Our CC is a top one. The team is great and highly qualified. The process to schedule appts and tests for combined rad and chemo has been poor, disconnected as scheduling systems are not integrated, and there are no patient navigators in site (learned that hospital admin layed off many of them.)

I don't mind, actually feel I'm doing something by being my Dad's navigator. And I have a reputation for not waiting and calling up the chain for results. I want to be sure that I'm being reasonable:
-5 days ago we received news of potential metastasis by phone
-3 days ago a trial was proposed, my Dad accepted but needs more CATS and of course, a BIOPSY. These needed to be scheduled first before he starts the trial.
-Today I'm still calling the same oncology administrative assistant for scheduling. I've been patient and polite, but it's now the day before Thanksgiving and I suspect the long holiday pushes us back further.

Am I being unreasonable in my expectations towards responsiveness?

No... you are not. Keep making phone calls... the squeaky wheel gets the attention... if you just wait for them to do the stuff for you you could get lost in the shuffle. So push. This is your dad's life. Every day matters. so make noise if you have to. Things slow down going into christmas. Get whatever has to be done ASAP... plus with possible metastases... time is important.

Call the ENT's office directly see if you can book the biopsy that way. Then call the imaging department, tell them the situation and tell them you are willing to take any last minute cancellations etc...

Good luck. And hugs and I am hoping it is not metastatic. Prayers and blessings to you and your dad.

Yes and no. Doctors are like everyone else - some are very efficient and others are procrastinators. Realistically though, a complete diagnostic work up with all of the different scans, blood work, hearing tests, baseline TSH test, creatinine clearance, pathology and radiology readings, RT treatment plan programming, mask creation and simulation, etc. can take over a month. In the scheme of things that's pretty typical and shouldn't have any significant difference in the outcome. In other words, a one month delay shouldn't affect the staging. Everyones treatment plan is custom made. They can't jump the gun on this - all the pieces must be in place before Tx can begin. Cheryl is correct, however, that it doesn't hurt to be a proactive advocate. The 2 institutions where I was treated fast tracked me on everything and it still took over a month before treatment started and I was Dx'd prior to Thanksgiving.

Another thing to consider is you will be stunned when treatment actually starts with the amount of people in the infusion unit, RT unit, etc. It's a logistical nightmare. Many institutions run the RT machines 2 shifts and occasionally they break - screwing up all of the scheduling. It's a lot like being in a stockyard!

You are correct that the MO, who typically coordinates everything, including your team, and takes care of medications, orders scans, pain relief, etc., should be your primary point of contact.

Hi Caco,
I understand the frustration...having lived a portion of it during our situation. I tried "patient and polite". But, got more mileage out of "bitc...I mean...caregiver from hell". Or as Gary says..."proactive advocate". Between doctors' egos and more than a few staffers with a lack of work ethic, there were eff-ups a plenty. And, I went proactive all over their butt. More than one doctor got a bolus of proactivity.

You don't have to go to that extreme. But, sometimes, the ineptitude and abject stupidity of some of folks (doctors are NOT exempt)can push a patient's advocate over the edge. I decided to make the best of it and greatly enjoyed helping a few who were particularly in need of having their cranium resected from their colon.

We were going through it at exactly this time last year. And, even people who are professional and/or who work in the medical field can get really stupid and selfish during the holidays. But, push away. When you aren't getting treated with consideration and expediency, don't be afraid to say words that will curdle egg nog. After all, they have a job that requires them to actually work during November, December and January. They should be expected to do a competent job despite the days they are closed for celebrating. Some things can't and shouldn't be put off for later. It might not be life or death for them...but it is for you and someone you love.

Escalate to a person of higher authority (you can stop short of God, though) to get some action. When the person in charge of scheduling repeatedly dropped the ball in scheduling J's tests, I spoke with her employer--the doctor. I made sure he knew that I understood that staff members who make mistakes not only cause critical delays in treatment but are also a threat to the health of his business. He appreciated the feedback and took some of my suggestions with him into the next staff meeting.

Be a nice enough advocate to make the hired help want to help you. But, be enough of a harpy to make them want to do their best work to avoid your rath (if not your phone calls) at all costs. It worked for me!

thanks everyone. as this is possibly mets, i expected shorter response time. as it turned out, i was on the phone until wed afternoon b4 thxgiving tracking down admins who still hadnt confirmed dates for cts and his biopsy. we took a 6pm slot today (we travel to get there) but the admin neglected to schedule his muga which he needs to start the trial. she "didnt know he needed it" (although i have the printed script in front of me and read it to her) and she also didnt know the number of the dept to get it scheduled, had to transfer me to an operator so i could do it.

where this gets fun, i'm transfered to the wrong number: an attending physician who is expecting another call. thinking i'm his call he asks how i am. "my dad was told a week ago he has mets and needs a muga, can you help?" awkward pause as he aplogizes and gets their dept admin, i have the appt in 1 minute.

Awesome!!!!! but not so awesome - on the wait!