Author contribution pending

This is a placeholder stub for a clinical-efficiency article to be written by a practicing hem/onc attending.

Suggested outline

1. Why APP delegation matters more in oncology than other specialties

   • Complexity gradient — routine survivorship follow-up vs treatment decisions
   • The RVU-generation math (APP-collected visits vs attending-collected)
   • Institutional politics of shared workload

2. The delegation spectrum

   • Fully independent — routine survivorship follow-ups, prescription refills, symptom management for stable regimens
   • Shared / co-signed — on-treatment monitoring, tumor board prep, initial genetic-testing counseling
   • Attending-only — new patient consults, treatment decision points, breaking bad news, goals-of-care conversations, clinical trial enrollment discussions

3. First-six-month ramp

   • Week 1: shadowing / mutual observation
   • Weeks 2–4: structured co-visits
   • Month 2: APP-independent visits with defined escalation triggers
   • Month 3+: full delegation for approved visit types

4. Escalation triggers

   • New symptoms / functional decline
   • Lab abnormalities beyond defined ranges
   • Any change in treatment plan
   • Patient / family request for physician contact
   • Concerns about goals of care

5. Practice-type variation

   • Academic (chief complaint visits usually APP-first)
   • Community group (mix varies by group culture)
   • Private practice (highest APP autonomy typically)

6. Common mistakes

   • Not sharing note templates and dot phrases
   • Weekly meetings that get skipped
   • Failing to build APP-to-attending curbside culture
   • Under- or over-delegating in month one

What we need from a contributing author

• 1000–1500 words
• Named attribution with credentials + years working with an APP
• Adaptable across NP and PA differences (scope of practice varies by state)
• Clear "your institution's policies govern" framing throughout