Abstract

Currently, the specific role of family physicians (fps) in the care of people with cancer is not well defined. Our goal was to explore physician perspectives and contextual factors related to the coordination of cancer care and the role of fps. Using a constructivist grounded theory approach, we conducted telephone interviews with 58 primary and cancer specialist health care providers from across Canada. The participants-21 fps, 15 surgeons, 12 medical oncologists, 6 radiation oncologists, and 4 general practitioners in oncology-were asked to describe both the role that fps currently play and the role that, in their opinion, fps should play in the future care of cancer patients across the cancer continuum. Participants identified 3 key roles: coordinating cancer care, managing comorbidities, and providing psychosocial care to patients and their families. However, fps and specialists discussed many challenges that prevent fps from fully performing those roles: ■ The fps described communication problems resulting from not being kept "in the loop" because they weren't copied on patient reports and also the lack of clearly defined roles for all the various health care providers involved in providing care to cancer patients.■ The specialists expressed concerns about a lack of patient access to fp care, leaving specialists to fill the care gaps. The fps and specialists both recommended additional training and education for fps in survivorship care, cancer screening, genetic testing, and new cancer treatments. Better communication, more collaboration, and further education are needed to enhance the role of fps in the care of cancer patients.

Highlights

  • ■■ The fps described communication problems resulting from not being kept “in the loop” because they weren’t copied on patient reports and the lack of clearly defined roles for all the various health care providers involved in providing care to cancer patients

  • Better communication, more collaboration, and further education are needed to enhance the role of fps in the care of cancer patients

  • In Canada, an estimated 196,900 people received a new diagnosis of cancer in 2015, with colorectal cancer accounting for 13% of diagnoses for both men and women, and breast cancer accounting for 26% of all new cancers diagnosed in women[1]

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Summary

Introduction

In Canada, an estimated 196,900 people received a new diagnosis of cancer in 2015, with colorectal cancer accounting for 13% of diagnoses for both men and women, and breast cancer accounting for 26% of all new cancers diagnosed in women[1]. Because of improvements in early detection and treatment, increasing numbers of people are living with and beyond cancer[2]. Care for that growing number of cancer patients is often shared between primary and secondary care providers. Cancer specialists are primarily responsible for the active treatment and management of cancer patients after diagnosis; the specific role of family physicians (fps) is still not well defined and is constantly evolving[2,3,4,5]. The specific role of family physicians (fps) in the care of people with cancer is not well defined. Our goal was to explore physician perspectives and contextual factors related to the coordination of cancer care and the role of fps

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