Services Provided

Comprehensive care for the patient and family with cancer.

Individualized treatment plans are based upon respect for patient values and goals. We have experience in both conventional and complementary therapies and seek to integrate the best of each system.

Many patients are comfortable with mainstream medicine and wish to receive standard treatment in a supportive and compassionate environment. Many others wish to integrate conventional and complementary therapies and are looking for a physician who is respectful of their desires and can help guide them.

When chemotherapy is part of the program, it is given in our office with an emphasis upon minimizing side effects and allowing the person to maintain as normal a lifestyle as possible.

There is a strong emphasis upon psychological support for patient and family both during and after treatment. Psychological and psycho-spiritual techniques are recommended and include imagery, biofeedback, meditation, and stress reduction.

Because today’s treatments are so often successful we offer a Cancer Survivor Program that follows patients into their lives beyond treatment. This includes an individualized risk assessment to treat or prevent delayed side effects as well as to prevent recurrent cancer. This program is available to patients whether they have been treated in our office or by other doctors.

Nutritional advice is individualized and varies according to the needs of the patient at the time.

Second opinions and integrative treatments

We offer consultation to develop a strategy to deal with cancer as well as coordinate conventional and complementary therapies. Patients may wish independent evaluation of their treatment program in an effort to integrate therapies as well as insure that they are not missing some important component of their treatment.

For patients who are unable to come to our office we offer consultation by telephone.

Hematology:

Diagnosis and treatment of blood diseases such as anemia, leukemia, and bleeding or bruising problems.

Psychotherapy and counseling:

Dr. Susie Buchholz and Mary Tabor provide counseling for individuals, couples, and families; treatment of depression, anxiety disorders; psychological support for patients with medical illness, and patients with family crises.

Infusion therapy

Because we provide infusions of chemotherapy and biotherapy for cancer patients we can safely administer similar treatments for non-cancer patients. These include monoclonal antibody therapies for patients with rheumatoid arthritis, inflammatory bowel diseases such as ulcerative colitis and Crohns disease, multiple sclerosis.

We also treat osteoporosis with intravenous medication (brand name Reclast) which is given annually rather than oral medications which are given once per week or once per month.

Traditional Chinese Medicine

Acupuncture and herbal medicine, for treatment of chronic pain, cancer, side effects of cancer treatment, and selected medical conditions.

For patients who wish to include Chinese medicine, Catherine Burns and Damon Miller, M.D. provide acupuncture and herbal medicine. They maintain their own offices but work closely with us to integrate their services with ours. We are happy to coordinate treatments with other practitioners as well.

• Catherine Burns 650 949-3637
• Damon Miller 650-566-9900

Healing Guided Imagery

Mary Horngren, CMHT, MH provides individual and group instruction on the use of mental imagery for stress reduction and promoting greater health.

Mary Horngren, 650.799.5512 MHorngren@aol.com www.maryhorngren.com

Integrative Oncology Network

No one office can provide all the resources patients need. We have developed a network of providers who can address many of these issues. Please see a listing of these practitioners in the Integrative Oncology Network.

PHILOSOPHY OF CARE

It is obvious that our health care delivery system is broken. We spend too much and don’t get enough value for our payments. Current efforts may ultimately be successful in fixing it but while that is happening we propose a “Common Sense Model of Medical Care” based upon an educated partnership between patient and physician. Insurance is necessary to pay for care but should not determine care. Physicians are expected to consider the needs of the whole patient, proving direct medical care, education, and preventive services. Patients are expected to be active partners, working along with their doctor, pursuing common goals.

Education is a necessary part of any treatment program. We either provide or refer to classes on stress reduction, exercise, nutrition, and support groups.

No one medical system has all the answers. Illness affects body and mind, emotions and spirit, the individual and the family. For many serious illnesses full recovery requires addressing all of these: the physical effects on the body, the psychological effects on the mind, and the impact on the family system. Conventional medicine is very good at treating certain problems such as some cancers, pneumonia, heart attacks, etc. Psychotherapy is effective in treating emotional problems such as depression, anxiety, and family crises. Complementary therapies have value in treating many problems that are not effectively addressed by conventional practices. When all of these are integrated, they offer a broader approach to complex problems than any one discipline can provide.

The growing field of Mind-Body Medicine integrates all of these perspectives. Though sometimes described as “Alternative” it is just common sense to make use of all resources. Research in this area is promising but as yet incomplete. We recognize that everything that is plausible is not necessarily possible or even practical. We do agree with the author Vaclav Havel who wrote: “Hope is the ability to say no to what is directly in front of you, because that is not all that exists.”

We see patients in PPOs and various health plans. We recognize, however, that what the insurance companies define as a “covered benefit” and are willing to pay for may not be adequate to solve the health problems patients have. We urge you to accept the fact that insurance will not cover all of your medical expenses and be prepared to “self insure” for the services you want or need.

Philosophy of Cancer Care

The diagnosis of cancer precipitates a maelstrom of events. There are tests, often surgery, a sometimes overwhelming sense of being out of control, decisions to be made under pressure, and a confrontation with one’s own mortality. Patients and families may need a guide to assist them successfully through this process. We believe that cancer should be treated according to the following principles.

1. There is always hope. No matter how dismal the prognosis, there are always cases where patients proved their doctors wrong and outlived expectations. If there is not hope for cure then there is hope for remission. If there is little hope for length of days then there is always hope for a quality life and a meaningful life. False despair is no remedy for false hope; acceptance of where a patient is and support for change does help.
2. The wound of cancer is far more complex than a surgical incision. The whole person and his or her family and friends are affected physically, emotionally and spiritually. A comprehensive treatment program understands this and addresses the unique needs of each individual, treating the person as well as the disease.
3. No one system of medicine has all the answers. Conventional medicine has very powerful and useful treatments for certain cancers. Other aspects of treatment are better addressed by complementary therapies. Psychological techniques likewise are important in dealing with attitudes and emotions and their effects on recovery. A comprehensive program considers all of these systems and is inclusive rather than exclusive.
4. Work smarter, not just harder. Developing a strategy to deal with cancer requires knowing not only what treatments to use but when to use them. Patients may correctly conclude that they must change their diet or deal with spiritual concerns. This might have to be delayed while surgery to prevent a bowel obstruction takes precedence. Fighting cancer alone is too exhausting; patients should use all their resources and support.
5. Each person’s healing is unique. Although not everyone is cured, the potential for becoming whole again is possible for all of us. Each of us has the potential to be a hero or to grow wiser. We need to take care of ourselves, honor what is most precious within us, and at the same time become more forgiving of our own humanity. What makes cancer a heroic journey is the style in which it is done.
6. Hospice care and palliative care are important options. There comes a time when the struggle to prolong life becomes undesirable and the quality of life takes precedence. We honor that decision and continue to provide the very best possible supportive care including pain and symptom control.

OFFICE POLICIES

Dr. William Buchholz sees patients with blood disorders and cancer for prevention, evaluation, treatment, and post-treatment care. New Hematology or Oncology patients will be seen promptly.

COUNSELLING

Dr. Susie Buchholz and Mary tabor see patients, couples and families for counseling by appointment. Dr. Susie does not accept insurance but provides patients with the necessary documents to submit to insurance for reimbursement.

FEES AND PATIENT PAYMENT POLICIES

How are patient charges set?

Medicare charges are set by the government; we adhere to their rules carefully. We do not "accept assignment" which means that payment is expected at the time of the visit. You will then be reimbursed directly by Medicare. For patients with PPO's, we have agreed with your insurance to accept certain rates. We generally do not see patients with HMOs. Patients who are seen “out of network” are charged fees which generally reflect the “usual and customary charges” of the community. These fees are the responsibility of the patient, and are due at the time of service. The same policy is true for patients who do not have insurance and are "cash pay."

Who is responsible for my bill?

The obvious answer is, "you are.” We automatically bill your insurance electronically so that either you receive reimbursement or we credit your count within days. If there is any delay in hearing from your insurance company of greater than 45 days, we investigate the reason for this and resubmit the claim to your insurance. We will contact you directly if there is some way you can expedite this. Claims over 60 days are considered past due and you will be responsible for the charges. Interest is charged for these past due balances at 1%/month in accord with State laws. We will always work with patients to avoid putting them in collections whenever possible.

How can I pay my bill?

We accept Mastercard and Visa, personal check and cash. We generally bill your insurance and credit your account, though you are responsible for co-pay at the time of service. For all patients who are receiving chemotherapy, private insurance or Medicare, we bill insurance for you and credit your account. You will receive a statement for the balance that is not paid by insurance. We do not accept MediCal.

What about co-pays?

Most insurance plans specify the co-pay amount for that visit. The insurance contract states that we cannot see patients without their co-pay at the time of service without violating our contract. We don’t want you—or us—to get in trouble. Under extraordinary circumstances, if you do not have a credit card or money with you, we will allow you two working-days grace to bring in payment. Otherwise there will be a $25 charge added to your bill.

Are there charges for filling out forms or telephone calls?

This is a matter of judgment sometimes. Very brief forms or brief phone calls are provided as a courtesy. Multiple forms or lengthy documents do incur a charge. Longer phone calls, particularly when they require medical decisions or are in lieu of an office appointment, are charged in accord with national guidelines.

How do I get prescription refills?

As much as possible we try to do this electronically directly to your pharmacy, either by fax or by eRx. If medications require authorization, and this process is lengthy, we reserve the right to add an additional charge. We try to respond to prescription requests within 48 hours but delays may happen over weekends or if the request is forwarded to the on-call physician. It is your responsibility to contact your pharmacy to request refills 4-7 days in advance so you don’t run out.

What if I miss my appointment?

If you notify our office at least 24 hours before your appointment, we may offer this time to other patients who wish to see us. There is no charge if we have 24 hr notice of cancellation. If there are repeated late cancellations of appointments, there will be a charge of $50 for this, as indicated in the current insurance guidelines.

What if I can't come in to the office and wish to schedule a phone appointment?

We recognize that for reasons of mobility or distance or illness, it may not be possible for you to come to the office. We wish to accommodate you and will either substitute a phone appointment for an office appointment or even provide consultation by telephone and electronic means (Internet and electronic medical record). We hope to develop the ability to do tele-conference by WebCam services like Skype in the near future. In the era of electronic communication, insurance companies recognize that this is a common means that medical services are provided and generally pay for this. We will submit to your insurance, including Medicare, these charges. You will remain responsible for any noncovered benefits.

What if I need a copy of my chart records for another doctor?

We want to insure that your care is not interrupted or impaired if another physician lacks important information about your care in our office. We will provide a copy of the records another physician needs to help you promptly and, for one copy, at no charge. If you request multiple copies of your records you will be charged, depending upon the size of the record and the number of copies you request.

What is included in a doctor’s visit?

Besides the time you actually spend with the doctor, what else happens? Perhaps invisible to you, the following things are generally part of your visit: creation of a medical record, review of your lab and x-rays or scans, preparation or reports sent to other doctors, phone calls to the labs, other doctors, etc. to coordinate your care, phone calls and faxes to pharmacies for your medications, attendance at tumor board to present your case and learn from other doctors’ cases, letters to insurance companies, getting authorizations for your care, filling out forms you request or other organizations (e.g., turmor registry, disability, etc.) request, maintaining medical education requirements at conferences, reading journals, attending meetings to stay current with the frequently changing treatments.

Like an iceberg, 80% of medical care is beneath the surface. No wonder it is so expensive!

APPOINTMENTS

We try to see patients as quickly as possible. Urgent problems are seen within 24 to 36 hours. Depending upon the nature of the emergency, patients may have to be seen in the ER or Urgent Care Clinic if they cannot be accommodated that day in the office. Newly diagnosed patients with cancer are accommodated within 1 week. We generally run on time (really!) because we know you don't like to wait any more than we do. If you are referred by another patient or by a health professional please let us know.

If you have outside records or X-rays bring them with you or have them sent so they arrive before your visit. If you need lab tests or X-rays before your visit please arrange to have them done at least 1 week before your visit so the reports are available on time.

If you have to cancel your appointment please give 24 hour notice so we may allow other sick patients to use that time. There will be a charge for missed appointments unless notice is given.

Please verify your insurance coverage before making an appointment.

OFFICE HOURS

Dr. William Buchholz sees patients Monday through Thursday, 9:30AM to 5PM by appointment. He makes hospital rounds between 8AM and 9:30AM. Dr. Susan Buchholz sees patients Monday through Friday with both morning and afternoon appointments.

LABORATORY & X-RAYS

We will send or give you a laboratory or X-ray request if you need tests before your visit. You may have your blood drawn at various labs with the results generally available to us within 24 hours. X-Rays and scans are done at many facilities including El Camino Hospital or Valley Radiology. Patients may schedule their own mammograms. Some X-rays (chest X-ray, bone X-rays, etc.) do not need an appointment and a "walk-in" with a faxed or written request is adequate. Our staff will help you make appointments for CT, PET and MRI scans.

ON-CALL COVERAGE

Dr. William Buchholz shares call with a group of internists affiliated with El Camino Hospital. Dr. Susan Buchholz has several colleagues who are available if she is not. There is always a physician or psychologist available. If you need someone after hours or on weekends, call our office and our exchange will answer. They will put you through to us if we are on call or to the covering physician or psychologist.

PHONE CALLS

Phone calls are returned. Urgent phone calls are returned promptly and others by the end of the day (rarely, the next morning). Please specify the nature of the call and where you may be reached at various times. If distance or disability prevents you from coming to our office, you may make arrangements for phone consultations.

HOSPITAL AFFILIATIONS

Dr. William Buchholz has been on the medical staff of El Camino Hospital since 1978 and generally admits patients there.

LECTURES & WORKSHOPS

Members of our medical group are available to give lectures and workshops on topics including cancer prevention and treatment, Chinese medicine, wellness, preventive medicine, etc. Please contact our office if your company or group would like a speaker or health education program.