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. 1996 May;42:899–910.

Cancer in remission. Challenge in collaboration for family physicians and oncologists.

M L Wood 1, C L McWilliam 1
PMCID: PMC2146378  PMID: 8688693

Abstract

OBJECTIVE: To explore oncologists' perspectives on the process of cancer patient follow up and to identify what oncologists need from family physicians during the remission stage of cancer disease. DESIGN: Qualitative study with in-depth interviews. SETTING: Regional cancer centre serving a catchment area of 1.4 million people. PARTICIPANTS: A purposive sample of 10 oncologists. One was unable to participate because of sabbatical leave. The nine who participated represented both radiation and medical oncology. Oncologists who had practised at the cancer centre for less than 2 years were excluded from the study. MAIN OUTCOME MEASURES: Existing barriers to communication and collaboration between oncologists and family physicians in cancer patient follow up. RESULTS: Oncologists described roles for themselves in reassuring patients, detecting recurrence, monitoring toxicity of treatment, and gathering data for clinical trials. Collaboration with family physicians in the remission phase was identified as desirable but inhibited by variable and unpredictable interest, poor communication with family physicians, and patients' own preferences for follow up. Oncologists perceived the cancer system structure as a "black box" within which multidisciplinary teams worked well but seldom included family physicians. Oncologists expressed a need to see healthy patients and to have more understanding and support from family physicians, preferably through sharing follow-up care. Developing dialogue and a more collaborative approach were suggested. CONCLUSIONS: Family physicians should maintain a role in remission follow-up. However, a more collaborative approach with oncologists is warranted. Communication barriers, patient preferences, and misperceptions between groups must be addressed before roles are redefined.

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Selected References

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  1. Aiach P., Cebe D., Broclain D. What cancer tells us about general practice. Birth of an hypothesis. Soc Sci Med. 1990;30(11):1241–1246. doi: 10.1016/0277-9536(90)90264-s. [DOI] [PubMed] [Google Scholar]
  2. Cella D. F. Cancer survival: psychosocial and public issues. Cancer Invest. 1987;5(1):59–67. doi: 10.3109/07357908709020308. [DOI] [PubMed] [Google Scholar]
  3. Dworkind M., Shvartzman P., Adler P. S., Franco E. D. Urban family physicians and the care of cancer patients. Can Fam Physician. 1994 Jan;40:47–50. [PMC free article] [PubMed] [Google Scholar]
  4. Gilbert R., Willan A. R., Richardson S., Sellick S. Survey of family physicians: what is their role in cancer patient care? Can J Oncol. 1994 Jul;4(3):285–290. [PubMed] [Google Scholar]
  5. Grunfeld E., Mant D., Vessey M. P., Fitzpatrick R. Specialist and general practice views on routine follow-up of breast cancer patients in general practice. Fam Pract. 1995 Mar;12(1):60–65. doi: 10.1093/fampra/12.1.60. [DOI] [PubMed] [Google Scholar]
  6. Kattlove H., Liberati A., Keeler E., Brook R. H. Benefits and costs of screening and treatment for early breast cancer. Development of a basic benefit package. JAMA. 1995 Jan 11;273(2):142–148. [PubMed] [Google Scholar]
  7. Maguire P. Improving the detection of psychiatric problems in cancer patients. Soc Sci Med. 1985;20(8):819–823. doi: 10.1016/0277-9536(85)90336-3. [DOI] [PubMed] [Google Scholar]
  8. McWhinney I. R. Caring for patients with cancer. Family physicians' role. Can Fam Physician. 1994 Jan;40:16–19. [PMC free article] [PubMed] [Google Scholar]
  9. Patients benefit if cancer specialists, family physicians communicate. Iowa Med. 1993 Feb;83(2):49–50. [PubMed] [Google Scholar]
  10. Rosser J. E., Maguire P. Dilemmas in general practice: the care of the cancer patients. Soc Sci Med. 1982;16(3):315–322. doi: 10.1016/0277-9536(82)90341-0. [DOI] [PubMed] [Google Scholar]
  11. Stephens G. G. Acts of Endearment: Attending to the affectional bonds between physicians and patients. Can Fam Physician. 1992 Dec;38:2842–2846. [PMC free article] [PubMed] [Google Scholar]
  12. Wood M. L. Communication between cancer specialists and family doctors. Can Fam Physician. 1993 Jan;39:49–57. [PMC free article] [PubMed] [Google Scholar]
  13. Wood M. L. Focus Group Interview in Family Practice Research: Implementing a qualitative research method. Can Fam Physician. 1992 Dec;38:2821–2827. [PMC free article] [PubMed] [Google Scholar]
  14. Worster A., Bass M. J., Wood M. L. Willingness to follow breast cancer. Survey of family physicians. Can Fam Physician. 1996 Feb;42:263–268. [PMC free article] [PubMed] [Google Scholar]
  15. Worster A., Wood M. L., McWhinney I. R., Bass M. J. Who provides follow-up care for patients with early breast cancer? Can Fam Physician. 1995 Aug;41:1314–1320. [PMC free article] [PubMed] [Google Scholar]

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