Your oncologist appointment protocol?

Chelee · 05-14-2006, 02:38 AM

I've never seen this asked before & I am curious as to how much time your oncologist spends with each of you at your appointment?

I go in weekly due to my herceptin...but half the time I am lucky if I get five minutes. My first visit with my new oncologist was a good lenght of time...I was happy with that. But now I am seeing a pattern I don't like. She keeps telling me she is so busy. (Which I am sure she is...but she choose that profession and had to know what it involved.)

Now I do NOT expect her to spend alot of time with me weekly. But at least once a month I wouldn't think it would be too much to ask her to sit down for at least 10 minutes to see how I am feeling. To see if I have any questions, etc.

Mainly she looks at my lab work and sends me on my way. If I do have any problems...I HAVE to go through my infusion nurse which thankfully I love her to death. She is awesome. I would be lost without her.

But it seems like my new oncologist thinks that one LONG appointment we had when I first went to her to switch doctors was it. After that...she has no time for me. I feel like its just a production line down there.

How does it work with your oncologist? Do you guys get the time you need to cover the things that are important to you? Or do you all get the two minute appts like me?

Chelee

juanita · 05-14-2006, 06:37 AM

With my first onc, I had just brief meetings and he asked me once if he needed to examine me as if it were going to be some big chore to do so. This onc, the first time I saw him I had a long workup session, and he examined me. Since then it's shorter, unless I have questions, which he always takes the time to answer and makes sure I understand. And he always checks lymph nodes in neck, underarms, and---hummm, there's that fog again. Anyway, you get the idea.

Susan2 · 05-14-2006, 11:09 AM

I have been seeing the same onc for the past 6 years. (Diagnosed Stage 2b). She spends at least 10-20 minutes (sometimes more) at each visit - depending on my questions. And some of the questions that she can't answer off the top of her head, she takes and does more research and gets back to me (or has her nurse get back - depending on the question). She's unususal, of course. The nurses expect me to be late to chemo after an appointment because she spends so much time with each patient.

tousled1 · 05-14-2006, 11:54 AM

I only see my oncologist when I get my chemo which iss every three weeks. She takes the time to answer all my questions and concerns. In between that I see her physician's assistant and if I have questions or anything he answers them.

AlaskaAngel · 05-14-2006, 01:27 PM

The general medical onc I've had from the start is extremely in demand, very well-liked, and has to limit the number of patients he sees so that he can give the ones he does see a reasonable amount of time. But even so, he is seeing patients from 7 AM all the way to making phone calls back at 10 PM almost daily, not just to patients but to their doctors as well.

He is in Seattle and I am in Alaska so my day-to-day treatment has been entirely handled by my PCP. My PCP is wonderful and I still think he pretty much walks on water. He can't spend much time with every patient either.

My onc did a 20-minute visit the first time I saw him, and we have half-hour visits yearly. He always returns phone calls. But the communication has NEVER been good and that has resulted in some key problems. He NEVER commits at the end of an appointment as to whether I should book a return appointment or call him or whether he will call me, or what. He sends me off for imaging and frequently doesn't ever call with the results. Well, I'm hanging out there trying to decide just how long I can afford to stay in Seattle for possibly more tests, and what to do about booking my return trip to Alaska. So I've tried calling his office and leaving a message for his nurse to call me. He never allows a nurse to call me back, and calls me himself. When I was trying to decide whether to do chemo he was so vague about the answers to my questions that I asked if I could talk to a nurse or PA of his instead. It took 20 minutes of discussion about it on the phone to get him to have his nurse call me. She and I eventually talked for an hour. I think some oncs really do NEED ancillary staff who can counsel patients and decide which questions the onc needs to answer, and to help the onc understand what problems there are. I think my onc loses some of his valuable time avoiding letting others handle a lot of these questions.

I still feel that neither he nor I are able to communicate well with each other. So I ended up having a consult with an onc who specializes in breast care and genetics, and then later a consult with another onc who specializes in breast care, both of whom work in the same place where my onc works. Communication was far better with them.
A.A.

Jackie · 05-14-2006, 01:42 PM

When I was still receiving chemo I saw my onc every three weeks. Now that I am only on Herceptin I only see him every 3 months....unless something comes up. His infusion nurse is so good to answer many of my questions, but will have me schedule an appt. if there are questions for my onc to answer. This may mean that I will see him that day or later if it isn't pressing. When I do see him he is very good about answering any questions I have. On my reg. scheduled appt. he examines lymph nodes, breast, heart & lungs. This is in addition to the lab work done regularly.

jojo · 05-14-2006, 03:58 PM

If not for the excellent email communication between my onc & myself, and her breast oncology expertise, I do wonder if I would stay with her. I would probably leave, if it was only my onc....

However, I see her extremely experienced onc nurse in EVERY appt (every 3 weeks, actually, and currently every week before weekly chemo), so I meet the onc once every 3 months -- not weeks -- should the nurse think that any current issue require the onc's medical attention. Still, the nurse knows a LOT! She is retiring later this year. :-(

Yorkiegirl · 05-14-2006, 08:13 PM

I saw my Onc every two while on Chemo (Dose Dense).

I am now on weekly herceptin and I see him once a month.

If I needed to see him at other times I can, I may have to wait but I can be seen.

Vicki

Barbara · 05-14-2006, 08:21 PM

Hi:

I am stage 2B and when on dose dense I saw my oncologist every two weeks. Now I am on Herceptin and see him every 3-4 weeks. He does check my heart, lungs, liver and spleen but not my lymph nodes except those on my neck. He goes over my lab values and sits and chats about books, travel, etc. I have as much time as I need for questions.

Barbara

atdec05 · 05-14-2006, 08:41 PM

My onc. saw me at each of my 4 dose dense visits. Then did not see me for my weekly herceptin until I had a problem with high blood pressure. I then saw her after my echo. Other than not telling me that she would not see my weekly once I started my Herceptin treatments, I think she's been very accessible. The great thing is I can send her email if I have any questions and she's very quick to respond.

As others have mentioned, the onc. nurses are very knowledgeable. I'm satisfied that I do not need to be seen weekly on the herceptin.

- Anna

jojo · 05-14-2006, 09:43 PM

Sorry, I overlooked your questions.

First of all, I would see my onc nurse every 3 MONTHS, after I had done the original chemo regimen, until I recurred. I believe that my breast care clinic typically sets up follow-up appts with mets patients every 3 weeks, like me. Now, I am back on chemo, I see her on my chemo schedule, which is weekly Abraxane 3 weeks off / 1 week off.

I have been on maintenance Herceptin weekly, I do not necessarily visit my onc nurse before / after every infusion. I just walk up straight to the infusion floor to get my weekly Herceptin.

Now, to answer your questions Chelee: with my onc nurse, I would spend about 20-30 minutes (I am pretty asymptomic, except in my head, due to my history of brain mets), but with my onc, it would usually last only 10 minutes. Either I have a few questions for her occasionally, or she just rattles off very fast whatever is needed to be said to me. She is one of the quickest-thinking people I have ever met in my whole life, like she is rarely speechless!

sarah · 05-15-2006, 01:32 AM

I generally don't see my main oncologist (who sets my protocol) more than once every 6 months unless there's a panic. I get Herceptin every 3 weeks and the oncologist at the chemo, will look up at me but if I don't have a question for her, she doesn't talk to me either. i do talk to the nurses while they're setting me up and if I have some side effect, they'll mention it to the doctor on hand. I'm not troubled by not seeing an oncologist every time but then I feel I'm on a certain program and if I need to see someone, I can. The chemo oncologist generally wants to see everyone's blood test (weekly ) and a heart test every 3 months. Oncologists are super busy but if you have a worrying question or concern, you should find someone you trust to answer your questions.