Your medical team

Making sure you have the right medical team in place is important for your physical wellbeing and emotional wellbeing. While it’s normal to want to get your cancer dealt with by the first available specialist, it’s worth taking a little time to make sure you are comfortable with each member of your medical team.

Remember, you may have to see these people for several years as you go through your treatment and follow-up appointments.

Your choice of specialist

While you may initially be referred to one specialist, you do not need to stay with that specialist. If you are unhappy about or uncomfortable with the specialist you have been referred to, it’s a good idea to seek a second opinion. If you would like a second opinion, you can ask your GP or specialist for a referral to someone suitable.

When looking for a surgeon or medical oncologist, word of mouth goes a long way. If you’re not sure where to start, you may like to get recommendations from other people who have experienced breast cancer.

Public or private system?

You should feel empowered to make choices regarding your treatment and care. One of the choices you can make is whether to have your treatment in the public or private health system.

You can also choose to have some of your treatment in the private health system (chemotherapy) and some in the public health system (radiotherapy).

Here are some advantages and disadvantages of the public and private health systems in Australia.

As a public patient

You are entitled to be treated as a public (Medicare) patient in a public hospital, even if you have private health insurance; however, you must let your doctors know up front, before treatment begins.

Advantages of being a public patient

You will not be charged for most of your treatment and care.
You are more likely to have a multidisciplinary team (MDT) coordinating your care.
You are more likely to have access to a breast care nurse, social worker, physiotherapist and other allied health professionals.
You are more likely to have all your treatment team in the same place.

Disadvantages of being a public patient

You will be treated by doctors nominated by the hospital – in other words, you cannot choose your doctors.
You may see many different health professionals through the course of your treatment.
You may have to wait longer for appointments and treatment, but this should not affect the outcome of your treatment.
You will likely have to share a room with other patients for overnight stays in hospital.

As a private patient

If you don’t have private health insurance, you can pay to be treated as private patient. Your doctors can tell you how much this will cost.

Before treatment begins, you may want to clarify how much it will cost and exactly what your private health insurance will cover. To do this, ask your doctor to provide a quote and then ask your private health insurer which treatments are or/are not covered by your insurance, what excess or gaps you may have to pay, and what other services you can claim, for example, a wig, post-surgery bra or lymphoedema garment.

Advantages of being a private patient

You can choose your specialists and the hospital in which you wish to be treated.
Timelines for treatment are generally shorter.
Depending on your level of cover, you may be able to stay in a private hospital and have a private room.

Disadvantages of being a private patient

You could be faced with substantial out-of-pocket costs for your treatment, e.g. you may have to pay an ‘excess’ or gap for surgery and other types of treatment.
Private health insurance only covers inpatient procedures, so you will not be covered for any treatment that you receive as an outpatient, e.g., radiotherapy, radiology, pathology tests and visits to specialists in their rooms. While these items may have Medicare rebates, the rebate for an item may not always cover the whole fee.
You may be less likely to have access to allied health professionals such as a social worker or physiotherapist, as part of your care. You may have to seek out care from allied health professionals and pay for appointments. Check with your insurance provider what they will cover in an “extras” policy you may have.

More information on public and private patient care can be found on our factsheet Managing the financial impacts of breast cancer and the BCNA article offering tips to help deal with the financial stress of breast cancer.

Your medical team

The members of your medical team may include:

surgeon
medical oncologist
radiation oncologist
breast care nurse
oncology nurse.

Your GP will also play an important role in your care. Your GP can clarify any information given to you by your specialists, help you with treatment decisions, and assist you to find practical and emotional support.

Ask your specialists to send copies of all tests and planned treatments to your GP.

Multidisciplinary teams

In Australia it is considered best practice for breast cancer treatment to be managed though a multidisciplinary team (MDT) approach. This means that the health professionals involved in your care meet to discuss the best treatment options for you.

As well as the health professionals listed above, the MDT may include a pathologist and others involved in cancer care.

You can ask your surgeon if a multidisciplinary team is involved in your treatment.

Medical consultations

If you can, take someone with you to your medical appointments. Taking your partner or a support person can help them better understand your treatment. They can also take notes in case you forget something.
Try to write down any questions you might have before your appointment. It’s easy to forget things during a medical appointment and having them written down is an ideal reminder of what has been on your mind. Put your most important questions at the top of your list, in case you don’t get time to ask them all.

Things you can do now

Visit My Journey, BCNA’s online tool for information tailored to your diagnosis.
Join our Online Network if you think that talking to others online and sharing experiences will help.
Contact BCNA’s Helpline on 1800 500 258 between 9.00 am to 5.00 pm AEST Monday to Friday, for information about the services and supports that may be available for you and your family.
Use the Find a surgeon function on the Breast Surgeons of Australia and New Zealand website (BreastSurgANZ) website, which provides a comprehensive search of breast surgeons in your local area.

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