[quote]Lastly I would like to observe that we have had numerous people come here that were being seen by a single doctor, usually a surgeon, and not working with a multidisciplinary team, which I think is a less than desirable idea.[/quote]FIRSTLY, this is the point I'd drive home first. And that team approaches and configurations and multidisciplinary can be found beyond the walls of CCCs.

CCC likely have fully integrated records and patient care IT systems, enabling information flow between practitioners and patients smoother and seamless whereas docs not in CCC likely have non-integrated systems which require more manual flow of information.

Going to a single doctor, even if he were world renowned would be shortsighted to me. HNC is a complex disease in a complicated part of the body and requires expertise from multiple disciplines.

My own experience outside a formal CCC felt as effective. The ENT was part of hospital group A, MO was part of hospital group B, RO was part of cancer institute of hosptial group C, yet they are all formally and contractually bound together and convene tumor board on a standing basis much as a CCC.

One could argue that having even greater diversity of viewpoints and expertise and experience and possibly freer of politics could offer as good, maybe even better, more objective recommendations.

My RO is listed individually in the latest US News ratings and the facility he is part of. The ENT did his fellowship in HNC at Memorial Sloane Kettering, hard to find better credentials. My MO was very passionate and made very sound and supportable recommendations which the tumor board backed up. He was very egoless and more than willing to go back to tumor board open to getting more experienced minds to review different options. (We did go just the one time, which I did attend, another plus).

A quasi CCC team does require more personal oversight and sheparding due to the lack of integrated practice systems but as long as you stay on top of it, it was no big deal; very much like the back end of medicine has been forever.

One comment on CCC, more specifically academic associated CCC, not mentioned much before is that as teaching institutes I find there is far more turnover in doctors as they come and go. I experienced this with my son who received audiology services at a teaching institute and the lack of continuity was less than comforting.