Tumors: Oncologists and patients restricted to minimum 20-minute "times"

"We talk a lot about communication, relationship with the patient, reception. And then there is a 20-minute time limit for the oncology visit, which is absolutely inadequate." "Too often we have to become tightrope walkers between the patient in front of us and the computer screen where we have to be careful when entering the data about him. Circumstances that are very difficult to reconcile with the time of relationship and care, which is necessary because it is expressed both in adherence to therapies and in the patient's quality of life and in some way in the evolution of the prognosis."

The primary oncologists at Cipomo are shedding light on the tight deadlines and bureaucratic burden that influence one of the most delicate passages when it comes to tumors, that is, the treatment relationship. They reject the “dictates” on the minutes to dedicate to patients, just as they propose solutions to the growing weight of bureaucracy. A commitment that takes away 40% of their overall working time: if therapeutic innovation proceeds at a fast pace, the administrative burden is no less, and this is demonstrated by the national survey “Oncology and Administrative Burden: an Italian Survey”, promoted by Isheo, La Lampada di Aladino-Ets and by the same College of primary oncologists who just presented and discussed it at the 29th elective congress in Florence.

"The lack of IT systems and interoperability of systems does not help," explains the outgoing president of Cipomo Luisa Fioretto, head of the Oncology Department of Ausl Toscana Centro: "The survey we conducted throughout Italy tells us that this time dedicated to bureaucratic and administrative tasks must be reduced and that solutions must be found to delegate to other figures the activities that can be done: moreover, a greater appropriateness must be found in the use of professional profiles also in terms of costs. Just think of the cost of an hour of a first or second level doctor compared to that of an intermediate figure. The available resources must be used appropriately."

"Too often - explains Rosarita Silva, treasurer of Cipomo and director of Medical Oncology at Fabriano Hospital - we are reduced to also performing the functions of the Cup: in the so-called "taking charge" in the follow-up path the patient leaves the clinic with the referral, the instrumental tests booked in the slots dedicated to oncology and so on. Very well, but this takes away precious time that doctors could usefully recover both for that same patient and for others. This step could therefore be delegated to alternative figures. In short, in the face of an extraordinary administrative load we are called to respect deadlines and this is unacceptable".

Some regions have well-defined timeframes: a “model” is 30 minutes for the first visit and 20 minutes for follow-up visits, but it varies greatly from one region to another. “It depends on the sensitivity of the strategic directions and the strength of the professionals to pursue certain requests,” Fioretto reports. “In Tuscany we managed to obtain an hour for the first visit and 30 minutes for check-ups.” The minimum is reached in Lombardy and Liguria where the first visit takes 20 minutes. A “roadmap” also linked to DRG reimbursements and closely linked to the need to shorten waiting lists. Against which the regions must “get creative,” if only we consider that Lombardy has just signed a collaboration agreement with the Carabinieri of the NAS.