FIG. 3.

Patterns and process of referral for supportive care services. (A) Cancer patients presenting with severe symptoms may be referred to different supportive care services depending on which symptom is detected and the referral practice for each oncologist. This ranges from no referral at all (doctors C, D, and E), to involvement of selected services (doctors A and B) to palliative care referral (doctor F). (B) In this model of comprehensive cancer care, all patients with severe distress are referred to palliative care, and receive comprehensive assessment for their symptoms, communication and decision making needs, with the appropriate management provided by physicians, nurses, and counselors. Those with specific needs are then further referred to other services. This model ensures that supportive palliative care is delivered in a comprehensive, personalized and streamlined fashion.