With a focus on patient-centered cancer care, Kaiser Permanente’s Multidisciplinary Clinics bring the medical team together for quicker treatment that can lead to better outcomes.
Breast cancer patients find hope and inspiration in many places. For some, their “rock” can be found in a higher power. For others, it’s the data that suggests a positive outcome. Most people lean on their friends, family and caregivers. For Kaiser Permanente member Noelle Gross, her inspiration also comes from the wacky TV program, “Let’s Make a Deal.”
While receiving chemotherapy for breast cancer, Noelle watched her favorite TV game show. It was a breast cancer special, and many audience members were cancer survivors.
“Some had been free of that horrible disease five years, 15 years, and all looked healthy and fabulous. I was feeling awful at the time and vowed that I would be healthy enough to go on the show one year later,” she says.
Jump to October 2017, and Noelle has indeed appeared on "Let’s Make a Deal," accompanied by close pals carrying signs identifying themselves as “breast friend” and “breast sister.” Her prize, a Kia Soul automobile, will be delivered in a couple of months. (She hopes it’s pink.)
Noelle says, “that cancer stuff” — a single mastectomy and chemo — is behind her. Soon, she will undergo preventive removal of her other breast, then breast reconstruction. She’s feeling stronger and more hopeful every day.
Despite the obvious fear and anxiety of facing a breast cancer diagnosis, receiving care from Kaiser Permanente has been a good experience, she says.
“They made me feel like I was their only patient. They made it convenient and easy — words that don’t typically describe cancer care — and I was confident that I had a dedicated team of specialists in my corner, all in synch with one another.”
She’s referring to the Multidisciplinary Clinic (or MDC), an option for patients newly diagnosed with breast cancer.
Phoebe Harvey, MD, is chief of hematology and oncology and medical director of Kaiser Permanente’s cancer services. The department is accredited by the American College of Surgeons Commission on Cancer Comprehensive Community Cancer Program. She describes the clinic this way: “MDC is very patient centered. Patients meet with a surgical oncologist, medical oncologist and radiation oncologist, one at a time, in a single appointment.”
Immediately before meeting with the patient, a tumor board discusses each patient’s case and develops a path forward. The board is comprised of a team of cancer specialists, as well as pathologists, radiologists, nurses (including nurse navigators and research nurses), specialty care physician assistants, physical therapy clinicians, speech therapy clinicians, palliative care physicians, a tumor registry clinical coordinator, and specialty care residents.
“The preparation that goes into MDC, and the knowledge of having a plan in place helps patients to overcome the shell-shock that often comes with a breast cancer diagnosis,” says Dr. Harvey. “Patients get on their way to treatment quicker.”
The Northwest Region’s Breast Cancer Task Force received a Kaiser Permanente “Bring Your Best” care delivery award in 2015 for designing the clinic. The award says, “For outstanding work to improve patient outcomes and create the best care experiences for our members and their families."
Kaiser Permanente Northwest member Kathy Allen agrees.
“I can tell that my doctors take their commitment to their patients to the next level. It’s phenomenal to be able to meet with them at one appointment, instead of piecemeal over several weeks. The experience gave me the highest level of confidence in my care team.”
Compare the Multidisciplinary Clinic to the traditional approach to breast cancer care: After diagnosis, patients typically meet with a surgeon, then with other oncology specialists over the next several weeks. That means three days of lost work for the patient, three days of child care, three co-pays, and triple the stress, fear and anxiety.
Noelle’s husband and sister (a physician assistant) sat with her. They met Dr. Harvey, Katie Deming, MD, radiation oncologist; and Chris Moran, MD, surgical oncologist, each board-certified in their area of specialty.
“They knew about my case before they entered the room and everyone was on the same page, supportive, and compassionate. The appointment gave us a world of comfort and confidence,” says Noelle. “It was something upbeat and positive in an otherwise crummy year.”
She’s thankful her care team offered her a clinical trial that studies the impact of adding an anti-estrogen medication called Everolimus versus placebo in addition to regular anti-estrogen therapy in women with high-risk estrogen positive breast cancer. This is just one of many clinical trials Kaiser Permanente offers patients.
Noelle stays in close contact with her nurse navigator, Rhonda Wirth, who removes any barriers and prevents gaps in care. Noelle also relies on a binder full of information about her breast cancer diagnosis, treatment and reconstruction. The binder has information on genetics, physical therapy, support services, medical leave and other topics.
“The more a patient understands what is happening and why, and knows what to expect, the more empowered they feel,” explains Dr. Harvey. “Empowerment doesn’t erase fear, but it gives back a sense of control over what’s happening to them.”
Noelle’s back at work, teaching kindergarten students and thriving with her husband and two young children by cheering on the Portland Timbers. And of course watching "Let’s Make a Deal."