Running a Cancer Program in 2026: Capital, Operations, and the Job Behind the P&L

Yoel Bakas sits down with Jeff Siupik, a healthcare executive with 35 years in oncology operations and 25 years in oncology leadership. Jeff has put in eight to ten linear accelerators across his career, led oncology programs through every reimbursement shift since the early 1990s, and currently oversees operations across a multi-program system.The conversation walks through the actual job of an oncology administrator in 2026.The balance between growth and expense control. Why P&L looks worse before it looks better when a program is in growth mode, and what most administrators are explaining to finance committees right now.How to read your operation when the metrics look green. The stoplight framework Jeff uses for evaluating efficiency, and why a green department can still have staff running in the red line of mental capacity.The disconnect between the C-suite and the clinical team. Where volume responsibility actually belongs in a healthy program, and where leaders most often misallocate it.Capital decisions in radiation oncology. What separates the programs that get capital right from the ones that do not. Service contracts, software licensing, the ongoing-cost trap, and creative offsets like block leases.AI in oncology operations. A pragmatic take on what AI is actually doing in cancer programs right now versus what is being pitched. Where AI creates time, where it slows things down, and how to think about the patient-side implications.A worked example of how a leadership team handles competing capital requests across service lines, and why “every specialty feels their request is the highest priority” is the room every administrator is in.Yoel and Jeff have known each other for over a decade across the vendor and operator sides of radiation oncology. This is operator-thinking from someone who has lived the job.22 minutes. Worth the time for any administrator, medical director, or system executive running an oncology program in 2026.Medsolve Dynamics: medsolvedynamics.com Reach the team: [email protected]#RadiationOncology #OncologyLeadership #CapitalStrategy #HealthcareExecutive #OncologyOperations