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.
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