Research Hospitals Aren't As Impossible As They Seem
In my perfect world for cancer patients, I would be able to reach every cancer patient with an important message; “get a second opinion, and get it at a research facility.” Entering these research hospitals can be a time-consuming and often unfriendly task when you are urgently faced with a critical diagnosis. Yet I urge my patients to endure the initial frustration and press on by following a few suggestions I will outline below. I am working to effect change inside hospitals as well as ease the burden on cancer patients. Cancer is not a “please let me place you on hold” issue.
I believe research hospitals should open their doors for cancer patients to include diagnoses, second opinions, biopsies, surgeries, treatment, scans, etc. Inside the doors of our national research hospitals, you find the best chance for the most accurate diagnosis and treatment for your unique cancer. This is where research takes place, cancer treatments are designed, and clinical trials are developed. Research hospitals are where the nation’s top recruits are trained and where the best specialists in the world spend their lives treating patients. These facilities are where they meet as a collaborative team and develop the best protocol for your cancer diagnosis; the oncology, surgery, pathology, and radiology departments discuss, review and design specific treatment protocols for each patient’s unique cancer.
These facilities save lives. But they can be complicated to navigate, extremely busy, and frustrating to endure ongoing recordings, prompts, and voicemails. They don’t make it easy, and patients often give up and choose the easier and faster route by selecting the doctors who can see them first. Unfortunately, this can come at a cost - data shows up to 35% of cancers are misdiagnosed.
In a perfect world, I would develop a program that ensures every patient has access to sub-specialty oncologists who have the expertise to understand their cancer and how best to manage it. This includes community hospitals collaborating with research hospitals for the cancer patient, and it includes insurance not only paying for the second opinion but encouraging it.
In a perfect world, patients would understand that simply having insurance doesn’t always allow them access to the experts when they need them the most. In a perfect world, insurance providers would understand that the right diagnosis and treatment the first time means lives saved and efficiencies in cost.
It is not a perfect world, so we have to prioritize our health when faced with a healthcare crisis like cancer and understand the process of getting seen at a research hospital. Knowing in advance what the process entails can make the road a little smoother by following these steps:
NOTE: If your cancer and symptoms are critical, you may receive immediate surgery to remove tumors and/or handle any biopsies required. Prior to this occurring, there is usually time to inquire, “can this wait a few days to get a second opinion, or is it urgent?” Most doctors and hospitals understand second opinions (they would ask for it themselves), and they are honest with us. Often our doctors will agree and recommend whom they would refer us to. If they agree that we have some time to explore further, take the time.
Know in advance where your closest research hospital is. If you or a loved one is faced with a cancer diagnosis, this is one decision that will already be made: a second opinion at the facility closest to you.
Request your medical records immediately. This can be a daunting task through the anxiety of any diagnosis, but second opinions won’t occur without the specialist’s ability to review your records. The minute any diagnosis is made, assume you may want a second opinion and get the process moving.
Call the cancer number provided by your closest facility and request the best referral for your cancer. This is the point where your patience will most be tested as you endure the collection of data to establish yourself as a patient as well as the difficult insurance question. You will be asked for your full name, date of birth, address, phone, PCP name, emergency contact, and numerous other questions. Take deep breaths, this is not an easy process.
Insurance can be a problem if the research facility is not included in your insurance network. There are “cash-pay” options that are offered for second opinions. NOTE: As I often say, having insurance doesn’t always allow access to top-notch facilities. This is an important consideration when selecting insurance.
You cannot get an appointment until the records are received and reviewed. Expect to wait 5-10 days for a call back to provide the appointment date and time and the name of the specialist who is best suited for your unique cancer.
Take the appointment! If your cancer is urgent and critical, typically, you will get seen faster. You can use the time awaiting the appointment to meet with your local oncologist to understand the diagnosis and become educated on their recommended treatment protocol. This equips you with further information to apply to the research facility’s second opinion, which I like to call a confirmatory consult.
Though we often hear that the best hospitals are “impossible to get into,” I want to encourage you to be persistent, patient, and prepared. Confirmatory consults can be life-saving.