Setting up Oncology unit in a Multispeciality Private hospital

- Few Insights on the Journey

Disclaimer : One year is too short a time to feel " experienced" but the work Intensity if high , limited time is enough to feel so https://twitter.com/sujithonco/status/1308179803195891712

One of the pitfalls of #LMIC Oncology I have seen is options of the practice of Oncology at selected few centres in the country.

The patients often travel great distance from their home place.

We must bring treatment options to the patients in Tier 2 and 3 cities
@cspramesh

My experience at Kannur may be useful to young Oncology minds
who Wish to go back to their Home towns but don't dare because of uncertainty of Unknown.

It's very rewarding experience I can assure you

You will need to have patience though to build up from basics
@Avinashp9Dr

1) Constitute an Oncology team

The most important member of team is "The Oncology Nurse"

Select among existing nursing staff based on 1) Oncology training 2) More importantly, Interest to practice their expertise

Of few interested,Get Inspired ones in team
@OncologyNursing

2)" The Oncology pharmacy "

Expect less than 10% to be insurance patients, our patients pay from their pockets or bank loans

Affordable (for patient)and reasonable (for hospital): Balance vital

Generic choices are plenty: Negotiate with price not Quality

@IJMPOofficial

"The Oncology Daycare"
Don't wait for a full fledged 10 bed daycare to be ready as you join. It never happens in non Oncology multispeciality hospital

I turned a Suite room into 3 bedded Oncology daycare

Get the Biosafety cabinet as part of your joining requirement
@CRSTonline

"The Joint Team"

Most hospital dont have Surgical Oncology unit

Lucky if surgeons experienced in cancer surgery (I was!)

Concept of tumor board but is not clear to them: hurdles in care

Create regular Tumor Boards

Invite and Pursue hard,treat them well
@NawazUsmanDr

4)"Inter department referral"

As you join, the primary specialty like Gastro, Pulmo, Med already have referral pattern to bigger cancer centers around

Communicate and Create mutual respect and discussion

"You need patience before other doctors refer you patients"

@JGO_ASCO

5) "Connect to Cancer Centers Around"

Identify cancer centers in Tier 1 cities near

Talk to senior Oncologists there : Ask their insights

Inform availability and services

Be part of Oncology association meetings: get new friends

They add value to our Life!

@Amolpatel_dr

6)"The Oncology Records"

If Electronic medical records already available, call IT person and learn it

Though daily little time more needed, later saves much

If no system, write in Files/ Books : No loose papers

Keep File safe in medical records
For each visit
@VanitaNoronha

" The Palliative Care"

Expect more patients in advanced stages in your first months

Mostly they are advised Best supportive care from distant cancer centers to back home

Be there for them : they deserve it

Learn Pall care well: thats most important unmet need
@NaveenSalins

8) "The Oncology coordinator"

Being able to contact doctor in case of Emergency ie

"Accessibility" :helpful in improving QOL of patient but can cause Burnout esp if frequent calls (casual ones!)

Get an Oncology coordinator as the Link between you and patient

@oncologician

9) " The Patient Care"

You all are trained to treat cancer ,so no tips on that

" Communicate what you document, Document what you Communicate"

Avoid Jargon and Technical terms : Ask, Tell, Ask again

Respect wishes of family's choice after they have understood you.

@venkymd

10) Have a Life " Outside" Your Job

Being lone Oncologist, it's tough not to be busy

But,
Your family, your hobbies and Your responsibilities outside hospital
make you the person you are. You exist because of them

Your plans stand on these pillars of strength
@lingarajnayak

11) " The Academic Elixir"

As Oncologists, we are lifetime students with changing syllabus every day

Working in tier 2 cities, outside an institution,lack of academics will fatigue you

Create your own way of learning
through social media platforms, online CMEs
@DrNikitaMehra

12) "The Preventive Oncology"

Whichever city you decide to work on, be involved in cancer prevention activities

It helps you to remain young in mind and action just like the MBBS days

It refreshes you so well when you come back after a school talk or marathon
@oncology_bg