From Infusion Center Operations to Rounds: The Oncology Pharmacist’s Role at USC Norris Comprehensive Cancer Center

Pharmacy Times® interviewed David S. Bateshansky, PharmD, BCOP, a clinical pharmacist specialist at the University of Southern California (USC) Norris Comprehensive Cancer Center in Los Angeles, on his role in the cancer care team at USC and his work in direct and indirect patient care. Bateshansky shared insights into his evolving role over 18 years, highlighting his contributions across infusion center operations, inpatient oncology, investigational drug services, and direct patient care.

A view of hospital infusion and monitoring equipment in a patient care area. Image Credit: © Yotwarit - stock.adobe.com

Bateshansky discussed his involvement in multidisciplinary cancer care teams, collaborating with physicians, oncology/hematology fellows, and allied health professionals to optimize treatment decisions and ensure protocol adherence in clinical trials. While pharmacist-led research is permitted, his primary focus is supporting physician-led studies through regulatory oversight and investigational drug accountability.

Bateshansky also reflected on the growing recognition of oncology pharmacists' value in patient care and how USC Norris' close-knit environment fosters long-term relationships with patients and colleagues, enhancing the continuity of cancer care.

Pharmacy Times: How do oncology pharmacists at USC Norris Comprehensive Cancer Center work with other health care professionals on the cancer care team?

David S. Bateshansky, PharmD, BCOP: I have been an oncology pharmacist at USC for almost 18 years now, and my experience at USC Norris in the cancer center has allowed me a couple of things. One, it's allowed me the opportunity to grow my career and move into different areas of oncology pharmacy over the course of a long period of time. I've been allowed to work in the infusion center operations in the clinical side of the oncology infusion center. I've been allowed to work as an inpatient oncology operations pharmacist [and] as an investigational drug service pharmacist In the [latter] role, I actually [became] a member of the university's institutional review board or IRB, [which allowed me to get] face time with the physicians outside of oncology and outside of the pharmacy.

More recently, I've taken a more direct patient care role as an inpatient hematology clinical specialist, where I actually attend hematology service rounds with our providers, with our physician trainees, and with our medical residents. So that has allowed me to grow as a pharmacist and as a clinician, and it's allowed me, as I've gained experience and gained confidence, to contribute more and more to direct patient care and ensure better patient outcomes.

Pharmacy Times: What is the role of the oncology pharmacist in research at USC Norris Comprehensive Cancer Center, and are you involved in pharmacist-led research?

Bateshansky: Pharmacist-led research is allowed. It is permitted in my role and in the investigational drug services current configuration within Norris, [but] our role is more to support physician-led research, whether that be investigator-initiated or industry sponsor–initiated research. Our role involves the regulatory side of the clinical trial, the accountability of the investigational product, and making sure that the patients are treated according to protocols.

Pharmacy Times: What is your role in treatment decisions as an oncology pharmacist at USC Norris Comprehensive Cancer Center?

Bateshansky: So, every decision that I make I will discuss with either the hematology/oncology fellow or the attending physician, or both. As far as my role on rounds, though, I am screening treatment plans, ensuring that the treatment plan being considered is the best choice for the patient, given the patient's clinical status, their disease burden, any physical limitations of the patient, insurance issues, the patient's physical status, and the patient's ability to tolerate whatever treatment is being considered. I do have the ability to suggest alternatives and reason with the physicians, but again, I don't have at this time any clinical practice agreements in place that would allow me to make those choices independently.

Pharmacy Times: What is unique about the experience of the oncology pharmacist at USC Norris Comprehensive Cancer Center?

Bateshansky: Norris Cancer Center [is] a free standing cancer center that’s small by hospital standards, [and] we have many, many physicians, oncologists and hematologists. We have many pharmacists. We have many nurses, many physical therapists, and many other allied health professionals who have been a part of the USC Norris family for a very, very long time—decades in fact. So, that has allowed us to grow as somewhat of a family.

On top of that, as the treatment of cancer has evolved over the years, we see patients who have cancer living longer and longer and longer. So, the same pharmacists, the same allied health professionals in the same positions, and providers can now see these patients again and again and again and remember them and remember details of their case, whether they're in-patient or whether they're in the clinic or whether they're in the infusion center, and it creates a sense of cohesiveness among everyone involved.

Pharmacy Times: Do you feel like the value and role of the oncology pharmacist in direct and indirect patient care is understood and valued in your work?

Bateshansky: When I first began rounding with the hematology service, it was a newly created position. There had not ever been a pharmacist rounding with the hematology service before. Most of the attending physicians already knew who I was, because they had worked with me in the infusion center in the clinic or the investigational drug service. So, I will be honest with you, about a year or so ago, when I first began rounding with service, there was a question of, ‘Well, what exactly will the pharmacist do? What is your value here?’ I'm happy to say that now, having been working with the team for the better part of a year, that question no longer has to be asked. In fact, they know that I'm there to help make their jobs easier, to make the patient stay easier, and to improve outcomes for the patient. They come to me with their questions now without my having to prove my value to them any longer.

Pharmacy Times: Why did you choose to pursue work as an oncology pharmacist?

Bateshansky: So, I am not a PGY-2 trained oncology pharmacist. When I finished pharmacy school some time ago, I completed an acute care PGY-1 pharmacy practice residency, and then my first full time position post-residency was as a pharmacy manager in the small community hospital in another state, not in California. I did that for a couple of years and then realized how much I missed clinical practice—the PGY-1 residency had that much of an effect on me.

So for some people, management is what they want to do. I had a taste of that very early in my career and decided that it wasn't what I wanted to do, so I came back to Southern California, came to USC, and they graciously welcomed me in as a pharmacist without PGY-2 oncology training. Now, 17 to 18 years later, I am a board certified oncology pharmacist attending hematology rounds as the specialist on service.