Clinical Component

Navigating the Clinical Component

Practice Overview

This is a balanced, full-scope medical oncology practice with approximately a 50/50 mix of solid tumors and hematology. It is designed to maintain broad clinical competency across both disciplines while avoiding the narrow specialization or burnout common in high-volume tertiary centers.

The annual case volume averages around ~250 cases, supporting a steady, sustainable pace of care with strong continuity.

Practicing Medicine, the Way It Was Meant to Be

Your day starts at the Celilo Cancer Center, a modern, purpose-built space designed to support both patients and clinicians. It’s a place where patients are known by name, and where many members of the care team have worked side by side for years, creating a steady, collaborative environment. You’ll be practicing in a community that values having local access to oncology care and relies on it.

This is not high-volume, impersonal medicine. It’s a relationship-based practice, supported by systems that are designed to keep your workload sustainable and your focus on good clinical decision-making rather than volume.

Clinical Volume & Workflow

  • Current volume: ~10–12 patients/day
  • Target volume: ~12–16 patients/day
  • New consults: 60 minutes
  • Follow-ups: 30 minutes
  • Clinic hours: 8:00 AM – 4:30 PM
  • Last patient typically seen by ~3:30 PM

This lower-than-average volume (compared to many community oncology settings) supports:

  • More thoughtful clinical decision-making
  • Strong patient communication and education
  • Sustainable long-term practice without volume pressure

Clinical Scope

Oncology

A true general oncology practice with broad exposure to high-incidence cancers, emphasizing community-based breadth rather than ultra-tertiary specialization.

  • General solid tumor mix across common malignancies
  • Lung cancer (~7% of total case mix; consistently among the top diagnoses)
  • Breast cancer
  • Colorectal cancer (with surgical oncology support on-site for breast and colorectal cases)

This structure ensures strong ongoing competency in core oncology areas that are important for both board maintenance and long-term clinical flexibility.

Hematology

Balanced hematology practice that includes both malignant and benign disease:

  • Lymphoma and leukemia cases within a community scope
  • Benign hematology, including:
    • Anemia
    • Clotting disorders / DVT management
    • Hemochromatosis

Importantly, hematology is not phased out over time—this remains a consistent, active part of the practice.

Complexity & Referral Pathways

Managed locally, the practice handles bread-and-butter oncology cases such as lung, breast, and colorectal cancers, along with infusion therapy and longitudinal cancer care, plus general hematology management.

For local referring, the practice relies on established urology relationships that support GU oncology cases (prostate, bladder, kidney), with a reliable referral flow and shared management of these cases.

More complex cases, including CAR-T therapy, bone marrow transplant, and highly complex biopsies or ultra-specialized procedures, are referred to Portland, about an hour away.

This allows the site to remain clinically comprehensive without being overwhelmed by tertiary-level complexity.

A Seamless, Multidisciplinary Environment

Celilo’s clinical model integrates Medical Oncology, Radiation Oncology, Infusion, Pharmacy, and Nurse Navigation within one cohesive unit. The synergy between departments is intentional — the medical oncologist, pharmacists, and infusion nurses work side-by-side, communicating directly rather than through layers of bureaucracy. This creates a clinical flow where patient plans are implemented quickly, treatment toxicities are managed in real-time, and continuity never falters.

Radiation Oncology is led by Winnifred Wong, MD (Medical Director) and Keith Stelzer, MD (semi-retired founder), who provide continuity and mentorship, ensuring that your patients receive a seamless transition between disciplines. Together, you’ll participate in twice-monthly multidisciplinary tumor boards, offering CME credit through the OHSU Knight Cancer Institute. These sessions bring together surgeons, pathologists, urologists, and radiologists to discuss cases with academic-level rigor in a community-based setting — a perfect balance of collaboration and autonomy.

Practice Structure & Support

Call Responsibilities

  • No inpatient chemotherapy responsibilities
  • No call requirement

This structure intentionally prioritizes outpatient continuity, reduces burnout risk, and allows focus on longitudinal cancer care rather than inpatient coverage demands.

Patient Volume & Panel

  • Clinic panel: approximately 800 patients as the program now stands
  • Daily volume: 12–15 patients per day
  • New patients: up to 3 per day
  • Wait time for new patients: currently approximately one and a half to two weeks
  • Infusion room: currently booked two to three weeks out

Multidisciplinary & Academic Integration

Through affiliation with the OHSU Knight Cancer Institute, the practice maintains academic-level engagement. With that said, this position comes with:

  • Associate professor appointment
  • Access to research infrastructure and PubMed resources
  • Tumor boards meeting in person 2x/month including:
    • ENT
    • Surgery
    • Urology
    • Radiology
    • Pathology

This creates a hybrid environment: community-based practice with academic-level collaboration and case discussion.

Health System & Network Strength

The practice is part of a large integrated system:

  • ~23-hospital health system
  • ~11 cancer centers across the network
  • Epic EMR integration (upcoming) connecting all oncology sites

This means shared protocols and standardized care pathways, system-wide tumor board collaboration, Seamless referral pathways in and out of the system and Access to subspecialty support without leaving the community setting.

You are practicing locally but supported by a fully integrated regional oncology network.

Oncology APP Support

An embedded oncology-trained nurse practitioner supports follow-ups, symptom management, and infusion coordination, so you lead the practice with full clinical continuity and reduced administrative burden, never alone.

Empowered by Technology, Supported by Precision

Your work is enhanced by Epic EMR, shared directly with OHSU, allowing integrated documentation, consults, and data exchange between systems. This connectivity ensures that even in a rural region, you’re part of a sophisticated network of specialists. Tele-oncology, pathology review, and remote radiation planning capabilities further strengthen your ability to deliver advanced care locally. The pharmacy upstairs compounds all chemotherapy on-site, creating a fluid collaboration between physician, pharmacist, and nurse that eliminates bottlenecks and minimizes treatment delays.

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