​What are the needs of doctors to shorten the cancer patient’s journey and how can patients contribute to improving diagnosis and providing medical care? Fast and correct diagnosis is one of the keys to the problem: “There are questions we ask ourselves, and we try to find a way to diagnose and treat patients as quickly as possible, because we all know that time is not on our side – cancer disease. That is why quick, timely, correct, complete diagnosis is very important,” emphasizes Dr. Daniela Zob, head of the 1st Department of Medical Oncology at the Institute of Oncology “Prof. Dr. Alexander Trestioreanu” from Bucharest.

Another important decision is the mapping of institutions, “to be able to address patients without endlessly calling colleagues – to know exactly where and what is being done”: “I think we can start with what is already assigned to be done at the level of the Ministry of Health – the mapping of institutions and the transparency of this mapping, that is, to know exactly what each institution is doing, so that we can refer to patients without endlessly calling colleagues – to know exactly where and what is being done. For example, I recently had a patient with a pancreatic neoplasm that needed to be confirmed with a biopsy performed using echoendoscopy. We all know that not everyone does echoendoscopy, especially for pancreatic biopsies and the like. Transparency of institutions where these types of biopsies are performed is very important, and the Ministry of Health has this map, but it definitely needs to be updated,” said Dr. Daniela Zob during the “Onco – Meet the Experts” debate. organized by Health Policy Magazine and the Romanian Association of International Pharmaceutical Manufacturers (ARPIM).

“I think this is a solution, first of all, for speed, but also for the involvement of general practitioners, who are sometimes buried in the bureaucratic red tape of documents, reporting and multiple tickets. You want to do, for example, a full CT scan, and you need 4-5 referrals for that, when one should be enough. This reduction in bureaucracy, on which we lose a lot of time, would mean more time for patients, it would mean more time for the family doctor, who could be our support, especially in the first steps,” adds the head of the oncology department. Medical 1 at the Oncology Institute in Bucharest.

Can patients help improve diagnosis and care?

Can patients help improve diagnosis and care? Yes, here is the answer of Dr. Daniela Zob:

“Patients could help us with patient-to-patient information. I think that patient associations can campaign so that patients also know what can be done, because the internet is full of information that is often not true. I believe that the role of patient associations is very important here: to convey the right information to patients, to be visible, to raise awareness about screening, to change the mindset of the general public to go, for example, to these screening tests.”

Is there really a multidisciplinary pluripathology team working in Romania?

There are many patients with several pathologies, in addition to oncology, who require a multidisciplinary team. Is there really a multidisciplinary pluripathology team working in Romania?

“I’ll start by saying there should be more of us,” says Dr. Daniela Zob. “The number of doctors of any specialty is very small, and the number of oncologists is small compared to the needs of the population. In addition, multispecialty hospitals have an advantage, because when a patient comes to such a hospital, which has an oncology department, he will certainly be easily consulted in other specialties. I don’t think there’s a single oncologist who doesn’t have that multidisciplinary team because our patients have always had more than just cancer. Our patients always had problems with the heart, lungs, needed a surgeon, etc.”

Dr. Daniela Zob says that she grew up as a doctor in a multidisciplinary team: “I completed my residency at an oncology institute, where the patient was consulted only in a team with a surgeon, a radiation therapist, an oncologist. Of course, a multidisciplinary team also means the rest of the specialties involved in treating the patient’s whole body. The Institute has a cardiologist superspecialist in cardiac pathology related to neoplasms, a pulmonologist, doctors who perform bronchoscopy, etc. Unfortunately, in regional hospitals or polyclinics, where these specialties are not available, it is more difficult, because the patient must go to both a cardiologist and a pulmonologist, and make an appointment everywhere.”

According to the doctor, multidisciplinary teams are already working, but this is happening in large centers: “Recently, there has been talk of organizing regional oncology centers so that the patient, when he goes to the parent center, does everything necessary, and then is referred to the service for continued treatment. which does not have all the possibilities. When something intervenes, the patient can be sent back to the parent center. I believe that this would be the best operation we can do in the face of this great shortage of medical and support staff. The answer is that these multidisciplinary teams exist, they work in large centers. If we talk about more isolated polyclinics, colleagues there refer patients to us when they have problems.”

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