Running a Multi-Disciplinary Breast Center

by: Holly Mason, MD FACS

One of the great challenges and great accomplishments of my career has been the oversight of the Baystate Breast & Wellness Center. Under one roof, patients can undergo breast imaging, breast surgery consultation, plastic surgery consultation and high risk assessment. Patients with cancer are transitioned to medical and radiation oncology at the Cancer Center at the appropriate time. The sum of all of this is that coordination of care is needed between multiple specialties, providers and staff all while respecting the patients emotional needs and desires. The presence of nurse navigators significantly improves this coordination of care and lowers the anxiety of the patient as they now have a guide to lead them through the care process. Finesse and patience is required when dealing with the specialties; I am a surgeon and may not understand why a specialist has to do things in a certain way or why the process takes a certain amount of time. I simply want things done (that is the surgeon in me). As a surgeon in a leadership position, I need to temper the surgeon part of my personality to give the collaborative part of me a chance to succeed.

We live in a time of change and our practice needs to keep up with that change. The purpose of our clinical steering committee is to delve into the processes of the Breast Center to sort out those that work both for the patient and the institution and those that do not. Our leadership team regularly looks at metrics to ensure that our access rates are appropriate and that our imaging meets or surpasses national standards. It is necessary to look at the financial impact of the choices we make and the tests that we order. No other specialty highlights this challenge quite like breast cancer care. We have advanced technology to evaluate patients but it is necessary to choose wisely what is indicated medically and what is not to keep costs under control. We can’t order a test just because we can. We have the surgical skills to treat the breast in the form of the patients choosing, but, as recent data shows, there is significant cost both to the patient (increased complication rates for patients undergoing bilateral mastectomy and reconstruction, for example) and to the health care system. Most of my hour-long visit with a breast cancer patient is spent trying to find the correct balance for the individual patient that optimizes cancer care and minimizes risk.

I am fortunate to work with providers as passionate about breast cancer as I am. Our multidisciplinary team meets regularly to review protocols and practices to ensure that we are keeping up with the rapidly changing world that is breast cancer care. Together, we strive to provide high quality efficient care that can work in a changing cost-control environment. As a surgeon in a leadership position, I balance the need to keep a “big picture” view of the impact of our patient care choices with the maintenance of an active clinical practice.  I wouldn’t have it any other way.

Dr. Holly Mason is the Director of Breast Surgical Services at Baystate Medical Center in Springfield, MA.  She is also the Co-Medical Director of the Baystate Breast & Wellness Center.  Besides her specialized work in breast surgery, she enjoys time with her husband and two daughters and tries to remind herself to take a deep breath every now and then to enjoy the world around her.