Heme/Onc Procedures and BMT

[Gleevec]

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I was wondering what kind of procedures a heme/onc can perform? The only one I have encountered (aside from a biopsy) is bone marrow/stem cell transplantation. What other procedures are out there? Also, is there any additional training required after fellowship for such procedures?

Thanks in advance, I appreciate any info. 😀

 

[sanfilippo]

besides the "core" procedures one must learn during residency in IM, I have seen some hem/onc people gain additional training in how to perform apheresis.

-s.

 

[Gleevec]

If anyone has done a rotation or is in the field, Id be interested to hear about the average workday in terms of # patients seen, procedures performed, etc. Thanks!

 

[johnd]

Hem/oncs do all kinds of cool procedures:

-signing their name on preprinted chemo orders
-cranking the focus on the microscope while reviewing blood smears


Just kidding...In all seriousness, hemonc is not a procedurally oriented field at all. Heck, at MD Anderson they have bone marrow techs to do the BM biopsies. Just like any other field the average workday will vary wildly depending on the particular situation. Typically, hemonc involves a lot of time seeing outpatients in clinic with varying amounts of inpatients. Most of the inpatient responsibilities involve seeing consults and scheduled admits for treatment. Not a ton of overnight emergencies compared to some other specialties but there are some.

 

[lf777]

Hi

I am not sure it this is considered a "procedure" but all the blood-banking services provided are done by heme-oncs. I am not sure how this gets billed, though.
You can do apheresis not only for collection of specific cells, but also to remove plasma, lipids etc.

 

[Adawaal]

OK, I finally had to jump in here. My wife completed her Hem/Onc fellowship a year ago, is just wrapping up a 12-month BMT fellowship and will be starting as an asst. prof in BMT (or HSCT as they prefer to refer to it) next month. I read her some of the posts, and she especially enjoyed John's list of all the "cool procedures."

Hem/Onc in general (and BMT/HSCT in particular) are in no way procedurally related. With the exception of the biopsy, now done by techs, NPs, fellows, the occasional resident, sometimes housekeeping, and even the random brave/delusional patient him/herself, there are no procedures. Hell, most of these docs (my wife included) would take over an hour to get a simple IV started. Don't even get me started on central lines (that's mostly IR now, at least for tunneled caths).

Sure, from time to time they'll go look at a smear (well, at least they'll send a fellow to go do it), but the MD never does their own smear. That's hematopath's job: to set it up, put it under the scope and focus it for the doc.

Apheresis is "done" by Hem/Onc'ers the way that an O&P is "done" by the ID team. They order it to be done. Again, this is hooking up lots of very technical tubes to lines, not a busy MD's strong suit. We have techs for this just like we do for dialysis.

Blood banking is done by -- wait for it -- techs. The Division of Hem/Onc may very well run the blood bank at your hospital, but they're simply management.

I couldn't think of any procedures Hem/Onc and/or BMT/HSCT docs do on anything other than an annual basis, so I asked my wife. She just laughed and said, "Look, if I wanted something procedural, I'd have gone into surgery, right?" Or at least Rad Onc....