To grieve over our past OR Change the world!!!

To grieve over our past OR Change the world!!!

John V. Cox

Jun 30, 2010

As I highlighted in the May editor’s desk column -- a colleague noted that in traveling the country, she had found oncologists often voiced feelings of being victimized by the ‘system’. They were tired, overburdened by the moment, and struggling with market forces in their locales, whether insurance contracting, hospital/institutional relationships, or interpersonal conflicts in practice. The language used is that of victims.

A cancer survivor, on hearing this discussion, questioned, “Don't you see? You folks are in the perfect place! You have influence over the patients in your care. You can change the system.” She saw the opportunity in change. Are oncologists so focused on the moment, grieving for what is lost and what has “been done to them,” that they do not see the opportunity that health care change can provide?

This is not to underestimate the challenge. Our future lies not in models of care built around buy-and-bill chemotherapy services, nor does it lie in elaborate, freestanding centers with integrated technology designed to diversify revenue. The future is ours to define, and it will be patient centric. My bet is that it will focus on teamplay, on cooperation rather than competition, and on integrating disciplines rather than simply diversifying income streams. Such patient-centered approaches are featured in the “Blueprint for a Better Cancer Care System” created by the Cancer Quality Alliance. A better system will be generated by our innovation, spurred on by the stressful opportunity of change.

To this end, the May issue of the Journal of Oncology Practice contains the first part of an article by two attorneys, Barkley and Blau, describing the complexities of bringing about structural business change in a market context. How do you partner with your competition or your hospital neighbor? The article is based on a presentation at the Third Annual Cancer Business Summit held last year in Dallas, Texas. The detail and depth of this piece will provide readers with an understanding of the complexities with which change will force us to grapple. Yet I believe the opportunities of working together to provide better care will likely drive many of these discussions. The second part of the article will be published in the July issue.

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