How to Choose an Oncologist: Medical, Radiation and Surgical Oncology

Types of oncologists

NCI's guide to finding cancer care defines an oncologist as a doctor who has special training in diagnosing and treating cancer, and notes that most physicians who treat cancer are MDs or DOs. NCI lists other specialists who treat cancer:

• Hematologists focus on diseases of the blood and related tissues, including the bone marrow, spleen and lymph nodes.
• Radiation oncologists use x-rays and other forms of radiation to diagnose and treat disease.
• Surgeons perform operations and may specialize in a certain type of surgery.

How they appear in NPI records

The NUCC Health Care Provider Taxonomy used in NPI records has separate codes for these specialists. NUCC describes a medical oncologist as an internist who specializes in the diagnosis and treatment of all types of cancer and other tumors, decides on and gives therapy for them, and consults with surgeons and radiation oncologists on other treatments. It describes radiation oncology as dealing with the therapeutic uses of radiant energy, especially for malignant tumors. There are also codes for hematology and oncology combined, surgical oncology and gynecologic oncology. A profile on this site shows the codes a physician registered; they are self-reported, so treat them as a starting point.

Who leads your care

Because several specialists may be involved, ask at the first visit who will coordinate your treatment plan, who your main contact is, and how the specialists share information with each other and with your primary care clinician.

NCI-Designated Cancer Centers

NCI's Cancer Centers Program recognizes centers that meet rigorous standards for research on preventing, diagnosing and treating cancer. NCI says there are 74 NCI-Designated Cancer Centers in 37 states and the District of Columbia, most of them affiliated with university medical centers. Of these, 58 are Comprehensive Cancer Centers and 8 are Clinical Cancer Centers; the other 8 are Basic Laboratory Cancer Centers focused on laboratory research. NCI's site has a "Find a Cancer Center" page with contact information for each one.

You do not have to be treated at a designated center: NCI's guide lists several ways to find care, including your local hospital. NCI notes that at any given time hundreds of research studies are under way at the cancer centers, so a center can also be a place to ask about clinical research. NCI's guide also suggests asking any hospital whether it has experience treating your condition, how it checks and improves the quality of its care, and whether it offers support services such as social workers and help with financial assistance.

Finding a cancer doctor

NCI suggests several ways to find an oncologist: ask your primary care doctor, ask your local hospital for a list of oncologists who practice there, contact your nearest NCI-Designated Cancer Center, or use directories run by professional organizations. If you have health insurance, NCI notes that your choice may be limited to doctors in your plan, and that it is important to contact the doctor's office to check that they are accepting new patients through your plan, including under Medicare or Medicaid.

NCI also lists things to consider when choosing: whether the doctor has the education and training you need, who covers for them when they are unavailable, whether they explain things clearly and encourage questions, and whether their office hours and appointment availability meet your needs.

Second opinions

NCI's guide says getting a second opinion is very common, that most doctors welcome it, and that many health insurance companies pay for one or even require it, particularly when surgery is recommended. It suggests involving your doctor, because your records, test results and imaging must be sent to the doctor giving the second opinion. NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237) can help you find a specialist.

For Original Medicare, Medicare.gov's page on second surgical opinions says Part B covers a second opinion in some cases before medically necessary surgery that is not an emergency, and a third opinion if the first two differ. Medicare Advantage and other plans set their own rules, so ask your plan first.

Checking license and board certification

NCI explains that doctors must pass an exam to be licensed in their state, and that independent specialty boards certify physicians who meet education and training standards and pass the board's exam. Check the license with the state medical board, listed by the FSMB; each clinician profile on this site links to the board for the practice state. Board certification is not part of NPI or Medicare records, so check it on Certification Matters or, for osteopathic boards, through the search the American Osteopathic Association points patients to.

What Medicare covers

• Chemotherapy: Medicare.gov's chemotherapy page says Part A covers it when you are a hospital inpatient, and Part B covers it in a hospital outpatient setting, a doctor's office or a freestanding clinic. After the Part B deductible you typically pay 20% of the Medicare-approved amount. Drugs you take at home are generally covered under Part D; our Part D guide explains plan rules and the yearly out-of-pocket cap.
• Clinical research studies: Medicare.gov's clinical research page says Parts A and B cover some costs, like office visits and tests, in certain clinical research studies, which test new treatments such as a new cancer drug.
• Assignment: under Original Medicare, a provider who accepts assignment charges you only the deductible and coinsurance, as Medicare.gov's assignment page explains.

What CMS data on a profile mean

Oncologist profiles on this site may show two kinds of Medicare data:

• Part B services: the service codes billed to Original Medicare in past years, which for oncologists can include office visits and drugs given in the office. CMS's methodology says the data cover Original Medicare claims only and exclude any service provided to 10 or fewer patients.
• Part D prescribing: drugs prescribed to Medicare patients and paid under Part D, from CMS's Part D Prescribers dataset. CMS does not publish a drug for a prescriber with fewer than 11 claims.

These figures describe billing and prescribing volume. They do not show survival, response to treatment, side effects or quality of care, and they should never be used to judge whether a treatment is right for you.

Questions for the first visit

• What type and stage of cancer do I have, and what other tests are needed?
• What are my treatment options, and what is the goal of each one?
• Who else will be on my care team, and who is my main contact?
• How many patients with my type of cancer do you treat?
• Is there a clinical research study I could join?
• Where will treatment take place, and what will my insurance cover?
• Would you help me get a second opinion?

NCI notes that you may wish to bring a family member along for support when you ask for a second opinion. It can also help to bring a notebook or ask whether you can record the conversation.

Find an oncologist near you

On T-MedInfo you can browse clinicians by state and city from the city listings below and open the hematology and oncology, medical oncology or radiation oncology listings, or search by name. On each profile, check the specialty codes, practice address and state board link, and confirm network status with your plan. Our specialist checklist covers the remaining steps.