Oncopolitical issues: obstacles and options for success in a comprehensive breast center

Over the last 20 years of breast center development, it has been found that for every obstacle there is an option for resolution. The solutions are not uniform in each setting, but rather they are a reflection of the medical staff politics, interests, and strengths, the resources and commitment of the institution, and the needs of the community. The most important message of this article is to validate local medical staff issues as legitimate concerns. The crucial obstacle is the lack of cooperation among the medical specialties and the lack of trust between the medical staff and management. The obstacles need to be appropriately addressed by the creation of an effective organizational structure that is successful in the local environment and by the programmatic development that reflects the medical staff's interests and strengths. This will ensure comprehensive breast center success in the local political environment and ultimately translates into enhanced expertise, pride, and higher quality patient care.