THE WELCH COMPANY
440 Davis Court #1602
San Francisco, CA 94111-2496
415 781 5700
rodwelch@pacbell.net


S U M M A R Y


DIARY: October 4, 2004 11:16 AM Monday; Rod Welch

Called cancer centers for 2nd opinion on Millie's condition.

1...Summary/Objective
....UCFS Medical Center
....UCFS Cancer Center
....Referral Numbers...
........UCSF Cancer Resource Center
2...Stanford School of Medicine
3...Department of Radiation Oncology
........Stanford Referral Center
4...UC Davis Cancer Center

ACTION ITEMS.................. Click here to comment!

1...Need to check with Doctor Johnson for authorization and submission of

CONTACTS 
0202 - University of California San Franci                                                                                                                                O-00000835 0404
020201 - Ms. Sheridan L. Tinker                                                                                                                                           O-00000835 0404
020202 - New Patient Coordinator
020204 - Admissions                                                                                                                                                       O-00000835 0404

SUBJECTS
2nd Opinion Verify Scope of Problem and Treatment Planning Tumor Boa
2nd Opinion Requested from UCSF, Stanford, UC Davis Cancer Centers

1204 -
1204 -    ..
1205 - Summary/Objective
1206 -
120601 - Follow up ref SDS 6 0000, ref SDS 5 0000.
120602 -
120603 - Scheduled 2nd opinion at Stanford for 041019, ref SDS 0 528V  Did step
120604 - to register for new patient at UCSF. ref SDS 0 5G7I  Received feedback
120605 - from UCSF on getting second opinion, explaining Kaiser pays for
120606 - referrals in some cases. ref SDS 0 QY9J  Sent response to UCSF with
120607 - copy to Rosalie at Kaiser for submission to Doctor Johnson to prepare
120608 - for the meeting tomorrow, and set out basis for Kaiser to pay for 2nd
120609 - opinion. ref SDS 0 Y26L
120610 -
120611 -
120612 -
120613 -
120614 -
120615 -
120616 -
120618 -  ..
1207 -
1208 -
1209 - Background
1210 -
121001 - The record on 040517 lists relevant background.
121002 -
121003 -        Lump under left arm.................. 040517, ref SDS 2 OW3I
121004 -        IBC.................................. 040517, ref SDS 2 2F4G
121005 -        Tumor Board Report inadequate........ 040517, ref SDS 2 4R59
121006 -        Pending issues 2nd opinion........... 040614, ref SDS 4 RU5F
121007 -
121009 -  ..
121010 - Research today found...
121012 -     ..
121013 -    UCFS Medical Center
121014 -    UCFS Cancer Center
121015 -    Referral Numbers...
121016 -
121017 -    Follow up ref SDS 6 IH4Q.
121018 -
121019 -               http://cc.ucsf.edu/clinical/index.html
121020 -
121021 -            For Patients
121022 -            800.888.8664 (toll-free) or 415.885.7777
121023 -            email:  referral.center@ucsfmedicalcenter.org
121025 -             ..
121026 -            For Referring Physicians/Health Care Professionals
121027 -            800.444.2559 (toll-free) or 415.885.7777
121028 -            email: referral.center@ucsfmedicalcenter.org
121029 -
121030 -
121032 -         ..
121033 -        UCSF Cancer Resource Center
121034 -
121035 -        Follow up ref SDS 6 0089.
121036 -
121037 -        Contact the CRC online, by phone or e-mail (415.885.3693,
121038 -        crc@ucsfmedctr.org), or in person at 1600 Divisadero Street,
121039 -        Room B101, San Francisco.
121040 -
121041 -           http://128.218.158.58/interact/crc/index.asp
121042 -
121044 -  ..
121045 - Talked to Carol.
121047 -  ..
121048 - Explained background submitted in Millie's letter on 041001.
121049 - ref SDS 6 K138
121051 -  ..
121052 - Carol has not yet received the letter, ref DIP 1 0001, submitted on
121053 - 041002. ref SDS 6 K138
121055 -  ..
121056 - Recommends talking to Sheridan.
121057 -
121058 -     New patient coordinater.   415 353 7111
121059 -
121060 -                  sheridan.tinker@ucsfmedctr.org
121061 -
121062 -
121064 -  ..
1211 -
1212 -
1213 - 1126 transferred to Sheridan
1214 -
121401 - Patient care representative.
121402 -
121403 - Talked to EJ.
121405 -  ..
121406 - Explained background submitted in the letter on 041001. ref SDS 6 K138
121408 -  ..
121409 - EJ will call us back to get us registered.
121410 -
121411 -
121413 -  ..
1215 -
1216 -
1217 - 1148 EJ called back
1218 -
121801 - Could not talk to EJ, was talking to UC Davis. ref SDS 0 8L6O  Agreed
121802 - to call back in about 10 minutes.
121803 -
121804 -
121806 -  ..
1219 -
1220 -
1221 - 1159 called EJ back
1222 -
122201 - Got answering service.
122202 -
122204 -  ..
1223 -
1224 -
1225 - 1422 EJ called back.
1226 -
122601 - She suggested resending Millie's letter explaining background on the
122602 - case to...
122604 -                  ..
122605 -                 sheridan.tinker@ucsfmedctr.org
122607 -  ..
122608 - EJ took registration information.  Millie is now registered as a new
122609 - patient.  EJ took...
122611 -  ..
122614 -  ..
122617 -  ..
122620 -  ..
122621 - EJ suggested calling and leaving a message telling Sheridan that
122622 - Millie is registered and needs a date and time to meet wit a doctor.
122623 -
122624 -
122626 -  ..
1227 -
1228 -
1229 - 1458 called Sheridan.
1230 -
123001 - Sheridan is the new patient coordinator.
123002 -
123003 -           415 353 7027
123005 -  ..
123006 - Left message per above, asking Sheridan to call back and schedule
123007 - Millie for a meeting.  Advised of letter Millie sent with background
123008 - on her case.
123009 -
123011 -  ..
1231 -
1232 -
1233 - 1534
1234 -
123401 - Received ref DRT 1 0001 from Sheridan saying...
123402 -
123403 -        I've received your e mail. I'll review it and get back to you.
123404 -
123405 - ...with a link to the letter, ref DIP 1 0001, submitted on 041002.
123406 - ref SDS 6 K138
123407 -
123408 -
123410 -  ..
1235 -
1236 -
1237 - 1644
1238 -
123801 - Submitted ref DIT 1 0001 notifyng Sheridan of plans to speak with
123802 - Doctor Johnson tomorrow...
123803 -
123804 -    1.  Thanks for your letter this afternoon, ref SDS 0 VS6O,
123805 -        reporting you have received the letter on October 2nd,
123806 -        ref DIP 1 0001, asking about a 2nd opinion, with background on
123807 -        my condition. ref SDS 6 K138,
123809 -         ..
123810 -    2.  Earlier today, EJ took registration information, so hopefully,
123811 -        if you feel UCSF can help, ref SDS 0 5G7I, all we need is to
123812 -        schedule a date for an examination to complement review of the
123813 -        record received from Kaiser. ref DIT 1 9Q6F
123815 -         ..
123816 -    3.  I am meeting my oncologist, Doctor Johnson, tomorrow, and will
123817 -        request that Kaiser support review to assist the Kaiser team
123818 -        and me in deciding on the course ahead, ref DIT 1 QT7J, as set
123819 -        out in the letter to you on October 2.
123821 -         ..
123822 -    4.  By copy to Doctor Johnson (through the Avastin Protocol nurse,
123823 -        Rosalie), I am giving a heads up to prepare for the meeting
123824 -        tomorrow, so we can expedite transfer of records, and
123825 -        authorizations. ref DIT 1 YV7O  We will ask Doctor Johnson and
123826 -        his staff to take the lead on coordinating supplemental review
123827 -        by UCSF, based on understandings from the meeting on March 18,
123828 -        2004, when Doctor Johnson indicated Kaiser routinely makes
123829 -        referrals, and spoke highly of the program at UCSF. ref SDS 1
123830 -        AW6M
123832 -         ..
123833 -    5.  At that time, the doctor recommended deferring a 2nd opinion to
123834 -        assess response to the Avastin trial.  We now have a record of
123835 -        6 months which makes the case ready for review. ref DIT 1 7I9G
123836 -
123837 -
123839 -  ..
1239 -
1240 -
1241 - 1749
1242 -
124201 - Received ref DRT 2 0001 from Sheridan saying...
124202 -
124203 -    1.  hI AGAIN......I only began to review your letter when I
124204 -        realized my bus will be coming soon.  I wanted to get you SOME
124205 -        information to review in the meantime.  We do have SOME Kaiser
124206 -        referrals and authorizations for treatment.  I would guess at
124207 -        approximately 2 out of 40....mostly Kaiser does not pay for
124208 -        outside referrals when they have oncologist and surgeons within
124209 -        the plan.  However, please know that if your Dr. Johnson can
124210 -        get you a referral authorization through the outside referral
124211 -        office at Kaiser we will glad ly accept it as payment and no
124212 -        cost to you. ref DRT 2 0001
124214 -         ..
124215 -    2.  I am attaching some information for you to review, and even the
124216 -        registration forms to fill out .  I will be back with you
124217 -        tomorrow about the actual appointment.   You might also want to
124218 -        look us over on our website www.ucsfbreastcarecenter.org,
124219 -        ref DRT 2 MM6J
124220 -
124221 -
124223 -  ..
1243 -
1244 -
1245 - 2047
1246 -
124601 - Submitted ref DIT 2 0001 to Sheridan with a copy to Rosalie for
124602 - submission to Doctor Johnson that will enable the doctor to be
124603 - prepared for the meeting tomorrow...
124604 -
124605 -    1.  Thanks for timely response in your letter this afternoon.
124606 -        ref SDS 0 QY9J  By copy to Doctor Johnson (through the Avastin
124607 -        Protocol Nurse, Rosalie), we will submit your requirements on
124608 -        referrals.  Doctor Johnson has indicated a preference for
124609 -        working with your team; so I will work with the doctor tomorrow
124610 -        on making it happen. ref DIT 2 0001
124612 -         ..
124613 -    2.  There are strong grounds for a Kaiser referral because Doctor
124614 -        Johnson is the Department Chief for oncology, which presents a
124615 -        conflict for review by others within Kaiser.  I am sure Kaiser
124616 -        can make a good faith, competent review, but it is unfair to
124617 -        place the staff in a conflicting position. ref DIT 2 C46F
124619 -         ..
124620 -    3.  Please note that I have treatments on Thursdays and do blood
124621 -        work the day before on Wednesday, although lately we have
124622 -        experimented with doing same day blood work on Thursdays.  In
124623 -        any case, suggest scheduling any meetings for Monday, Tuesday
124624 -        or Friday.  If weekends are an option that would be okay too.
124625 -        ref DIT 2 007P
124627 -         ..
124628 -    4.  I found your web site with Google, which facilitated the
124629 -        initial referral. The attached material seems a bit garbled.
124630 -        Any chance you can zip the files and resubmit? ref DIT 2 7F7G
124632 -         ..
124633 -    5.  Thanks again reviewing my case.  Hopefully, Doctor Johnson will
124634 -        make the referral, and we will be in touch after the meeting at
124635 -        0915 tomorrow. ref DIT 2 009Q
124637 -         ..
124638 -    6.  Post Script
124640 -         ..
124641 -        By copy asking Rosalie to submit to Doctor Johnson for
124642 -        preparing to meet tomorrow. ref DIT 2 Q49I
124643 -
124644 -
124645 -
124646 -
124647 -
124648 -
124650 -  ..
1247 -
1248 -
1249 - 1131 called Stanford Med Center
1250 -
125001 - Stanford School of Medicine
125002 - Department of Radiation Oncology
125003 -
125004 - Follow up ref SDS 6 YR5I.
125005 -
125006 -          http://www-radonc.stanford.edu/
125007 -
125008 -    Breast Cancer Treatment
125009 -
125010 -          http://cancer.stanfordhospital.com/cancerTypes/breast/surgery.html
125011 -
125013 -     ..
125014 -    Patient Care
125015 -
125016 -          http://radonc.stanford.edu/patient_care/
125018 -         ..
125019 -        Contact
125021 -         ..
125022 -        Jan Porter, L.C.S.W.
125023 -        Phone: 650-725-4765
125024 -        FAX: 650-725-8231
125025 -        E-mail: jporter@stanfordmed.org
125026 -
125028 -         ..
125029 -        Stanford Referral Center
125030 -
125031 -        Follow up ref SDS 6 E37I.
125032 -
125033 -        You may contact us by phone at (800) 756-9000 or
125035 -         ..
125036 -        email:  referral@stanfordmed.org
125037 -
125038 -          http://www.stanfordhospital.com/forPatients/requestAppt/referralCenterConsumerSHCl
125040 -  ..
125041 - Talked to Irene.
125043 -  ..
125044 - Millie is 68.  Concord, CA
125046 -  ..
125047 - Talked to Lorna Breast Cancer Clinic.
125048 -
125049 -          650 498 7904
125051 -  ..
125052 - Lorna initially proposed submitting Millie's case to the Stanford
125053 - Tumor Board.
125055 -  ..
125056 - We reviewed background on 040517 showing that the tumor board report
125057 - in Millie's case that was not helpful. ref SDS 2 4R59
125059 -  ..
125060 - Lorna then suggested talking to Michelle to schedule a meeting with
125061 - an oncologist, who can review the file and recommend whether the
125062 - Stanford Tumor board can be helpful.
125064 -  ..
125065 - Michelle's number is...
125066 -
125067 -          650 725 7330
125069 -  ..
125070 - Left message for Michelle to call back.
125071 -
125072 -
125074 -  ..
1251 -
1252 -
1253 - 1503 called Michelle back
1254 -
125401 - Michelle took registration, including social security number and
125402 - Kaiser account, per above. ref SDS 0 5183
125404 -  ..
125405 - Schedule meeting for Wednesday 041019 1330 with....
125406 -
125407 -    Doctor Alice Guardino, Oncologist.
125409 -  ..
125410 - Key issue is experience with IBC, per review on 040517, ref SDS 2
125411 - 6M9H, and telecon with Jeannie on 040602. ref SDS 3 XI35
125413 -  ..
125414 - Need to check with Doctor Johnson for authorization and submission of
125415 - medical history.
125416 -
125417 -    Need medical records transmitted.
125418 -
125419 -    Treatment summary, including radiation.
125421 -     ..
125422 -    Testings.
125424 -  ..
125425 - FAX:  650 723 6956
125427 -  ..
125428 - Cost is $606 for consultation if Kaiser does not pay.
125430 -  ..
125431 - Millie resubmitted her letter, ref DIP 1 0001, on 041002, ref SDS 6
125432 - K138, to Michelle, who will submit to Doctor Guardino for review prior
125433 - to meeting on 041019.
125434 -
125435 -        mmalig@stanfordmed.org
125436 -
125437 -
125439 -  ..
1255 -
1256 -
1257 - 1548
1258 -
125801 - Michelle called back and reported she received Mil's letter, and will
125802 - submit it to Doctor Guardino to prepare for the meeting on 041019.
125803 -
125804 -
125806 -  ..
1259 -
1260 -
1261 - 1635
1262 -
126201 - Received a form letter from Carol Walovich, RN acknowledging receipt
126202 - of the email, ref DIT 1 0001, and independent of the work Michelle
126203 - did to schedule a meeting with Doctor Guardino on 041019, since
126204 - Carol's letter says in part...
126205 -
126206 -        Thank you for your email. If you could call me directly, I
126207 -        could refer you to the new patient coordinator for the Breast
126208 -        oncology service. She would be able to help you to initiate
126209 -        care and schedule you with one of our medical oncology
126210 -        specialists.
126212 -         ..
126213 -        I can be reached at (877) 668-7535, Monday through Friday from
126214 -        8:00 a.m.-5:00p.m., Pacific Daylight time.
126215 -
126217 -  ..
1263 -
1264 -
1265 - 1703
1266 -
126601 - Submitted ref DIT 3 0001 to Carol saying...
126602 -
126603 -    1.  We spoke to Michelle this afternoon, and she has scheduled a
126604 -        meeting with Doctor Guardino on 041019 OA 1330.  Michelle has
126605 -        forwarded to Doctor Guardino the letter on 041002 that lists
126606 -        two (2) case studies on my medical history working with Kaiser,
126607 -        ref DIP 1 VX91, which was submitted previously to Stanford
126608 -        Medical Center on 041002, ref SDS 6 K138, in order for Doctor
126609 -        Guardino to prepare for the meeting on 041019.
126611 -         ..
126612 -    2.  Thanks for timely response.
126613 -
126614 -
126615 -
126617 -  ..
1267 -
1268 -
1269 - 1144 called
1270 -
127001 - UC Davis Cancer Center
127002 -
127003 - Follow up ref SDS 6 5M7I.
127004 -
127005 -           http://www.ucdmc.ucdavis.edu/cancer/
127007 -         ..
127008 -        Welcome to UC Davis Cancer Center. We are your NCI-designated
127009 -        cancer center - the only cancer center in our region to have
127010 -        achieved designation by the National Cancer Institute, the
127011 -        nation's top cancer organization
127013 -         ..
127014 -        Patient Referral Office
127015 -
127016 -           Call (916) 734-5900, toll-free (800) 362-5566, 8 a.m. to 5
127017 -           p.m., Monday through Friday or A faculty physician is always
127018 -           available to help speed the referral process.
127019 -
127021 -  ..
127022 - Talked to Linda.
127023 -
127024 -     Cost under $1000.
127025 -
127026 -     Kaiser Utilization Department must approve payment for 2nd
127027 -     opinion.
127029 -      ..
127030 -     Contact Medical Secretaries Department and fill out a form to
127031 -     release records to UC Davis.
127032 -
127033 -           UC Davis Cancer Center
127034 -           4501 X Street Room 3007
127035 -           Sacramento, CA  95817
127036 -
127037 -
127038 -
127039 -
127040 -
127041 -
127042 -
127043 -
127044 -
127045 -
127046 -
127047 -
127048 -
127049 -
127050 -
127051 -
127052 -
127053 -
1271 -