With the passage of the Affordable Care Act in 2010 and most provisions due to take effect in 2014, it’s reasonable to ask what MD Anderson is doing to prepare.
Fall 2013 : Hospitalist Care Service
With longer lives come complications
Norman Brito-Dellan, M.D., is one of nine hospitalists at MD Anderson. Photo: Wyatt McSpadden
Although most cancer treatment occurs in an outpatient setting, sometimes it’s an inside job. Cancer patients can require hospitalization for a variety of reasons.
They may be related to complications caused by comorbidities — health conditions like diabetes or high blood pressure that may complicate treatment and recovery — or to the effects of long-ago cancer treatments.
A growing medical specialty aims to meet the demand for skilled care for these acutely ill patients in the hospital. Called hospitalists, these physicians are experts in providing treatment in a multidisciplinary setting, liaising with specialists as needed, and managing comorbidities and complications of therapy and the disease process.
Norman Brito-Dellan, M.D., assistant professor, is one of MD Anderson’s nine hospitalists. The explosion in demand for this specialty is driven by a simple and wonderful fact, he says.
“Cancer patients are living longer. Targeted therapies are effective, and even those with metastatic disease have added years to their lives,” he says. “This is a great thing. But with longer lives come unique complications.”
There may be consequences of treatment — past exposure to chemotherapy, radiation and more. Hospitalists are well suited to treating these late effects in acutely ill patients in the hospital. They work cooperatively with supervising oncologists and return patients to their care when the acute issues are resolved.
Split schedule allows for intensive patient care, research
Brito-Dellan came to MD Anderson in 2011 from Intermountain Healthcare in Utah, where he also practiced as a hospitalist. He relishes the demanding pace of the seven-days-on/seven-days-off schedule. His clinical research — on improving the health and quality of life for those with advanced cancer — is conducted on the “off” weeks.
He wouldn’t have it any other way.
“It’s a very interesting patient population,” he says. “For each type of cancer, there may be some distinctive, associated comorbidities. For example, patients with lung cancer may present with acute exacerbations of chronic bronchitis, repeated lung infections and so forth.”
Another research focus is standardizing insulin management among inpatients, most with advanced cancer.
“It leads to better outcomes — fewer complications, improved healing, less infection and reduced mortality.”
His seven-days-on rotations allow him to really connect with patients and their loved ones, he says. “I love caring for these patients. I learn a lot from them. At some of the worst moments of their lives, they’re inspiring. It’s something you don’t get in other places.”
And how does he cope with his stressful schedule? “I run,” he says. “I ran a marathon last year.”
Related story: Creating an umbrella of care
More Stories From Conquest
Creating an umbrella of care
Patients in cancer treatment often have other health issues that can affect treatment and/or quality of life. Over the past 25 years, MD Anderson has added myriad services to handle these conditions while providing quality care for patients.
Seed, soil and metastasis
In 1889, Stephen Paget, an English surgeon and pathologist, hypothesized that metastasis (the spread of cancer) did not occur randomly. It took nearly a century before Isaiah Fidler came along to prove him right.
50 years of educating scientists
As the graduate school celebrates its 50th anniversary, its two leaders assess their first year as deans and look forward to an exciting future.
Understanding epigenetics to develop new therapies
Some might call it fate. Three scientists who started their careers in different parts of the world and come from different scientific disciplines now work together at MD Anderson to develop new treatments for patients.
