Hospital-based medical oncologists work for a local health system, hospital or an academic institution. Hospital-based physicians routinely have significant non-clinical obligations in administration, research and teaching, and therefore may spend less time with patients, making it more difficult for patients to receive regular, consistent communication from them.

The primary difference between care in the independent community setting and care in the hospital setting is related to cost. Because hospital-based oncologists bill through the hospital’s contracts, the costs to your health plan through insurance claims—and to you through increased co-pay—can be higher. Recent studies show the cost for receiving the same drug and treatment, through the same process, may possibly be two to three times more expensive when obtained from a hospital outpatient-based oncologist as compared to an independent community oncologist.

The issue of cost in cancer care is not one to be taken lightly. Cancer is unfortunately an expensive disease to treat. The drugs can be very costly, as are imaging studies, lab tests and many other procedures. However, the biggest single determinant of the cost of your care, which is in your control, is your choice of oncologist – specifically, whether or not he functions as a community oncologist or as part of a hospital system or institution.