The Care Business

Cancer care has changed over the last several years. Through friends here I have learned that even locally cancer care is housed in one location. Eighteen years ago my surgeon and medical oncologist were both in Columbus. Though there was an oncologist in the town where I lived, I never really considered going to him. My family and I felt the best medical treatment was in Columbus and to me the 26 mile commute was manageable.

Back then my oncologist’s office was right across the street from a major medical center. It made it convenient to go to the hospital for tests and then to return to my doctor’s office for results.

Now I travel an hour to an oncology center in Columbus where the doctor’s offices, chemotherapy, radiation, and testing are all in the same building. Patients are tracked on a computer, and they know our whereabouts in the building at all times. For all appearances it is one stop cancer care. Though it is spacious and consolidated the contemporary furnishings and hard line decorating fail to enhance my feeling of wellness. I prefer a warmer and more charming decor.

The center’s large aquariums are calming but they are a little too much so for a person like me who uses a fast-paced computer most of every day. I usually long for something to hold my interest besides conversation with the person I am with. I would love to read to pass the time but I am not physically able. I suppose if I had an iPod, all things would be different. However, I think the planners wanted patients to relax while they are waiting.

I learned from a friend that she and her husband travel many miles to a large facility for medical care. Since she and her husband’s doctors are located in the same building, each can see their doctor on the same day, thereby avoiding repetitive trips. They also enjoy the coffee shop located there. My sister, in a different location, can also see more than one doctor within the same building on the same day.

Newspapers call the practitioners in these facilities “Big Box Docs”. I do not know if this is medical care’s version of big business or just a glorified HMO. But there is a whole bureaucracy within it. For instance, my oncology center has only voicemail, unless you have a personal extension to dial. Believe me that voicemail is a maze that the nurses here, my sister, nor I like to navigate. I also miss the reassurance of a friendly voice answering the phone.

Instead of one check-in point when you arrive, you can see an insurance/finance person and there is even a social worker available. I did chuckle because they took my photo for the record with a web cam. Though there is big business aspect to it, the old way of scheduling different appointments at separate facilities was confusing and time consuming. ‘

Within a few years these centers will have found their niche. They will have adapted to their populations and have added amenities that are not present now. Someday, patients who bring a carry-in lunch to eat during chemotherapy may be able to order from a creative eatery on site. In the future too these big box docs will be able to more easily coordinate treatment for patients in rural areas like me.