PAs specializing in oncology

[Jchen14]

Hi everyone,

prospective PA here. I'm wondering if there are any PAs here that have practiced in oncology or were/are hospitalists that work closely with cancer patients. I find cancer to be a fascinating field that earns the respect of the most empathetic healthcare professionals. The nurses on the oncology unit where I work are outstanding in terms of quality of care. I haven't seen many oncological PAs in the hospital - only MDs or DOs. I want to hear about your experiences and what you do on the daily. What are your struggles on the job? What do you love about your job? How is oncology practice different from other specialties? Thanks in advance :)

[MCHAD]

I lasted a little less than a year in oncology before I went back to primary care.  I’ll try to give you my perspective...

i worked with great doctors and an awesome NP.  I worked in community medical oncology.  Private practice owned by 3 physicians.  

The positives:

awesome staff

amazingly grateful patients for the most part

it got me out of my comfort zone and I got to learn a ton! 

Provided me the opportunity to hone my skills for having the tough conversations of medicine with patients like the reality of their illnesses and end of life care, but also the wonderful opportunity of giving good news to patients when their response to treatment was favorable.  

The negatives: 

The narrow spectrum of disease processes dealt with day in and day out was manotanous to me after a while.  The good in this though is i learned I truly love primary care and don’t think I’d be happy in any specialty, I’ll never have the “what if” thoughts I was having about working in a specialty. 

I don’t do well with compartmentalizing so the burden of the reality of cancer often followed me home and overflowed into my personal life. 

The hours, obviously this is going to be dependent on each set up but I worked 50-60 hours a week and often it was a 6 day week.  

The lack of autonomy, this is going to depend on years of experience as well as the doctors you work with, but in the practice I worked at I got a history and did a physical and then one of the doctors  came in as I sat like a student/scribe in the corner on 90% of the oncology patients.  Hematology patients were mine for the most part if established but on EVERY new consult, even the simple cases I presented every case after history and physical and then the doctor came in the room with me while I sat like a student/scribe.  Since I have left, the NP they hired to replace me doesn’t see ANY patients on his own, Doc goes in to every room after initial interview or even from the start some times and then the NP dictates EVERY note.  

For me the negatives outweighed the positives, the final straw was having to tell a patient my age (32) married with 5 kids under 10 years old, that he had CML (chronic Myelogenous leukemia) and while there have been great strides in the last 15 years in treatments, this was a disease that is incurable at this time, and will ultimately take his life most likely.  

After he left I went in my office and sobbed.  Then I went home and hugged my wife and kids a little tighter that night, tucked them into bed, and didn’t sleep because i couldn’t stop thinking about my patient and is family.  

That being said the docs and the NP I worked with have something I don’t I guess and they LOVE their work.