Doctors are no different to the rest of us in their need to take vacations and the like.  Also – and like you and me – they do from time to time succumb to minor ailments requiring time away from their professional duties in order to recover. Much more common is the tendency for members of medical staff to regularly attend scientific meetings/conferences and the like. There is great value in sharing a common interest, professional or otherwise, which in this case can only result in even greater good.

The multi-disciplinary style of approach to patient management and care found in specialist centres, ensures that every case will, at least to some degree, become known and thus share equal opportunity for review by all members of the treatment team.  Indeed, often after only a short while, it really does become possible to appreciate and take strength from this cooperative team approach. But let me briefly explain to you how this is achieved. Although it is now a while since I regularly attended OP oncology clinics, let me tell you something about the preparation for a typical clinic day as I experienced it in an actual oncology unit. (Changes to practice and procedure are, of course, endemic, in the interests of improved efficiency and more comprehensive approaches to patient care. Moreover, as patients, records become increasingly subject to electronic storage via computerisation, changes to what I recall of the locating and retrieval of patients’ records etc. are bound to evolve in the interests of labour saving and efficiency).

Around 8.30 every morning we (i.e. at least one consultant but commonly three or four, together with other members of the wards’ medical, nursing and support staff) would foregather in a seminar room just off the main wards. There we would receive the latest reports on current in-patients delivered by nursing staff and begin to plan the work and requirements for that day.

On outpatient clinic days, we (and by “we” in this instance, I mean an even wider representation of disciplines and specialities involved in the clinical, teaching, research and chaplaincy day-to-day running of the department) would similarly come together in the said seminar room.  From the top there would often be the professor and head of department, together with senior lecturers (since this was also a university teaching department) and other colleagues at lecturer grade. These colleagues conjointly made up the department’s complement of senior consultants in oncology, radiology and haematology. Senior registrars, registrars and junior doctors, together with the ward sister and two or three other members of the ward’s nursing team would invariably be present, as would one or more specialist consultant surgeons, representatives from physiotherapy, radiography, pharmacy, chaplaincy and medical social work.  One other invariable attendee for many years at such meetings would be “yours truly” together, perhaps, with a colleague or two also involved in psychosocial clinical practice and research.

At the time to which I am referring, all clinical records of all patients, both present on the ward and attending outpatient clinics that day, would be piled randomly into two supermarket-type trolleys.  Each member of the medical staff present – from the most senior to the more junior – would then lift a handful of folders containing patients’ case notes, again randomly, in order to review each patient scheduled to attend from their actual case record. Anyone present with anything to contribute would receive a hearing and throughout the review and discussion the unit’s secretary would compile a three or four line summary of proposed action for that day concerning each patient.  Prior to the commencement of the outpatients’ clinic proper, this document was made available to all as and when they needed it in the staff room of the appropriate Day Ward.

As I hope you are now coming more readily to appreciate, there really is no need to worry unduly about what at first you might well interpret as a break in the continuity of communication.  Of course, and however specialist and ‘state-of-the-art’ any Oncology Centre may be, its complement of staff at every grade and discipline, remain human.  They too have emotions and needs; have families and homes. They also experience tiredness and fatigue in similar fashion to you and me.  What I can tell you in complete honesty – and I do it with no small measure of regard and yes, admiration and at times in the past, genuine warmth and affection – is that these immensely skilled and wonderfully dedicated people do indeed represent and have the best interests of all their patients very much at heart.

As already stated above, methods and procedures of this kind will obviously differ from Centre to Centre and will also change with the passage of time. I have been careful to describe only what has been known and familiar to me.  Be that as it may, you may be assured (and as you have every right to expect) that there is a consultant in charge of every patient’s case record, whose dedicated task is to see that everyone else involved is properly and adequately appraised of every treatment need.

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