53 min
Episode 17: Tumor boards, team-based care, and the business of healthcare with medical oncologist Dr. Gabriel A. Brooks Patient from Hell
-
- Medicine
Key highlights:
The art and science of personalized cancer treatment.
What are tumor boards, how do they work, and why are they important for cancer treatment decision-making?
Team-based oncology care delivery, understanding patient preferences, and providing appropriate care.
The business of oncology and how reimbursement influences patient care decisions.
About our guest:
Dr. Gabriel A. Brooks is an oncologist in Lebanon, New Hampshire and is affiliated with multiple hospitals in the area, including Dartmouth Hitchcock Medical Center and White River Junction Veterans Affairs Medical Center. He received his medical degree from Perelman School of Medicine at the University of Pennsylvania and has been in practice for 11-20 years.
Key Moments:
At 16 mins and 0 seconds: About team-based care in cancer.
“Nothing I do for my patients happens in a vaccum. There are questions about radiation, radiology or pathology…the cases we bring to tumor board are the cases where we have questions. It maybe for a patient with a new diagnosis or a patient I’ve had for years and the situation has changed and there is a new question. I could send the patient to another specialist but it’s not the same as four specialists in one room looking at a single case.”
At 30 mins and 05 seconds: Tumor board vis-a-vis guidelines.
“The NCCN guidelines are very influential documents that say what the evidence is in that cancer type. They are not proscriptive. There are lots of areas that are highly subjective in patient care. It’s also true that they are a US organization and refer to drugs available in the US. Tumor board addresses the issues where guidelines are not detailed enough, or where more subjective discrimination is required.”
At 32 mins and 50 seconds: Guidelines drive most situations.
“95% of the time, or rather 99% of the time…most of the things that I do are consistent with the NCCN guidelines. Once is a while there is situations where the guidelines don’t apply.”
At 39 mins and 12 seconds: Decision making in cancer.
“The idea that you can make this decision today that is going to specify every step along the way for the rest of the year for most of our patients is not realistic.”
At 41 mins and 13 seconds: Honesty in difficult conversations.
“I think it is very important for me to be truthful to my patients and tell them that my goal is to help you live longer and help you, but maybe not to cure you. …It’s not my job to tell my patients what the future holds, because we really don’t know.”
Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.
---
Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support
Key highlights:
The art and science of personalized cancer treatment.
What are tumor boards, how do they work, and why are they important for cancer treatment decision-making?
Team-based oncology care delivery, understanding patient preferences, and providing appropriate care.
The business of oncology and how reimbursement influences patient care decisions.
About our guest:
Dr. Gabriel A. Brooks is an oncologist in Lebanon, New Hampshire and is affiliated with multiple hospitals in the area, including Dartmouth Hitchcock Medical Center and White River Junction Veterans Affairs Medical Center. He received his medical degree from Perelman School of Medicine at the University of Pennsylvania and has been in practice for 11-20 years.
Key Moments:
At 16 mins and 0 seconds: About team-based care in cancer.
“Nothing I do for my patients happens in a vaccum. There are questions about radiation, radiology or pathology…the cases we bring to tumor board are the cases where we have questions. It maybe for a patient with a new diagnosis or a patient I’ve had for years and the situation has changed and there is a new question. I could send the patient to another specialist but it’s not the same as four specialists in one room looking at a single case.”
At 30 mins and 05 seconds: Tumor board vis-a-vis guidelines.
“The NCCN guidelines are very influential documents that say what the evidence is in that cancer type. They are not proscriptive. There are lots of areas that are highly subjective in patient care. It’s also true that they are a US organization and refer to drugs available in the US. Tumor board addresses the issues where guidelines are not detailed enough, or where more subjective discrimination is required.”
At 32 mins and 50 seconds: Guidelines drive most situations.
“95% of the time, or rather 99% of the time…most of the things that I do are consistent with the NCCN guidelines. Once is a while there is situations where the guidelines don’t apply.”
At 39 mins and 12 seconds: Decision making in cancer.
“The idea that you can make this decision today that is going to specify every step along the way for the rest of the year for most of our patients is not realistic.”
At 41 mins and 13 seconds: Honesty in difficult conversations.
“I think it is very important for me to be truthful to my patients and tell them that my goal is to help you live longer and help you, but maybe not to cure you. …It’s not my job to tell my patients what the future holds, because we really don’t know.”
Disclaimer: This podcast is for general informational purposes only and does not constitute the practice of medicine, nursing or other professional health care services, including the giving of medical advice, and no doctor/patient relationship is formed. The use of information on this podcast or materials linked from this podcast is at the user's own risk. The content of this podcast is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Users should not disregard, or delay in obtaining, medical advice for any medical condition they may have, and should seek the assistance of their health care professionals for any such conditions.
---
Support this podcast: https://podcasters.spotify.com/pod/show/manta-cares/support
53 min