Midlevels in Oncology

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How common are midlevels in Oncology? I am talking about deciding on cancer treatments for cancer patients.

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I'm not sure if they decide on the therapy plan for patients without attending oversight. At my institution, we have a plethora of midlevels, but they don't see patients independently.

Honestly, for simple oncology cases, it is relatively protocol-based, so I can see how this is a possibility in the near future.
 
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A seasoned midlevel in a tumor-specific clinic will often make the right decisions for patients. Still an MD has to sign off on a new treatment or change in treatment.
 
It's fairly common to see them where I am currently training. They're often on inpatient playing a similar role to residents (and generally do a pretty great job where I'm at) or in the clinics seeing patients for follow-up appointments after they get into their treatment. I've seen NPs/PAs discuss changes in treatments with the attending but it's really the primary oncologist's job to sign off and decide on where to go next if something isn't working.
 
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