose and attention/processing speed. Later, we discuss specific methods used in the NTCP work. How can this work be translated to clinical counseling and practice? Also, Matt argues that building NTCP models based on neurocognitive outcomes, such as attention or fine motor control, can be more difficult to model than more simple clinical outcomes such as pneumonitis.Here are some links to things we discussed during the show:Connor et al., 2023. Fine Motor Skill Decline After Brain Radiation Therapy—A Multivariate Normal Tissue Complication Probability Study of a Prospective TrialUnnikrishnan et al., 2021. Phase II Clinical Trial of Image-Guided Cognitive-Sparing SRS in Patients With Brain MetastasesOscar's Mexican Seafood, Oncology Twitter's favorite fish tacos in San Diego.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.
MattPAC #1: MPFS, Sites of Service, and HR2474/HR3674
Nov 10 2023
MattPAC #1: MPFS, Sites of Service, and HR2474/HR3674
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 #RadOnc advocacy in 30 minutes or less.  In MattPAC #1, Matt covers two current congressional bills that are currently being considered for inclusion into next year's Medicare legislation: HR 2474 and HR3674. These bills seek to link Medicare physician pay to inflation and boost practice expense reimbursement for freestanding practices. The history of Medicare, administration processes, the payment formula, and sites of service are covered for context. Here are some good resources for further reading on these topics:A paper on how Medicare drove hospital desegregation, especially in the south.Power To Heal: Medicare and The Civil Rights RevolutionHow is Medicare Funded?Information about Medicare administration and procedures, WikipediaA lot of info on the RUC, AMAThe medicare physician fee schedule payment formula, MedicalBillersAndCoders.comInteresting write up of history of conversion factors, AMAMedicare payments are not keeping up with inflation, AMAFramework for Rational Medicare, AMAAMA letter to congress about these issues, March 2023AMA commends MedPAC for recognizing challenges of inflationary environment, April 2023HR 2474A Primer On Office Based Specialty Care, USPAUSPA Letter to MedPAC about threats to free standing specialty practices, such as Rad Onc2023 survey of multi-specialty practices regarding Medicare cutsHR 3674The 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.
Why You Should Care and How to Care Less: Billing with Shawna from Radformation
Sep 26 2023
Why You Should Care and How to Care Less: Billing with Shawna from Radformation
It's a Photon Media crossover episode! Accelerators co-hosts Drs. Matt Spraker and Simul Parikh team up with Dr. Jason Beckta, host of the Out Of The Basement podcast, to talk about billing. We are joined by Shawna Stacey, ROCC, MBA, Coding and Billing Specialist at Radformation. The episode kicks off with a discussion about why you should care about billing and coding. Matt, Simul, and Jason discuss their (lack of training) training and experiences trying to learn on the job. Simply learning about billing and coding doesn't make you greedy, it helps you understand how you are paid for your work. A transparent and well funded clinic offers the best chance of optimizing care for your patients! Feeling overwhelmed by billing and wish you could just stick to patient care? Us too. Later in the episode, we discuss resources that help you not care, especially Radformation's QuickCode. You already know how AutoContour and ClearCheck have automated your clinic, QuickCode does it for billing and coding. Don't believe us? We close the episode by asking Jason and Simul to "break" QuickCode with a complicated billing and coding scenario that is sure to frighten even the experts. Here are some things we discussed during the show:"What is a MAC?", from CMS"What's an LCD?", from Medicare.govACROInsights Newsletter from the Goverment Relations/Economics Committee (membership required)Editor's Note: While our love for their products is genuine, The Accelerators were compensated for this episode and Radformation participated in planning the content. The discussions in this episode are the opinions of the participants and are not billing and coding advice. Please see our website for complete information on our past and current sponsors. The Accelerators Podcast is a Photon Media production.
“Dare I Say It”: Psychedelics in Oncology With Daniel
Aug 24 2023
“Dare I Say It”: Psychedelics in Oncology With Daniel
On this week's episode, Accelerator Dr. Simul Parikh hosts Radiation Oncologist Dr. Daniel Koffler to discuss psychedelics in oncology!They kick off the conversation by discussing ketamine. They review it's use in head and neck and gynecologic cancers, and discuss two trials by Daniel and colleagues (see below).Later, they discuss the systemic use of psychedelics, some practical advice for incorporating psychedelics (topical and systemic) and collaborating with psychiatrists and psychologists in your local practice.Here are some things discussed during the show as well as some more stuff you should check out:Clinical trial of ketamine mouthwash by Daniel and friends (get the protocol)Clinical trial of ketamine psychotherapy (KAPTIVATED) by the sameAnalgesic effects of topical ketamine, a reviewTreatment of severe mucositis pain with oral ketamine mouthwashTopical Ketamine in the Treatment of Mucositis Pain, a dramatic case report"Finding medical value in mescaline" in NatureEfficacy of ketamine therapy in the treatment of depressionEfficacy of Esketamine Nasal Spray Plus Oral Antidepressant Treatment for Relapse Prevention in Depression(Editor's Book Recommendation! For an excellent book on the history of psychedelics research and their resurgence, check out How To Change Your Mind by Michael Pollen)Podcast art generously donated by Dr. Danielle Cunningham. Intro and Outro music by Emmy-award winning artist Lucas Cantor Santiago.The Accelerators Podcast is a Photon Media production.