out of the basement / radiation medicine

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

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...

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 "radiati...

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...

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

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 deferenc...

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 o...

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 t...

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 s...

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...

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)....

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...

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, eve...

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...

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

"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...

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 Supervisi...

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"...

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...

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 hospita...

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 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...

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 al...

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...

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 d...