Deciding on specialist care

It is important that you feel comfortable and confident with your choice of specialist because you will have a lot of contact with them and they will influence your care. Some people are happy to leave the choice of specialist to their doctor. However, you have a right to be involved in this decision if you would like to be. You may prefer to choose a specialist based on recommendations from family, friends or colleagues, or from your own research.

Choosing a specialist

Under the Medicare system, you need a referral to see a specialist. This referral can come from a GP or another specialist.

You have the right to be treated as a public patient in any public hospital. If you are treated in the public system, you will be treated by the specialist appointed by the hospital. You might want to research public treatment centres that specialise in the type of cancer you have. Public hospitals may give priority to patients in their local area, so you may have to wait longer if you want to be treated in a hospital outside your area.

If you have private health insurance, you can choose to be treated as a private patient, or you can avoid out-of-pocket costs by being treated as a public patient in a public hospital.

Key issues to consider

There are a few issues to think about when deciding which specialist should be responsible for your treatment. Before visiting your cancer specialist for the first time, take some time to prepare for the appointment.

Number of patients – Some specialists and treatment centres have particular expertise in treating certain types of cancer because they see a large number of patients and therefore have more experience. For some types of cancer, there is evidence that health professionals who treat a lot of patients have the best treatment outcomes.

Multidisciplinary care – There is evidence that patients do better if their doctor works as part of a multidisciplinary team (MDT). This means health professionals who specialise in different aspects of your care work together to plan treatment.

The MDT often includes a surgeon, a medical oncologist, a radiation oncologist, a cancer care coordinator, a nurse, and allied health professionals, such as a physiotherapist, dietitian and social worker. They meet regularly to review cases and consider treatment options. The team also discusses how best to help individuals cope with the physical and emotional effects of cancer.

Specialist centres – Another way to tap into expertise is to see if there are treatment centres that specialise in the type of cancer you have. These centres have many patients and also tend to treat rare cancers or cancers that don’t have a typical response to treatment.

Specialist treatment centres have multidisciplinary teams of health professionals experienced in treating particular cancers. They are often teaching centres, which means you might be treated by a junior doctor who is supervised by a specialist. There could be long waiting lists for these centres.

The key principle is that it’s your right to ask your GP or other doctors about specialist treatment centres and to be referred to a specialist in one of those centres, even if it’s not in your local area.

Your preferences – You may prefer to see all your doctors at the one hospital, even if it is a long way from home, or to attend your local hospital to reduce travel time. It’s your right to determine what is most important to you and your doctors should respect your preferences.

How to find a specialist

Ask your GP – Your GP will be able to refer you to a suitable specialist or treatment centre. Your GP should have clear reasons for their choice. You are entitled to ask about those reasons and to receive a clear answer – for example, is it because the specialist has particular skills or simply because they are nearby? You also have the right to ask your GP for a referral to more than one specialist.

Search online – Check the websites of medical colleges for a list of specialists. For example, you can search for colorectal surgeons on the Colorectal Surgical Society of Australia and New Zealand’s website. You can also check the registration status of a specialist on the national register of practitioners.

Contact the treating hospital or centre – The websites of many hospitals allow you to search for a specialist who works at that location.  Alternatively, you can call the hospital and ask about specialists who treat the type of cancer you have.

If you live in a rural or remote area

In rural areas, your GP may refer you to a local specialist or treatment centre, or to a visiting oncologist. Depending on the type of cancer, they may recommend you travel to a centre that specialises in a particular treatment.

There are some excellent regional cancer centres in Australia, and some regional specialists treat many cancer patients. However, some regional specialists treat far fewer cancer cases than doctors in metropolitan areas, and there may be a long wait to see the visiting oncologist.

All state and territory governments have a patient travel assistance scheme. If treatment for your cancer type is not available close to home, you may be eligible for financial assistance to help cover the cost of travel to a suitable treatment centre. The scheme may also assist with the cost of accommodation.

For more information, call Cancer Council 13 11 20 or talk to the hospital social worker.