Clinical Component

Navigating the Clinical Component

The current oncology office is 3,500 sq ft, located inside a medical office building attached to the hospital. Good Shepherd is breaking ground on a new 12,000 sq ft Cancer Center that will include an expanded infusion suite, an onsite pharmacy, and a linear accelerator for in-house radiation therapy. Radiation cases currently refer to the Tri-Cities. You will have direct input on the design and service scope of the new facility.

Schedule and Call

  • Four 10-hour clinic days per week
  • No nights, no weekends, no call
  • Daytime inpatient consults handled collaboratively with the ED and hospitalist teams
  • Average inpatient rounding: 30 to 45 minutes per day
  • Active tumor boards with participation across specialties

Imaging and Procedures

Onsite imaging includes MRI and CT. A new PET/CT scanner has been purchased and is currently housed in a trailer while the new imaging center is built. The program has historically sent out roughly 12 PET scans per month, representing volume that will move in-house.

Interventional Radiology is onsite four weeks per month and supports a full range of oncology procedures:

  • Image-guided biopsies for diagnosis and staging
  • Tumor ablation, including radiofrequency and cryoablation
  • Chemoembolization and embolization
  • Radioembolization
  • Catheter and port placement for chemotherapy and long-term venous access
  • Palliative procedures for pain and obstruction management

Surgical Support

  • General Surgery performs most cancer surgery in-house, including some breast surgery
  • Colorectal surgery coordinated with providers in the Tri-Cities
  • Higher-acuity and complex surgical cases referred to OHSU in Portland
  • Bone marrow transplant cases referred to Portland or Spokane

Infusion and Clinical Support

  • Infusion Center with 7 chairs, expanding with the new build
  • Saturday infusion clinic being added
  • Onsite hospice and palliative care programs
  • Epic EMR across all clinical services

Team and Support Staff

  • One medical assistant per provider
  • Susan Damico, the full-time oncology nurse practitioner who manages a high hematology caseload and covers oncology patients when contracted physicians are remote
  • Plan to add a second NP after the new oncologist is hired

Referral Volume and Program Growth

Dr. Iacoboni's panel is more than half hematology, and a significant share of complex oncology cases has historically referred out. Hospital-employed primary care generates a steady referral stream that has outgrown current program capacity. As the new Cancer Center opens and in-house capabilities expand, the incoming oncologist will be positioned to recapture this volume and build a long-term outpatient panel.

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