Provider Roles

Lately I have noticed that there is a lot of confusion about who to contact and what is the expected role of the various health professionals that you come into contact with. Once the diagnosis has been confirmed you will either have a consultation with a surgeon, medical oncologist or both. There is a distinct advantage to seeing both as their knowledge about each others fields are somewhat limited. A surgeon is not an expert in chemotherapy and often is not aware of the new clinical trials that are available and often times if a surgery cannot be completed as planned will send you back to a local oncologist who also is usually not well informed. If you meet with a medical oncologist with a expertise in mesothelioma then they can discuss chemotherapy options as well as be prepared to take over your care following surgery, in preparation for surgery or when surgery is not an option. Once the surgery is completed and you have been discharged the surgeon has no role in your care. He should not be counted on to give advice regarding chemotherapy or interventional radiology procedures. You need to move on as you are now entering a new realm and your care should be directed by an oncologist who will manage your care for the duration of your oncology needs. Most of the surgeons and oncologist will have either a PA or NP who works closely with them. This is the person who is usually the most accessible and will direct your calls to the physician if there is something that requires more expertise than they have been trained for. The research nurse is responsible for the study that you might be on and there role is to make sure that the requirements of the study are fulfilled, you will need to get clarification of their role as every practice is different. The radiologist who performs your scans is usually not the person who gives you the results and the medical oncologist or surgeon will sometimes need to discuss your history with the radiologist so that they can make some judgement calls with the history factored in. All results are interpreted based on your prior scans, medical history and sometimes with the timing of the chemotherapy. We usually do not release the results to the patient until the physician has signed off and hopefully has had a chance to discuss them with the patient. There is nothing worse than being saddled with bad news from someone who is not able to tell you what you can do to turn the situation around.

~Mary Hesdorffer, NP