October 2010: The Alabama Cancer Congress (ACC) was born on January 1, 2010, the result of a merger between the Oncology Providers Network (an Alabama practice managers’ organization) and the Alabama Society of Clinical Oncology (which served medical oncologists). In the interview that follows, ACC leadership including President Stephen L. Davidson, MD, Vice President Gina Seibert, Terry Lynn Jeffcoat, and Executive Director Mary Jo Wichers discuss the administrative and programmatic decisions that have allowed their society to better serve its members.

AC: What are the particular challenges faced by oncology care providers in Alabama? How does ACC work to address those challenges?
ACC: The issues Alabama faces are no different than those being experienced on a national level. The cost of care and the demands practices must navigate in the current environment are becoming more and more treacherous. Remaining nimble in an industry that is under attack, serving the uninsured and underinsured, and maintaining a thorough understanding of the requirements to manage a business and remain viable is critical in the provision of care.

The three components central to ACC are the answers to address the challenges: Members must be educated, must remain engaged in the changing landscape, and must do so as a body rather than as individual members.

AC: ACC went through a revitalization recently. How did that come about? What changes have you observed in the society?
ACC: ACC was formed through the merger of two existing oncology societies in Alabama—the Alabama Society of Clinical Oncology (physicians), and Oncology Providers Network (practice managers) under the new name of Alabama Cancer Congress, effective January 1, 2010. Our mission focuses on “Advocacy, Education, and Sense of Community.”

Leadership by ACC President Stephen L. Davidson, MD, of Montgomery Cancer Center, has made all the difference in the merger and the new society. Dr. Davidson recognized that success in a state society would come from involving representation from each oncologic discipline. He recruited board members who were recognized by their peers as leaders in their specialty. He knew that contributions from various perspectives would benefit the society as a whole in efforts addressing core issues of advocacy and education in our community of care providers. The responses and input from those individuals actually lead to the success [of the organization]; their recognition of the need for combined efforts was consistent with the intentions of ACC, and they were willing to participate and provide leadership to their colleagues. Dr. Davidson is skilled at building consensus among Board members.

Alabama Cancer Congress is an umbrella-type organization where all the types of cancer providers in the state come together. The representation of each discipline is illustrated on our website (www.ALcancercongress.org). There are a number of “home” pages so that different specialties can provide information for their particular membership.

AC: How have electing a Board of Directors and hiring an Executive Director made the organization more effective?
ACC: The new Board of Directors represents all of the cancer providers in the state for the first time: medical, radiation, gynecologic, and neuro-oncologists; practice managers; oncology nurses; second-year fellows; radiation therapists; and rural, urban, community, and academic physicians.

Having an Executive Director (ED) helps the society to be more neutral, rather than passing leadership back and forth between large practices. The ED is able to work with the different providers to provide relevant programming, plus different types of accreditation. We are lucky to have a strong partnership with academia and the community. In fact, the University of Alabama Birmingham is providing continuing medical education for our meetings at no charge.

Having an ED has also helped with political and legislative issues. There is now continuity among all disciplines, particularly regarding advocacy, as the Executive Director can empower the masses on issues that need to be addressed. Rather than having just a few of the larger practices involved in legislative issues, now all practices, no matter their size, are able to participate and have representation. Every practice and specialty is educated and provided consistent talking points and instruction for contacting Congress in addition to other local and national decision makers. With the increased demands within a practice regarding reimbursement issues, there is now a greater understanding that brings involvement. The message is clearer.

Our ED has seven years of experience working with state affiliates and specializes in taking low-functioning societies and revitalizing them into strong ones.

AC: Describe the Destin meeting – how did it all come together? What were the highlights? Was it a successful event?
ACC: Our meeting in Destin was a success. The first meeting following the formation of ACC was a landmark event with focus and vision. The meeting began with a general session introducing the website, the vision of ACC, and the decisions that had been made by the Board to involve the entire oncology community in this effort. We had clinical, business, nurse, and radiation therapy tracks.

The educational sessions began Friday at lunch for nurses, radiation therapists, and business attendees. The sessions on Saturday included clinical, radiation therapy, nurse, and business tracks. Sunday morning the nurses and radiation therapists partnered together for their speakers. There were several combined-modality therapy sessions to provide topics of interest to different types of oncologists. Our radiation oncologists and therapists say they finally feel like a part of the society!

An Advocacy Panel began the General Session on Saturday with the largest gathering of attendees for a statewide meeting. Representatives from ASCO, the Community Oncology Alliance (COA), the Medical Association of the State of Alabama (MASA), Cahaba (Medicare), and a representative of Blue Cross Blue Shield (BCBS) of Alabama presented.

It was so successful that we had to order 60 additional lunches on the first day for attendees who hadn’t registered. We also had to increase all the meal numbers. Our attendance was 300-plus for the first time. We had two great networking receptions on Friday and Saturday nights.

There was definitely a “Sense of Community” during the Destin meeting. As a result of the meeting we are now working with BCBS of Alabama, which has 80% of the private payer market.

AC: What was the impetus for your 2009-2010 State Affiliate Grant project “Census of Cancer Providers in Alabama”? How is the project progressing?
ACC: While researching cancer providers in the state, the ED came upon a list of members of the Alabama Comprehensive Cancer Control Network. There wasn’t a single community oncologist listed. At our first Board meeting we discovered that the different specialties didn’t have full and accurate information about their members. That’s when we decided to apply for the ASCO grant.

We now have 604 cancer providers in our database. A quick review shows 200 nurses, 10 mid-level providers, 167 physicians, 55 radiation oncologists, 83 radiation therapists, 69 business members, and 6 fellows, plus a few others. Getting complete information for all of them is a work in progress.

We partnered with a large accounting firm with a health specialty focus and did an online survey earlier this year on the operational aspects of practices. We were disappointed in the results and so have done a second survey (by paper) which went out with all brochures for our October 15th meeting. Many surveys have already been faxed in. We also sent out a third survey about a week ago, this one online. It covers salary information so we will get information about the average pay rate for all of the oncology positions we could think of. We won’t have results of that survey for a couple more weeks.

AC: What advice would you give to other state societies that are looking to get energized and have a bigger impact on their communities?
ACC: Reach out to other types of cancer providers and get them involved on the Board and/or as speakers. A paid professional ED has the ability to provide more services than someone doing the work as a volunteer above and beyond their regular job. There must be continuity and a return to the membership. Look around at the different types of cancer providers in your state and see who might want to partner with the state society. Having members of different types (business, nurse, radiation therapy) can make the society stronger. The approach of combined modalities works in patient care and can be quite successful in the life of a society. As various perspectives are offered, solutions are more dynamic.