An oncologist for almost 20 years, Dr. Jennings walks into her office and follows her daily routine. She hangs up her coat, gets settled into her chair, and pulls open her laptop to check her emails. She hears a knock at the door, one of the nurses comes in to provide her with a run-down of the day and a list of patients with appointments. She looks to the column right of the patients’ names and observes the prescription level each patient is on. She makes a mental note of the patients without prescriptions, and to be mindful of the associated costs of treatments.
Dr. Jennings' first patient of the day is a newly diagnosed breast cancer patient who is feeling anxious about her visit. Reviewing the genomic sequencing data in her profile, Dr. Jennings reassures her of the many treatment options available to her. From immunotherapy, to targeting new mutant proteins and identifying their weaknesses, she begins by walking her through a personalized treatment based on her genetic information. Slowly, she notices her patient's demeanor begins to calm, as she focuses on asking questions about next steps. When Dr. Jennings mentions the costly impact of personalized therapies, the patient is reassured her insurance can cover it and agrees to further testing. After the patient leaves the clinic, Dr. Jennings feels slightly relieved – starting off the day optimistic.
The next few hours are filled back-to-back with appointments until Dr. Jennings switches over into telehealth mode. The patients she interacts with virtually on a regular basis are on higher tiered prescription levels, and as a result have positive check-ins with precise HCP monitoring. While she enjoys interacting with patients, these virtual visits are very detail oriented and are booked consecutively after one another, leaving Dr. Jennings feeling exhausted going from patient to patient. As she feels her energy slowing down, Dr. Jennings transfers her patients over to the nursing team whenever she encounters a challenge with insurance or access to a medication.
As she reviews the file for the last patient of the day, Dr. Jennings notices this patient is currently on chemotherapy and radiotherapy treatments. When the patient walks in, she can tell by their demeanor that the patient is not doing well. Remembering this patient is on the lowest prescription access tier, Dr. Jennings reminds herself to be mindful of financial barriers while also providing the best quality of care. After a discussion about symptoms and next steps, the patient becomes overwhelmed by the process, putting their hands onto their head trying to conceal tears. They are unable to afford the next level of care for physical and emotional support and are left feeling abandoned.
After the patient leaves, Dr. Jennings feels defeated. She's tried her best to connect the patient with different advocacy and patient support programs but is limited by the options of support that are within the patient’s range. Over the past couple of years, she notices the disparities between patients have become more apparent, with seamless care for those who can afford it, and fragmented care for those who can’t. As she wraps up the day sifting through emails from clinic staff, pharma reps, and journal studies, Dr. Jennings can’t shake the feeling in her gut – she wishes she could do more but feels she’s done all she can. She heads home feeling drained, thinking about all the patients who couldn’t afford more care.