The Oncology Setting That Fits Your Needs
If you live in the Washington Metropolitan area you are very lucky your oncology options are numerous and quite good across the board.
In general, a tertiary care center (university) is an ideal setting for special procedures like transplants or experimental protocols. Also if you have a very rare cancer, an academic center is probably a better fit for you.
Notoriously, tertiary cancer centers are very inefficient. Often it takes weeks just to get an initial consultation and once you get seen, it takes weeks to actually start the therapy. Also, patients do not realize that the day-to-day care is in the hands of doctors-in-training, so if you have special needs this is not an ideal setting for you.
Nowadays, hospitals are being swallowed by large management companies that are trying to increase revenues. Outpatient infusion centers are mushrooming all over the place. What you do not realize is that hospitals can charge 10 times more for a drug compared to private practitioners. One patient who received gemzar in my office for $1,200 was charged $12,000 when his therapy was administered in a hospital infusion center. This is very important to know because if your insurance company pays only a portion of your charges, you will be left with a huge out-of-pocket expense. Also, what would be a one-hour procedure in an office setting becomes a 5-8 hour ordeal, which is fine if time is not an object.
The NCI (National Cancer Institute) is an ideal place if you need an experimental protocol and have no insurance since the drugs will be given to you free of charge. In order to qualify for an NCI trial you have to meet the strict protocol criteria.
As far as finding a private practitioner, board certification is very important, but in addition to that you want a well read physician who keeps up with the literature since the number of drugs being developed in oncology has sky rocketed and treatments are increasingly more effective and less toxic. You can choose large groups with large non-private infusions rooms, some patients like to chat with neighbors while getting treatment. Or you can choose smaller groups or solo practices with private rooms you can share with family and friends only. Usually in the private practice setting you have more direct contact with your doctor and the treatment flow and timing is much more efficient.
Remember, you are the customer, if you are not satisfied you can change.