NEW PORT RICHEY — A patient comes to his doctor with a persistent cough, shortness of breath, chest pain. The doctor suspects lung cancer.
What happens next? Typically, more tests, more appointments with more specialists. By the time treatment begins, up to two months might have passed.
That drawn-out process exhausts patients and delays treatment of an aggressive disease that kills more Americans than any other kind of cancer. So Morton Plant North Bay is trying something new in the county: A one-day clinic in which patients get a diagnosis and a treatment plan.
Hospital officials hope the streamlined approach will cut the testing and diagnosis time so that treatment can begin much faster.
"The quicker you can get them treated, the better," said Dr. Louis Astra, the surgeon who serves as medical director of the Morton Plant North Bay Thoracic Program.
The hospital is starting with lung cancer and, depending on patient feedback, could eventually start similar one-day clinics for other cancer patients.
Lung cancer was chosen first because of its prevalence. In Pasco County, where one in four adults smokes, about 430 people die each year from the disease, the hospital says.
"Why not start with the biggest problem?" Astra said.
The clinic, which opened last week, works like this: A patient sets up an appointment, either through his primary care physician or through a self-referral, at the clinic, held once a week at North Bay's Cardiovascular Center. He undergoes a range of tests, such as CT scans and blood tests, procedures that have typically been performed on different days and at different offices.
The patient hangs out at the clinic while the test results come back. Then a multidisciplinary team of doctors — a thoracic surgeon, medical oncologist, radiation oncologist and a pulmonologist — review the results, get together in a conference room and develop a treatment plan.
The clinic will treat about five people a week.
Rosemary Giuliano, the "nurse navigator" who will coordinate the patients' visit and treatment, said the clinic will be especially helpful to younger patients, who may otherwise have to miss multiple days of work to go to various appointments.
"We recognize that, especially in this economy, time is precious," she said.
Hospitals around the country are using the clinic approach for lung cancer diagnosis. One of them, Sanford Cancer Center in South Dakota, says its patients begin getting treatment within 16 days of coming to the clinic.
That compares to industry averages of more than three months, the clinic says in information on its Web site.
Giuliano said the North Bay clinic, which took about eight months worth of planning, is modeled after a community hospital program outside Atlanta. That program cut the average time from the onset of symptoms to treatment from 83 days to 14.
So why didn't hospitals long ago scrap the disjointed systems for these centralized clinics?
Astra said the clinics are very common in university and research-based hospitals. But getting doctors in community settings, who tend to have offices that are spread far apart, to meet in one place and talk about patients can be a challenge.
"For the doctors, it's a huge investment of time," he said.
For patients, the trickiest part of the new clinic may be whether their private insurance pays all the costs, Astra said. Some of the doctors on the clinic team may be in a patient's network while others may not. How that will work out remains to be seen, he said.
Astra said the clinic's success won't be measured by the outcomes of the patient's treatment. That could be a hard thing to gauge. The success, he said, will be based on feedback from the patients: Did the clinic make sense for them?
"If patients like it," he said, "that, to me, is the biggest plus."
Jodie Tillman can be reached at [email protected] or (727) 869-6247.