Australian general practitioners' preferences for managing the care of people diagnosed with cancer

Abstract

While many GPs are currently involved in some aspects of cancer management, with training, good communication and support from specialists this role may be successfully expanded.

Primary Care Physicians’ Perspectives of Their Role in Cancer Care: A Systematic Review

“…56,58,60,62,69,70 PCPs reported that they rarely or inconsistently received sufficient correspondence from oncologists. 43,48,52,58,60,67 Though oncologists' letters contained details on investigation and examination findings, items such as treatment/management plans, future management and expectations, goals and procedures of follow-up, and psychosocial concerns were less commonly mentioned. 56,62 In one study, approximately half of PCPs reported never having received a treatment summary.…”

“…52 In terms of information preferences, 85-99 % of PCPs would have liked to have received additional information from oncologists regarding cancer treatments, 40,56,57 the referring PCP's role, 56 findings of investigations and likely prognosis, 56 the oncologist's follow-up plan, 56,57 clinical practice guidelines for survivorship care, 40 and potential short and long term sideeffects, including suggested management.…”

“…69 For the management of paediatric cancer survivors, one study reported that 30-40 % of PCPs had participated in a conversation with a colleague about survivorship care, participated in medical education activities, or read one or more survivorship articles, and approximately 20 % had experienced formal training, possibly as distant as during their undergraduate studies. 59 lack of time and workload pressure, 49,52,64,71,72 lack of remuneration and inadequate funding, 49,52,72 lack of patient trust, 44,64 inadequate resources including cancer-specific guidelines and opportunities for mental health or multi-disciplinary referrals 40,47,52,60,69 and increased medicolegal risk. 72 Qualitative and quantitative results are summarized in Table 3.…”

“…39 However, conclusive evidence has not yet determined which model may be most effective. PCPs have indicated an interest in increasing their role in cancer patient care 39,42,46 ; however, PCPs' limited confidence 38,40,54,60,61 and ability 40,49,52,59,64,66,71 to perform the various roles pose a challenge. It appears that PCP confidence levels fluctuate along the cancer care continuum and according to the type of care needed.…”

Rethinking system change in cancer

“…However, there is little systematic attention to developing models of care that increase the role of primary care providers. There is also some evidence that Australian cancer specialists prefer controlling follow-up locally 6 and general practitioners (GPs) may be reluctant to take on follow-up and other cancer care roles 7 without improved training and supportive models of care.…”