Cancer patients get better care than patients in primary care

Why do my patients with cancer get better care than my patients in primary care? As the senior resident on my hospital’s inpatient leukemia service recently, this question troubled and intrigued me daily.

Despite the sheer complexity of treating leukemia (administration of chemotherapy, bone marrow biopsies, stem cell transplantation), the resources required (transplantation routinely costs $1 million), and the severity of the illness (patients with little to no functional immune system), I couldn’t help but marvel at how coordinated, integrated, and patient-centric the care was.

From the first day I saw that things in leukemia worked differently. Most inpatient ward teams consist of an attending, a senior medical resident, one or two interns, and medical students. Each member of the team is “on service” for 2-4 weeks after which they rotate to different parts of the hospital or to the outpatient or research setting. As a result a patient admitted to general medicine today is taken care of by a completely different team than took care of her 3 months earlier when she came in for the same problem. On leukemia, our medical team included an advanced practice nurse (APN) who did not rotate off and on service.

via kevinmd.com

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