By Jennifer Dimond, LCSW, OSW-C
New England Cancer Specialists (NECS) is a private, physician-owned hematology/oncology practice founded more than 50 years ago, serving nearly 15,000 patients throughout Maine and New Hampshire annually. NECS was the first practice to be named an affiliate member of the world-renowned Dana-Farber Cancer Institute.
NECS’s mission is to achieve the best possible outcome for each individual patient, starting with expert, specialized, cutting-edge and compassionate care plus integrated support. Recognizing that the emotional impact of cancer on patients and their families is significant and touches each individual at different points along their cancer journey, in 2021, NECS demonstrated its commitment to providing support for the whole person by investing in a team of clinical social workers specifically to address the mental health needs of patients and caregivers. Today, we have three full-time LCSWs serving patients at our four practice locations. Since our oncology counseling program started in 2021, our team has collectively seen nearly 1,000 unique patients for approximately 5,000 visits.
NECS also employs a team of financial advocates whose responsibility is to support patients’ financial and resource needs—tasks that in many settings fall under the social work umbrella—this allows us to focus solely on providing mental health counseling to address a wide range of issues that impact our patients, whether they are newly diagnosed, in remission or survivorship, experiencing a recurrence, or transitioning to palliative/hospice care.
Referrals come to us through routine distress and depression screenings, but just as often through our providers who listen intently to our patients and recognize when they are struggling with stress, anxiety, depression, treatment decisions, or adjustment to their diagnosis. Sometimes patients self-refer, expressing relief that they can access trained counselors easily in our clinic; these are often folks who have searched for a therapist in the community and been frustrated by the long wait lists or the inability to find a provider who accepts their insurance. Our LCSW team is credentialed with every insurance provider NECS accepts, including Medicare and Medicaid, removing a significant barrier to accessing care. We are able to meet in person or via telehealth—an important consideration in a state as geographically large, and rural as Maine. Another unique aspect of our program is that we are able to offer counseling to the patient’s primary caregiver, establishing them as a NECS patient, billing their insurance separately, and maintaining separate medical records and counselors to provide confidentiality.
We use a variety of modalities in our care, based on each patient’s unique needs and goals, to help our patients become confident self-advocates, set healthy boundaries, and learn skills for managing their anxiety, depression, or difficulty adjusting to living with cancer. While the focus of our work is scheduled counseling visits, we are able as needed to provide support to clinic staff for patients experiencing a mental health crisis or to offer brief chair-side visits in the infusion room to patients needing a little extra support.
In November 2024, our team became certified by the American Heart Association as tobacco treatment specialists, enabling us to provide counseling to those who wish to quit smoking or using other tobacco products. Being integrated into the oncology practice, we see many patients who have never considered therapy before but who find it helpful and comforting to have a safe space to openly express the range of emotions cancer brings — the thoughts they don’t share with their family and closest friends in order not to add to their worries.
While our counseling program has been well received, we have encountered our fair share of challenges along the way since, as we like to say, we’re building the plane while flying it. It took time and many conversations to educate team members on what our role is and is not; this teaching is ongoing as new providers and support staff come and go. Meeting our productivity goals week to week can be challenging at times, as patients sometimes cancel their appointments at the last minute, or do not show up at all, for any number of reasons that are understandable when one is living with cancer. Also, we have had to adjust the way caseloads are distributed, as there are three of us covering four clinics, one of which is substantially larger and busier than the others. Providing counseling via telehealth has helped with this. Finally, having the capacity to nurture strong relationships with individual provider teams is impacted by our availability (we typically have seven patients scheduled for an eight-hour day). It is a continual work in progress, but we are encouraged by the increased demand for our services and by the positive feedback from providers, patients, and caregivers. Our providers are seeing the positive results of our work as patients report decreased anxiety and increased confidence in their ability to cope with the emotional challenges cancer brings. And we hear it directly from our patients. Among my favorite feedback from recent patient satisfaction surveys:
- “I feel like you really listened.”
- “I was skeptical when my oncologist recommended I see the counselor, but I went anyway and I couldn’t be happier.”
If you have any questions about our practice, I’d be happy to connect with you. Please email me at dimonj@newecs.org.
