Dr. Todd Scarbrough and Dr. Nick Zaorsky (http://zaorsky.com/) join Dr. Matt Spraker for a jobs show boost! In this show we take a deep dive on radiotherapy utilization in the US. We start our exploration by reviewing a recent Cancer publication from Nick's team evaluating facility volumes. By reformatting Nick's data presentation, Todd discovers that utilization exists in a Pareto distribution across centers; most centers are treating a relatively low volume of patients per year.  How does this affect the job market? How does it affect your job?Also, Simul calls in to speak against training expansion and Todd and Matt shares their thoughts on the changing landscape of radiotherapy utilization for patients with lung cancers. Here are some links to things we discussed on the show:Nick’s tweetorial about his team's paper Todd’s tweetorial evaluating Nick’s team's data Todd's tweetorial evaluating medicare payment dataTodd's tweetorial on radiotherapy utilization for lung cancer The Alabama Band Dr. Join Luh's editorial on how the proposed RO-APM could have impacted small and rural radiotherapy centers.Show art generously donated by Dr. Danielle Cunningham.