COVID-19 Resource Center

COVID-19 Resource Center

Source:

The Cancer Letter. Clifford Hudis: What a virtual meeting can accomplish—and what a virtual meeting cannot accomplish. Available at: https://cancerletter.com/articles/20200605_6/. Accessed July 1, 2020.

Disclosures: Petrelli reports no relevant financial disclosures.
July 21, 2020
3 min read
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Somebody needs to mute themselves: A commentary on virtual tumor conferences

Source:

The Cancer Letter. Clifford Hudis: What a virtual meeting can accomplish—and what a virtual meeting cannot accomplish. Available at: https://cancerletter.com/articles/20200605_6/. Accessed July 1, 2020.

Disclosures: Petrelli reports no relevant financial disclosures.
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Let me preface this brief commentary by stating outright that I still use an iPhone 5 and enjoy listening to several 45s on an old record player. “In the Still of the Night” by The Five Satins is a favorite.

So, perhaps you have already labeled me as “old-fashioned.” If so, you’re not alone — my daughters feel the same way.

However, bear with me on the topic of virtual tumor conferences.

‘Virtual is here to stay’

Virtual tumor conferences have kept multidisciplinary discussions going through the COVID-19 pandemic at cancer centers throughout the country, and for good reason.

Nicholas J. Petrelli, MD, FACS
Nicholas Petrelli

Maintaining these discussions is critical because, as we all know, cancer care is multidisciplinary and the team delivers quality care when everyone is on the same page, causing less confusion for patients and family members.

Virtual also is critical and necessary as long as social distancing is mandatory. We want to protect both our patients and all our caregivers, which takes cooperation on the part of all cancer center personnel. Social distancing is a major challenge and accomplishment by everyone involved.

We also know that virtual is here to stay, especially for many specialties — including cancer. The follow-up of our patients with cancer depends on their disease status, and also on how long and at what level CMS and private insurers will pay.

New collaborations

However, as Clifford A. Hudis, MD, FACP, FASCO, CEO of ASCO, said following this year’s ASCO20 Virtual Scientific Program, “If we were robots, and our job was to vacuum up all of the information in the most efficient way possible, the virtual meeting gets us in that direction pretty successfully.

Clifford A. Hudis, MD, FACP, FASCO
Clifford A. Hudis

“But, that is not really what makes the ASCO meeting useful to the world,” Hudis added. “What makes it useful to the world is you bump into people, you sit down and, over a cup of coffee, you talk about some ideas you have. Out of those happenstance and planned meetings, new collaborations are born.”

To a degree, I have seen this happen at all our tumor conferences at my institution over the years, although recently coffee and bagels were missing at our Thursday morning general conference — they will be back!

I’ve seen the general surgical residents talk to the attending surgeons before the tumor conference to update their patients’ statuses following morning rounds, including patients undergoing surgery that day. I’ve seen an interesting case presented at a conference and, afterward, attendings talking to each other about writing a manuscript or talking to the genetic counselors about a patient, because the counselors found more information in the family history than the physician. The latter is not a rare occurrence.

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Then there is the discussion of a new project with a multidisciplinary group staying after a conference. Just prior to COVID-19, we discussed the project of putting a primary care physician in the cancer center, which is soon to become a reality. This was stimulated by the fact that oncologists saw a significant percentage of patients with no PCP to oversee their chronic conditions, like hypertension and diabetes. Hence, it was not uncommon for these patients to be seen in the ED.

What’s lost

I have the privilege of moderating our general Thursday morning tumor conference.

Of course, the ultimate benefit of a face-to face conference is looking someone straight in the eyes and saying, “Would you really do that again?” or, “Perhaps you read this information in the National Enquirer, since it can’t be found elsewhere.”

Under such scrutiny, my colleagues can’t disconnect or mute themselves. Fortunately, you also can’t mute the moderator during a face-to-face tumor conference.

It’s also refreshing to hear a radiation oncologist say, “I believe there is no role for radiation therapy for this patient,” and have the moderator respond, “thank you,” and receive a respectful laugh from the audience.

There is something special about questioning the next generation of oncologists in person, whether they are medical, surgical or radiation oncologists. This is something that is lost virtually, maybe because you can’t look them straight in the eyes. It is always exciting and educational for everyone.

Our chief of surgical oncology and I were discussing our disease site multidisciplinary centers and how some are utilizing virtual platforms for some patients, which is understandable during the pandemic. However, he noted, “As a surgeon, I need the eye test on a patient.” That can’t be done virtually.

All of this demonstrates the esprit de corps of face-to-face conferences. They are a way of getting to know your colleagues beyond the medicine. Frankly, in our “business,” we need that.

So, for the moment, virtual continues to play a role and will in the future.

During virtual meetings, the moderator will continue to mute individuals and individuals will forget to unmute themselves and have to repeat what they said 5 minutes before.

I can’t wait to get back to a packed tumor board conference room every week and have our previous chair of radiation oncology tell us what it was like giving radiation in “the old days.” That also gets a respectful laugh.

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Until then, can the doctor with the kids and dog in the background please mute themselves?