Development of an Integrative Oncology Consult Service: Program Analysis and Public Health Implications

Introduction

Public Health research has shown that cancer patients frequently use complementary and alternative medicine(CAM), yet often it is not communicated to the physician. To address this public health issue, we began Integrative Oncology (IO) consultations and >100 patients have been seen. We will describe the establishment of the service and present a program analysis.

Methods

Benchmarking of hospitals with IM programs was performed to identify best practices. Standards for documentation and reimbursement were investigated. Policies and procedures were created. A retrospective review of data from consultation notes was performed.

Results

Benchmarking revealed few hospitals were offering physician IM consultations and none reported having specific credentialing/privileging procedures for IO consultations. In the first 2.5 years, 106 patients were seen: 72 female (68%) and 34 male (32%) with a mean adult age of 54 years (range, 18-87). Most frequent cancer diagnoses were: breast, hematologic, neuro-oncology, lung, and ovarian. Patients most frequently were interested in improving their QOL, managing symptoms, and learning about therapies. Analysis of recommendations focused on incorporating mind/body therapies (48%), improving diet/nutrition (32%) using acupuncture for symptoms and QOL (16%), and assessing herb interactions (4%). Mind/body therapies most recommended include: physical activity, massage therapy, stress/anxiety management, yoga, and meditation.

Conclusions

Patients and physicians have reported great satisfaction with the IO consult service. It provides valuable information for patients and physicians. IO consultations may be an effective service to add to public health programs to address cancer patients' questions and to improve patient-physician communication.