How does your cancer center schedule appointments?

Larkin,

That sounds awful! All my visits, labs and infusions were done on the same day, though that was last year and may have changed since then.

You're right to petition the higher ups for change. This is hard enough without the added ass-ache of multiple trips. Good luck, and hope you're able to effect change.

Vickki

I schedule everything for the same day. It's a long day, but I don't have to drive the hour plus back and forth two days in a row, so it's worth it. Don't let them get away with that shit.

I usually have labs, injections or infusions on one day and then doctor visits on a different day. i do labs/injections (Faslodex) every month, but only see the doc every six to eight weeks, so it doesn't work out that well to have them on the same day. I live fairly close (20 minutes) to the office, and I would actually rather separate the two things because otherwise it takes the whole day. Those days that I have combined them I wind up waiting a long time in the waiting room between appointments, which I find harder than coming back for a shorter visit another day.

Thought I would chime in, but my situation sounds different that all the others.  I live in a small  town and see a MO at our local cancer center.   So I don't have to drive any distance.  I have appointment for injection/treatment ( Lupron and port flush) monthly, I get my monthly Labs at our local hospital outpatient lab (walk-in type situation so I can come anytime convenient for me), and then monthly MO office visit.       For this situation---appointments---this set up is good for me since I don't have to drive, park, and wait at a large facility.   But, a MAJOR drawback is that I feel I may not get the advanced care that a large cancer center offers and that DOES worry me.  

I can kind of see the rationale behind separating appointments----do the Lab work before MO visit so they have report to discuss with the patient, and treatments separate so if the MO visit changes the treatment plan then they can arrange the new treatment and have it ready for the treatment appointment.  Of course, in a larger facility things may run quicker than in my situation.  For example, my monthly TM's go to a separate Lab for analysis and take 3 days to get report.  Where as, in a large cancer center turn around time of labs, pharmacy, etc may be much more efficient and quicker.  

I also do agree that MBC'ers should be taken into account and arranged different than others if we want to streamline appointments.

Good discussion. And good luck Larkin.

I have a great set-up. It's a small practice in an academic town. The scheduler is very aware of our needs and will bend over backwards to make sure that the appointments suit us.

Usually I get treatment once a week. I show up, they access my port, draw labs. While waiting on the labs, one of the fabulous nurses starts fluids. After about thirty minutes, the lab report comes back, and they start treatment. Lately, for the first time ever, I've been having some serology dips, so it's not always guaranteed that I'll be able to get chemo. No one minds. The nurses are glad to have popped some hydration into me.

Now, evil me could think that they use it as a chance to bill for fluids, but it happens so rarely that I'm not going to let my brain wander there.

They schedule my proper MO visit for the off week of treatment. I used to ask for it on a treatment week, but the scheduler countered with the fact that MO likes to see the whole treatment cycle at the visit.

My main nurse is a boss. I've been with her for six years, and she functions as kind of an NP for me. I have her phone number and email. There's about three other nurses that sub in and out for when main nurse is otherwise engaged. I have never met more caring and engaged people. The last time I had LFT values that were concerning, one of the alternate nurses called in the Gods (MO) to figure out if I should receive treatment. Standard of care said yes, but she wanted to talk to the Doc about it. I think they are one of the reasons I'm still here, even though I've never had longevity with any treatment protocol.

There are downsides to a smaller practice/institute, I'm sure, but in my case, personal attention is not one of them. Each time I come in, they have the "huddle" - main nurse informs all the nurses on the floor what is going on with me, treatment plan, and what my needs will be. This takes about two minutes, and they do it for every patient that comes in. So, all the nurses have a general idea of what is up for all the patients in chairs

It's a different story in Canada, at least in BC. I see my MO every three months. After each appointment I receive my next appointment with a requisition for bloodwork which I am to have about a week ahead of my meeting with him. I can have that done at the hospital or a private lab so it's not that inconvenient for me and it ensures he has the results prior to our appointment. I'm currently on Faslodex which I have done monthly at my GP's office. In addition, I have Pamidronate infusions once a month at the hospital. My MO also orders scans prior to our appointments so that he has all the information to discuss with me (Unless I raise any concerns during our visit in which case he will order scans and then follow up by email or phone.) When I was on chemo I was followed monthly, meeting a Cancer Agency GP who would assess for any effects of the treatment. Bloodwork would be scheduled for a couple of days before chemo so that they knew if my neutrophils were high enough to proceed with the next treatment.

There is a lot of back and forth but it hasn't been an issue for me and is just the way things run here.

I can see that having multiple appointments on one day could result in delays and frequent changes to nurse and infusion room work. If the doc runs late, it can throw everything off.

Right now I go every 3 weeks for infusions - I get my vitals checked and blood drawn as soon as I arrive, I have a consult with my MO while we're waiting for the lab results, then I go right to the infusion room. When I'm on weekly infusions my consults are every other week unless I have a problem. I have scans done at a separate facility, results are back the next day for my followup appointment with MO (when there's progression) so that's the only time I might have multiple appointments in one week (or when I see a specialist).

If I had to have labs and consults done on separate days from my infusions I'd go nuts, especially when I'm on weekly infusions. I really feel for those of you with long drives. Having everything done the same day can make for a long day, but I'd much prefer to get it all done in one trip. Some days it's all we can do to find the energy to drag ourselves out of the house that one day,and when I'm feeling well I'd rather have as much free time as possible to live my life.