Which subspecialty oncology has a lighter inbox workload?

[CluvK]

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I apologize if this seems like an odd question. My future employer (an employed community practice) has asked me to select two areas to "subspecialize" in from lung, GI, or GU oncology. I find each of these fields equally engaging, but I’m curious to know if any of them typically involve a lighter inbox workload. Any insights would be much appreciated!

 

[HemeOncHopeful19]

The real secret pro-tip for inbox management is to find a place that doesn’t use Epic

 

[HemeOncHopeful19]

I'm just a fellow but my GI attendings are available all the time - chemo clearance questions (FOLFOX being q14 doesn't help, NPs are there but they'll still ask) and questions from inpatient docs since GI patients get admitted the most. I myself have a lot of breast patients and my inbox is never empty. I'll be avoiding these two once I'm on the job hunt.

In a community job your FOLFOX q14 is an easy 99215 follow-up and clear for chemo with a visit so that helps mitigate the frustration.

Agree with GI being admitted a lot unfortunately.

 

[DoctorDontStop]

In a community job your FOLFOX q14 is an easy 99215 follow-up and clear for chemo with a visit so that helps mitigate the frustration.

Agree with GI being admitted a lot unfortunately.

GI admitted more than lung?? 🤔

 

[HemeOncHopeful19]

GI admitted more than lung?? 🤔

 

[guildsman]

I apologize if this seems like an odd question. My future employer (an employed community practice) has asked me to select two areas to "subspecialize" in from lung, GI, or GU oncology. I find each of these fields equally engaging, but I’m curious to know if any of them typically involve a lighter inbox workload. Any insights would be much appreciated!

Surveillance for GI is almost entirely scan dependent, so there are a lot of results and issues with results. Because the regimens are mostly infusion chemotherapy or biologic therapies, there are a lot of labs and clearance parameters. We also admit a lot of patients.

 

[dozitgetchahi]

The real secret pro-tip for inbox management is to find a place that doesn’t use Epic

Not sure I agree there.

The “secret tip” is to manage expectations from patients and make your staff handle what they should be handling for you. Epic is not the problem - in fact, Epic saves me boatloads of time each day versus some of the total crap EMRs (Centricity, Intergy, Meditech - looking at you) I’ve had the displeasure of using before.

 

[bobsmith]

The “secret tip” is to manage expectations from patients and make your staff handle what they should be handling for you.

Definitely agree with this. At my initial visit with pretty much all new patients that are not just one-and-done consults (and especially for active oncology patients), we go over expectations for our clinic, response times, what the after hours advice line does, etc.

ALL messages from our patients go to my staff first to screen / triage - I never see things like straightforward scheduling questions, clarifications on where to go for labs, or requests for paperwork; if something is needed (like my signature on something), my staff is trained to do the initial work first.

The other benefit of this setup is that if I clear my inbox at the end of the day on Friday, my patient messages box will stay empty until Monday morning, since my office staff are only checking their inbox during business hours. So even if I do log in on Sunday night to look something up / prep something for Monday, I don't get stressed / distracted by a bunch of inbox patient messages

We also make this very clear when they establish care with us, and I have yet to hear anybody complain that this is unreasonable

 

[HemeOncHopeful19]

Definitely agree with this. At my initial visit with pretty much all new patients that are not just one-and-done consults (and especially for active oncology patients), we go over expectations for our clinic, response times, what the after hours advice line does, etc.

ALL messages from our patients go to my staff first to screen / triage - I never see things like straightforward scheduling questions, clarifications on where to go for labs, or requests for paperwork; if something is needed (like my signature on something), my staff is trained to do the initial work first.

The other benefit of this setup is that if I clear my inbox at the end of the day on Friday, my patient messages box will stay empty until Monday morning, since my office staff are only checking their inbox during business hours. So even if I do log in on Sunday night to look something up / prep something for Monday, I don't get stressed / distracted by a bunch of inbox patient messages

We also make this very clear when they establish care with us, and I have yet to hear anybody complain that this is unreasonable

 

[ShuperNewbie]

I'm mostly heme (benign and malignant) and my inbox is super light

 

[MifflinDunder]

I'm mostly heme (benign and malignant) and my inbox is super light

Are you mostly inpatient/academic?

 

[ShuperNewbie]

Are you mostly inpatient/academic?

Nah I'm mostly outpatient / employed by a large hospital. A very interesting switch flips with my heme patients I noticed. You're viewed much more as a "this person just takes care of this issue" type of consultant (even with a lot of my malignant heme patients) and patients will direct general issues to their PCP more frequently, whereas in my solid onc patients, anything and everything revolves around the cancer (understandably so).

 

[gutonc]

That’s awesome only if there were more malignant heme outpatient jobs around. I’m a fellow and I’m already seeing the bolded in action. The precharting, charting, coordinating with other specialties is also significantly less cumbersome in malignant heme.

I think a lot of it is about setting expectations and making sure you've got good MA/nursing support to manage things. 90% of what comes in via phone/portal doesn't really need my input. So when your support staff is dialed in, there's not a lot of actual work to be done.