OBR Daily Commentary

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COA Applauds CMS on 340B Reforms in Final Medicare Rule

(COA) Nov 1, 2017 - The Community Oncology Alliance (COA) applauds the Centers for Medicare & Medicaid Services (CMS) on its recent policy change to curb abuses of the 340B Drug Discount Program.

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Thomas Marsland, MD (Posted: November 08, 2017)

quotesCertainly the original intent of the 340B program is laudable. Throughout the years the program grew and became subject to along list of abuses. Through numerous loop holes this became a vehicle for hospitals to expand costly cancer programs at the expense of more efficient community practices. This ruling is a welcome first step in helping to save the integrity of the program and its transparency. As the article suggests the patients and tax payers will benefit. Hospitals now will have to compete on a more even playing field with private practices and perhaps will learn some of the efficiency community physician had to learn the hard way when the original ASP rule went into effect.quotes

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New Study Finds Hospital Emergency Departments Should Improve Practices for Treating Older Adults with Cancer

(NCCN) Oct 24, 2017 - Original research in JNCCN advocates for hospital emergency departments to develop systems that will reduce unnecessary hospitalizations for older patients with cancer.

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Thomas Marsland, MD (Posted: November 01, 2017)

quotesEmergency rooms generally are not cancer patients friends. I have found that in routine community practices that if a cancer patients gets to the hospital they are almost routinely admitted. This causes frustrations for the patients and the oncologists. This is normally an after hours happening. Clearly extended office hours as proven in the "come home" project can minimize ER and hospital visits and help reduce the cost of care. Er's often over do testing and once patients are admitted especially to the hospitalist service tend to have extended admissions. Most community cancer practices can handle issues such as dehydration, N&V, diarrhea and pain control as an out patient. The concept of an observational unit is a good starting point but really most of these patients could be stabilized with minimal problems in the ER and then discharged to home with next day follow up in the office. quotes

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Oncology Most Stressful of Specialties: High Risk for Burnout

(Medscape Medical News) Oct 18, 2017 - Oncology is one of the most stressful of all medical specialties, and among the healthcare professionals on the cancer care team, oncologists are at highest risk for burnout.

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Thomas Marsland, MD (Posted: October 26, 2017)

quotesOK so there are days I feel stressed... who doesn't?? But burnout not really. People have asked me when I'm going to retire and I say never... I love what I do. Dealing with oncology patients is indeed challenging. They present with complex issues... medical but also emotional, financial, psycho-social, spiritual and more. It is difficult but rewarding in helping folks get through very difficult times. The stresses and burnout problems for me are much more in dealing with the non-clinical parts of the practice. All the new recording, documenting and regulatory requirements. The EMR's have turned me into the billing, coding, and scheduling person in addition to the care provider. I have been blessed with a loving and supportive family and have always been able to leave the stress of the job at the door when I leave. Balance is important, time for oneself (and family) help me get though all the burnout issues..... a good Napa Cab helps too..... quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Associate Cancer Center Director, Yale Cancer Center P...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...