The Organization of a Tumor Clinic in a General Hospital

Abstract

The Technic of Organization THE problems encountered in the organization of a tumor clinic in a general hospital differ fundamentally from those met with in the organization of special cancer hospitals, although the ultimate goal is similar. Certain principles are fundamental to the successful operation of a tumor clinic. 1. All patients in whom a diagnosis of neoplasm is made or suspected must receive the benefit of consultation before therapy is instituted. 2. The consultation must include opinions upon the clinical, pathologic, and radio-therapeutic aspects of the disease. The number of individuals participating in the consultation necessarily varies under different circumstances. 3. The most efficient surgical procedures, as well as the most modern and up-to-date radiotherapeutic facilities and tech-nic, must be available to the cancer patient. 4. There must be a rigid and critical follow-up of all patients treated for benign and malignant tumors; careful records must be made of the end-results. The technic by which these principles are to be followed can, perhaps, be most easily explained by a statement of the actual operation of the clinic in the Michael Reese Hospital. New patients are referred by the various departments of the hospital to the Out-patient Department of the Tumor Clinic for an opinion. After examination, patients are either referred to the department in which they originated or, at the discretion of the director, may be admitted on the various services of the hospital. All hospitalized ward patients with a diagnosis of neoplasm or suspected neoplasm receive the benefit of consultation by the attending physician on service and the director of the Tumor Clinic. The therapeutic procedures are executed by the surgical attending staff, the Radium Department, or the X-ray Department, as the case may be. After discharge from the hospital, the patient reports to the Tumor Clinic for follow-up examinations. Personnel.—The personnel necessary for the organization of a tumor clinic in a general hospital varies with the size of the institution, the proposed scope of activities, and the available funds. If a moderate endowment is available, there are obvious advantages in establishing the nucleus of the organization on a full-time basis. The full-time staff of the Tumor Clinic in the Michael Reese Hospital consists of: director, assistant, resident interne, radium nurse, two radium technicians, and secretary. The use of radium, especially when it is employed in the form of the element, introduces certain problems not within the scope of the nursing personnel in a general hospital. The custody of the radium from the point of view of safety, its distribution in various applicators, its sterilization and cleansing, require a special knowledge which the general nurse does not possess.