Expanding Access to Integrative Oncology Through Group Visits with Donald Abrams, MD
Purpose: Patients seeking integrative oncology consultation are often stymied by the dearth of providers practicing in the field. For many, this may mean that an initial appointment may be scheduled months down the line, after they have completed the initial treatment of their malignancy, a time during which integrative interventions may be most valuable. In an effort to ameliorate this situation, a pilot program initiating integrative oncology group visits at the University of California San Francisco Comprehensive Cancer Center was established with funding from a philanthropic donation. In addition to providing more timely care to a larger number of patients, the new program brought integrative oncology to the Cancer Center campus which had moved from being across the street from the Osher Center for Integrative Medicine to a new site 4 miles across town.
Method: Six to 12 participants and their caregivers were scheduled for each group. A series of 3 group visits was created. The first session focused on nutrition, the second on supplements including cannabis, and the third on other modalities integral to the practice of integrative medicine including physical activity, yoga, laughter yoga, traditional Chinese medicine, stress reduction and spirituality. Sessions were spaced one or two weeks apart in the pilot series. During each 2-hour session, one hour was spent in discussion of the topic and during the second hour patients spent 7-10 minutes in private consultation with the integrative oncologist. An EPIC note template was created for each visit and completed during the individual consultation, allowing the visit to be billed to the patient’s insurance. In the current era of telemedicine, the visits are conducted on ZOOM. Patients remain in the session room so they can continue to communicate while the oncologist meets with each individual in a “break out” room. The initial sessions were limited to patients with gastrointestinal malignancies receiving chemotherapy. Current sessions are open to patients receiving treatment as well as survivors regardless of site diagnosis. A similar program is now being offered solely to brain tumor survivors.
Results: During the pilot phase of the program, patients and caregivers were asked qualitative and quantitative questions via forms and structured interviews with a social anthropologist. Eighty-two participants rated the program very favorably using a Likert scale. With 5 as the top, the mean ratings were overall session 4.7; instructor’s organization, knowledge and attitudes 4.8; group visit format 4.6; adequate time for questions 4.3; and would recommend to others 4.9. As the sessions were financially sustainable, integrative oncology group visits have continued to be offered as a collaborative effort between the Cancer Center and the Osher Center for Integrative Medicine. Patients who have completed the series are invited to schedule follow-up individual visits with the integrative oncologist at the Osher Center for continued consultative care.
Conclusions: Integrative oncology group visits are feasible, well-received and financially sustainable. The model is adaptable to multiple clinical settings and can be modified as appropriate, allowing more patients to obtain consultation in a timely manner while benefitting from group support.
Learning Objectives
To describe a format for integrative oncology group medical visits
To review patient satisfaction with integrative oncology group medical visits
To demonstrate how group medical visits may be instituted to expand timely access to integrative oncology consultation
Purpose: Patients seeking integrative oncology consultation are often stymied by the dearth of providers practicing in the field. For many, this may mean that an initial appointment may be scheduled months down the line, after they have completed the initial treatment of their malignancy, a time during which integrative interventions may be most valuable. In an effort to ameliorate this situation, a pilot program initiating integrative oncology group visits at the University of California San Francisco Comprehensive Cancer Center was established with funding from a philanthropic donation. In addition to providing more timely care to a larger number of patients, the new program brought integrative oncology to the Cancer Center campus which had moved from being across the street from the Osher Center for Integrative Medicine to a new site 4 miles across town.
Method: Six to 12 participants and their caregivers were scheduled for each group. A series of 3 group visits was created. The first session focused on nutrition, the second on supplements including cannabis, and the third on other modalities integral to the practice of integrative medicine including physical activity, yoga, laughter yoga, traditional Chinese medicine, stress reduction and spirituality. Sessions were spaced one or two weeks apart in the pilot series. During each 2-hour session, one hour was spent in discussion of the topic and during the second hour patients spent 7-10 minutes in private consultation with the integrative oncologist. An EPIC note template was created for each visit and completed during the individual consultation, allowing the visit to be billed to the patient’s insurance. In the current era of telemedicine, the visits are conducted on ZOOM. Patients remain in the session room so they can continue to communicate while the oncologist meets with each individual in a “break out” room. The initial sessions were limited to patients with gastrointestinal malignancies receiving chemotherapy. Current sessions are open to patients receiving treatment as well as survivors regardless of site diagnosis. A similar program is now being offered solely to brain tumor survivors.
Results: During the pilot phase of the program, patients and caregivers were asked qualitative and quantitative questions via forms and structured interviews with a social anthropologist. Eighty-two participants rated the program very favorably using a Likert scale. With 5 as the top, the mean ratings were overall session 4.7; instructor’s organization, knowledge and attitudes 4.8; group visit format 4.6; adequate time for questions 4.3; and would recommend to others 4.9. As the sessions were financially sustainable, integrative oncology group visits have continued to be offered as a collaborative effort between the Cancer Center and the Osher Center for Integrative Medicine. Patients who have completed the series are invited to schedule follow-up individual visits with the integrative oncologist at the Osher Center for continued consultative care.
Conclusions: Integrative oncology group visits are feasible, well-received and financially sustainable. The model is adaptable to multiple clinical settings and can be modified as appropriate, allowing more patients to obtain consultation in a timely manner while benefitting from group support.
Learning Objectives
To describe a format for integrative oncology group medical visits
To review patient satisfaction with integrative oncology group medical visits
To demonstrate how group medical visits may be instituted to expand timely access to integrative oncology consultation
Purpose: Patients seeking integrative oncology consultation are often stymied by the dearth of providers practicing in the field. For many, this may mean that an initial appointment may be scheduled months down the line, after they have completed the initial treatment of their malignancy, a time during which integrative interventions may be most valuable. In an effort to ameliorate this situation, a pilot program initiating integrative oncology group visits at the University of California San Francisco Comprehensive Cancer Center was established with funding from a philanthropic donation. In addition to providing more timely care to a larger number of patients, the new program brought integrative oncology to the Cancer Center campus which had moved from being across the street from the Osher Center for Integrative Medicine to a new site 4 miles across town.
Method: Six to 12 participants and their caregivers were scheduled for each group. A series of 3 group visits was created. The first session focused on nutrition, the second on supplements including cannabis, and the third on other modalities integral to the practice of integrative medicine including physical activity, yoga, laughter yoga, traditional Chinese medicine, stress reduction and spirituality. Sessions were spaced one or two weeks apart in the pilot series. During each 2-hour session, one hour was spent in discussion of the topic and during the second hour patients spent 7-10 minutes in private consultation with the integrative oncologist. An EPIC note template was created for each visit and completed during the individual consultation, allowing the visit to be billed to the patient’s insurance. In the current era of telemedicine, the visits are conducted on ZOOM. Patients remain in the session room so they can continue to communicate while the oncologist meets with each individual in a “break out” room. The initial sessions were limited to patients with gastrointestinal malignancies receiving chemotherapy. Current sessions are open to patients receiving treatment as well as survivors regardless of site diagnosis. A similar program is now being offered solely to brain tumor survivors.
Results: During the pilot phase of the program, patients and caregivers were asked qualitative and quantitative questions via forms and structured interviews with a social anthropologist. Eighty-two participants rated the program very favorably using a Likert scale. With 5 as the top, the mean ratings were overall session 4.7; instructor’s organization, knowledge and attitudes 4.8; group visit format 4.6; adequate time for questions 4.3; and would recommend to others 4.9. As the sessions were financially sustainable, integrative oncology group visits have continued to be offered as a collaborative effort between the Cancer Center and the Osher Center for Integrative Medicine. Patients who have completed the series are invited to schedule follow-up individual visits with the integrative oncologist at the Osher Center for continued consultative care.
Conclusions: Integrative oncology group visits are feasible, well-received and financially sustainable. The model is adaptable to multiple clinical settings and can be modified as appropriate, allowing more patients to obtain consultation in a timely manner while benefitting from group support.
Learning Objectives
To describe a format for integrative oncology group medical visits
To review patient satisfaction with integrative oncology group medical visits
To demonstrate how group medical visits may be instituted to expand timely access to integrative oncology consultation