Taking a Deep Breath Before the Holidays

Dawn Holcombe, MBA, FACMPE, ACHE
Editor-in-Chief
President, DGH Consulting, South Windsor, CT

It seems that throughout 2014, those of us in oncology have ­been moving at 100 miles an hour. ­New challenges hit us every day and can involve regulatory or reimbursement issues, patient or personnel concerns, operational setbacks, or any combination of the above. We turn to our colleagues, resources such as Oncology Practice Management, and association conferences and meetings to stay well informed and ready to guide our organizations through the next day, week, month, or year. Despite the speed at which we are moving, though, I am awestruck at how far we still have to go. We are in the midst of a major healthcare transformation, and a window into oncology practices offers a microcosmic view of the entire healthcare system.

Our organizations are tasked daily with doing more with fewer resources. The changes now required of us and our practices challenge cultural norms, pitting physician against physician, and team members against one another. More than one practice has seen key staff members leave rather than accept the changes planned by a progressive group. The good news is that the remaining teams are definitely leaner and more focused. Change can be empowering, if you survive it.

?Will we embrace accountable care affiliations, medical home models, patient-focused culture shifts, integration, affiliation, acquisitions, and the breakup of existing acquisitions? The answer is probably that many of these options will hit each one of us, if they haven’t already. Each change will take a piece of us, both personally and professionally.We have payers and employers who are understandably concerned about oncology and who may have expectations regarding outcomes, data, and performance that are slightly ahead of where we are. It will take new and very tightly honed negotiating and analytical skills to push working collaborations.

In oncology, clinical issues are evolving and change is coming rapidly. We are rushing toward the concept of personalized medicine; however, while the tools, screenings, and biomarkers under development are being lauded for their potential in targeted therapy, some are also being challenged as a gray area in evidence-based medical decision-making. There are so many new tools being developed that we don’t have the time to sort the wheat from the chaff. It will take more time before we have the answers we want for our patients, yet we are tasked and challenged by both payers and patients to understand, explain, and justify the options.

This all seems overwhelming ?and humanly impossible to accomplish. Patients continue to need us, however, and in some mechanism, we will provide for them. Our world may soon look dramatically different in ways we cannot at this point comprehend, but we will get there. What gives me hope is that, as I continue to attend conferences and meetings, I am surrounded by intelligent people who have an undeniable passion for their patients, their colleagues, and the prospect of beating cancer.

Oncology leaders are a special group. We can reach our goals, and hopefully we can also take a deep breath and be proud of ourselves. I do think that we will need to reach out to each other through our professional associations, and even our mentally rejuvenating social media connections. As the holidays approach and we celebrate with our families, I’d also like to take a moment to celebrate our oncology family, all of whom keep moving forward despite the challenges we face. The holiday season draws closer, with all of its joys and obligations, but let’s also remember the beauty of our efforts, and not forget to stop, take a breath, and feel proud for a few moments.

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