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Jul 31, 2025, 15:59

David Waterhouse: Time Toxicity in Cancer Care is Failing Patients and Providers

David Waterhouse, Chief Innovation Officer at Oncology-Hematology Care, shared a post on LinkedIn:

“Time Toxicity.

Sadly, this term does not apply solely to our patients. It applies to providers as well. Today, our nurse practitioners were not available to do a ‘peer-to-peer’ to obtain certification for a patient with small cell carcinoma of the prostate gland to get his CT scan of the chest. NCCN guidelines are clear that these patients should be treated in a fashion similar to small-cell lung cancer patients. The CT scan recommendation was compliant and this should have been easy.

During the course of my trying to do this process, I was transferred 6 times. I gave my NPI number on 3 occasions. With each transfer. I had to give the patient’s name, their insurance number, the case number, and other identifying information. At no time was I told that the person on the line is not empowered with the decision. I decided to stay on the call to try and understand this process better. A

fter 50 minutes on the call, I was told that I could not speak to a person. I had to hang up because I had another priority that needed to be met. Unfortunately, the denial came yesterday, and the CT scan was scheduled for today. I doubt my patient will get that CAT scan today, and this is a shame. This is a shameful process.

Those of you who ARE empowered at AETNA (yes, I am calling out the name of the organization even though I know that this is a somewhat universal problem) need to accept that the time spent on this call was taken away from my patients, taken away from me, taken away from my family, and was costly.

Please respond to this message if you have suggestions on how we can help remedy this problem. I am blessed with fantastic nurse practitioners and I had no idea that this is what they were going through each day. I will take responsibility for my not fully understanding and will talk to them about what I will try to do to make things better. I chose to make this call today to pressure test the system and to unburden the nurse practitioners covering for my team. Not fun.”

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