VOLUME check COVID

[radoncgrad2019]

how many patients do you have on treat today, April 16th?

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[Lamount]

15 at a mid/large academic center.

 

[radoncgrad2019]

I have 15 today too

 

[w00tz]

Would be useful to know baseline, too? If we are trying to determine effect of COVID.

We are at 90% volume this week, will probably be at 100% next week. Private multispecialty group

 

[RadRadRad]

About 80% for us

 

[medgator]

100-110% but the sim schedule looking light lately, don't expect our current volume to last as people finish up this week and next week

 

[metallica81788]

~80%

I've been pushing back some breast and prostates. Sim schedule has been up and down. Consult volume has been stable to pre-COVID.

 

[RadOncDoc21]

We fluctuate month to month. Right now around 12, next week we will be at 20 but I will say I’m down to about 70% of what I typically would see. Most of my patients now are inpatients needing palliative RT. Mid-size community hospital.

 

[taserlaser]

Last week our larger academic centre of a dozen plus rad oncs saw about 40 consults. Volume is definitely down.

 

[ramsesthenice]

We are a medium academic center and our volume is 5% over or typical running volume. Consults dipped but are going back up again. I have 17 under treatment today which is pretty close to normal. Aside from all of the preventative measures in the hospital system and my lab being closed, I would honestly not know anything was going on around me (at work at least).

 

[radoncgrad2019]

We are a medium academic center and our volume is 5% over or typical running volume. Consults dipped but are going back up again. I have 17 under treatment today which is pretty close to normal. Aside from all of the preventative measures in the hospital system and my lab being closed, I would honestly not know anything was going on around me (at work at least).

so you guys must be in a location or institution that hasnt made efforts

deep south i imagine.

 

[Mandelin Rain]

I'm about 1/3rd down, though some of that is due to aggressive hypofractionation of the consults we are seeing.

 

[medgator]

so you guys must be in a location or institution that hasnt made efforts

deep south i imagine.

Not as hard to socially distance in rural settings?

 

[Lamount]

Would be useful to know baseline, too? If we are trying to determine effect of COVID.

We are at 90% volume this week, will probably be at 100% next week. Private multispecialty group

My on treat volume is about normal, and I am 'seeing' about the same number of consults (though half of them are phone/video consults). I think our breast/prostate docs are pushing out low risk patients but my perception is that most docs who specialize in aggressive cancers are at baseline.

 

[Neuronix]

I'd call us a moderate sized academic center. We're at about 75% of normal. Personally I'm at about 100% because I mostly treat neuro and there's no way I'm delaying brain mets and glioblastomas.

 

[BobbyHeenan]

Probably 30% down.

 

[MegaVoltagePhoton]

I treat gyn and back up gu (a weird combination) at an academic institution. Gyn volume steady but 0 prostate. Main gu guy seems busy but more with consult than on treat

 

[Chartreuse Wombat]

Academic practice (no resident help) Nearly 100% prostate and I use moderate hypo and SBRT exclusively

March 16 23 mostly prostate; the dictat comes down (Lower census; in-house modeling suggests peak about April 20)
March 30 16 mostly prostate
April 13 11 mostly prostate
April 27 Estimate 5

I have pushed all sims/starts until mid-May or later.

6 brachy cases in late March-April moved to late May June

June will be a bear

 

[ramsesthenice]

so you guys must be in a location or institution that hasnt made efforts

deep south i imagine.

nope. Midwest. we are down 15% from where we’re a couple weeks ago. But it’s all a matter of chance. today I had 5 consults. A new anal cancer (T3N0). Needs treatment. 47 y/o lady with a nasty urethral cancer and grossly positive surgical margins. Needs treatment. Patient with b/l respectable pancreatic CA finishing NA chemo. I will SBRT. The other 2 had recurrent prostate CA and will get upfront ADT to delay RT a while.

what efforts do you recommend? Not treating anal cancers?

 

[ramsesthenice]

nope. Midwest. we are down 15% from where we’re a couple weeks ago. But it’s all a matter of chance. today I had 5 consults. A new anal cancer (T3N0). Needs treatment. 47 y/o lady with a nasty urethral cancer and grossly positive surgical margins. Needs treatment. Patient with b/l respectable pancreatic CA finishing NA chemo. I will SBRT. The other 2 had recurrent prostate CA and will get upfront ADT to delay RT a while.

what efforts do you recommend? Not treating anal cancers?

I should clarify my frustration. Our COVID numbers state wide are pretty stable. our institution has instituted a lot of changes preparing for the coming surge of patients. Our ICUs are at 42% capacity with exactly 4 COVID patients on vents. At faculty meeting yesterday, hospital admin was asked us to explain why we were still seeing so many patients and wanted to know why were not doing more to minimize volumes. What do you say to that? Our mitigation efforts are working and we are being pushed to find more ways to minimize oncology utilization. Already put off early breast and prostate patients and implemented hypofrac where possible. Not sure what else can give. More annoyed we are being asked to give more when our own monitoring suggests the current mitigation efforts are working!

 

[RadOncDoc21]

I should clarify my frustration. Our COVID numbers state wide are pretty stable. our institution has instituted a lot of changes preparing for the coming surge of patients. Our ICUs are at 42% capacity with exactly 4 COVID patients on vents. At faculty meeting yesterday, hospital admin was asked us to explain why we were still seeing so many patients and wanted to know why were not doing more to minimize volumes. What do you say to that? Our mitigation efforts are working and we are being pushed to find more ways to minimize oncology utilization. Already put off early breast and prostate patients and implemented hypofrac where possible. Not sure what else can give. More annoyed we are being asked to give more when our own monitoring suggests the current mitigation efforts are working!

This was my situation 3-4 weeks ago and now we are trying to restart the entire process again pretty soon. To be fair, I think they did the right thing to try to get on top of it fast. Now, the question is how do we move to the next stage. I still don’t think we are where we’re suppose to be in regards to testing.

 

[ramsesthenice]

This was my situation 3-4 weeks ago and now we are trying to restart the entire process again pretty soon. To be fair, I think they did the right thing to try to get on top of it fast. Now, the question is how do we move to the next stage. I still don’t think we are where we’re suppose to be in regards to testing.

No one is questioning testing is dismal. Or that we are not done. But there is a difference between doing something to help and doing something to do something.

 

[deleted941485]

Academic satellite

Consults all day everyday via tele almost nonstop

Down 45% plus policy encouraging hypofrac plus people finishing expect that to decline even further

Emergencies only starting mostly palliative

Obviously My employer has already cancelled any production bonuses. When they see how lean we can run I’m pretty sure I’ll be getting canned.

 

[BobbyHeenan]

It seems so variable. Even within my own group covering a geographic region at 6 centers...we have volumes ranging from down 40% to up 5%. Trend is down, but some remain busy...though part of that is that some are more aggressively hypofrac'ing...but doesn't explain it fully.

 

[seper]

For those with volume down, what are your departments implementing? My admins are kind of just sizing up the situation this week. One new rule is strictly no overtime for hourly staff (affected SRS workflow a bit).


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[thecarbonionangle]

Academic satellite

Consults all day everyday via tele almost nonstop

Down 45% plus policy encouraging hypofrac plus people finishing expect that to decline even further

Emergencies only starting mostly palliative

Obviously My employer has already cancelled any production bonuses. When they see how lean we can run I’m pretty sure I’ll be getting canned.

I could totally see this happening. This is going to get many admin bean counters thinking, lots of thinking

 

[metallica81788]

Hospitals are asking physicians to take vacation days by end of Q2 to improve their budgetary situation and also prepare for surge later this year in appointments (other specialties not mine since I've been working this whole time).

 

[seper]

Not very obvious how early vacation would improve hospital accounting, but I did hear talk about taking as much vacation as possible now.

Hospitals are asking physicians to take vacation days by end of Q2 to improve their budgetary situation and also prepare for surge later this year in appointments (other specialties not mine since I've been working this whole time).

 

[Neuronix]

I cancelled my vacation. Where am I going to go?

 

[medgator]

Not very obvious how early vacation would improve hospital accounting, but I did hear talk about taking as much vacation as possible now.

Perfect timing when no one can go anywhere....

 

[seper]

Perfect timing when no one can go anywhere....

Solo daytime biking along the empty trail... Quite therapeutic.
Naturally, our Chairwoman prefers us to burn PTO time we are sitting idle, in case consults rebound in late summer/ fall.
I’m just not sure what that has to do with financials as Metallica suggested.


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[metallica81788]

Solo daytime biking along the empty trail... Quite therapeutic.
Naturally, our Chairwoman prefers us to burn PTO time we are sitting idle, in case consults rebound in late summer/ fall.
I’m just not sure what that has to do with financials as Metallica suggested.

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It has something to do with liability and hospital expenditure. When employees take vacation, liability is reduced. Also when no vacation is taken (like now) expenses account for regular compensation and vacation time.

Clearly, I know very little about this.