Balancing cancer treatment with work responsibilities can be challenging for both employees and employers. But a program piloted at Johns Hopkins called Managing Cancer at Work (MCaW) provides people in the workplace with navigation assistance, thereby decreasing patients’ time away from work while increasing employee satisfaction and empowering employers, according to Lillie D. Shockney, RN, BS, MAS.
One in 2 men and 1 in 3 women will be diagnosed with a life-threatening cancer in their lifetime, and most will be working when it happens. There are 14.3 million cancer survivors in the United States today, and more than 40% are of working age. Among 65- to 74-year-olds, labor force participation is predicted to hit 32% by 2022, up from 20% in 2002. In other words, many people can no longer afford to retire.
The MCaW program (managingcanceratwork.com) is a low-cost, high-impact employee benefit program designed specifically for the workplace environment. It provides comprehensive education for all employees on cancer prevention, screening, symptom recognition, treatment, and survivorship. It offers resources for individuals in management positions, as well as for caretakers of people with cancer, and is the first program to combine personalized nurse navigation with a unique web-based educational portal.
“One of the very first things people ask me, after ‘will I survive this?’ is ‘how much work will I miss?’” said Ms Shockney, Cofounder of the MCaW program, as well as Program Director and Cofounder of the Academy of Oncology Nurse & Patient Navigators (AONN+); University Distinguished Service Professor of Breast Cancer; Administrative Director, The Johns Hopkins Breast Center; and Director, Cancer Survivorship Programs at the Sidney Kimmel Cancer Center at Johns Hopkins.
Solely among the 21,000 employees at Johns Hopkins, 800 are diagnosed each year with cancer, she said, and many more are caregivers for their parents, spouses, and children diagnosed with cancer. “So we wanted to figure out how to support our employees going through a horrific time, while at the same time keeping business going,” she told attendees at the AONN+ 7th Annual Navigation & Survivorship Conference.
She emphasized the importance of normalcy, particularly during a medical crisis, and explained her philosophy when it comes to cancer, having dealt with 3 cancer diagnoses of her own. “I only want to give it enough time to get rid of it. It doesn’t deserve any more of my time,” she said. “If a person surrenders to their cancer and sits at home hoping they have enough sick days to get through it, then we’ve done something wrong in taking care of that person.”
Cancer Cost and Employers
Very few programs exist to help employers deal with cancer and the workplace, and it is nearly impossible for human resources staff and insurance companies to successfully navigate patients to high-quality, cost-effective care.
She stressed the importance of understanding the drivers of cancer cost to the employer, including the use of sick time, vacation time, and short- and long-term disability, failure to provide adequate education and support to employees who could work during their treatment, and lack of education for caregivers of cancer patients impacting their productive time.
Nationally, approximately 33.4 million disability days are attributable to cancer, and the cost of lost productivity is equal to 20% of the nation’s healthcare spending, but the MCaW program teaches employers how to avoid these wasted healthcare dollars. The managers’/supervisors’ tool kit addresses issues such as screening and prevention in the workplace, supporting employees diagnosed with cancer, balancing treatment needs and work schedules, and maintaining productivity.
Additionally, insensitivity and failure to accommodate workers with cancer due to a deficit in supervisor training and information can result in being successfully sued by an employee with cancer, “and they should sue,” said Ms Shockney. “They have every right to.”
Helpful Tools for Patients
MCaW provides employees with a host of navigation-related services such as screening tools to determine whether they’re at high risk for certain cancers, coping mechanisms for handling the shock of diagnosis, information on specific diagnoses, and tips for talking to an oncologist. It addresses emotional and lifestyle issues and cancer-related fatigue, and educates users on finding a cancer rehabilitation program and navigating health insurance, all while teaching them how to create balance between cancer treatment and work.
Nurse navigators are also available for one-on-one support for both employees who have been diagnosed or are functioning as a caregiver, and can, with patient and supervisor permission, coordinate employees’ work schedules with their treatment. Finally, MCaW’s comprehensive cancer survivorship programming helps to maximize smooth transitions back to work while minimizing the health risks of survivorship.
Overall, 63.5% of cancer survivors continue to work or return to work during and after cancer treatment, but after implementation of the MCaW program, 98.5% of Johns Hopkins employees are working during treatment (January 2015-June 2016), Ms Shockney reported. Employee satisfaction scores on a scale of 1 to 5, with 5 being the highest level of satisfaction, are at 4.7, and managers say they wish the program had been available sooner.
“Don’t underestimate the educational needs of supervisors and employees; this is a life-altering experience,” she said. “Fear of recurrence never totally goes away, and ‘back to normal’ doesn’t exist.”