. Author manuscript; available in PMC: 2018 Mar 1.

Published in final edited form as: Int J Gynecol Cancer. 2017 Mar;27(3):588–596. doi: 10.1097/IGC.0000000000000893

Table 3.

Long-term relationships with patients is a unique and defining aspect of gynecologic oncology that influences utilization of outpatient specialty palliative care

View	Representative Quotes
*Increases* utilization of palliative care	I think our patients may be more willing to see the supportive care team, especially if we’re recommending that they go, because I think that they have much more, I wouldn’t say better relationship but I think we have a longer relationship with them than say a medical or surgical oncologist who only sees them for kind of periods of time. Whereas in GYN oncology I really feel like we are those people, again, from time of diagnosis to end of life. And you know, these are often women who we have a long standing relationship with, with both the patient and their families, and I think that, I would imagine that sometimes makes kind of the introduction of palliative care, or the concept of palliative care, or hospice care, or addressing goals of care, actually a little bit easier for us, than for some other cancer care providers, because we have such long relationships with these people Because we do surgery and because we do chemo and because we do the long term follow up for our patients and we know them so well, I think it in many ways it just makes it easier to have very frank conversations with patients about things like involvement of palliative care
*Decreases* utilization of palliative care	I think we bond with our patients much more and there’s more of a relationship than there might be with surgical oncology or medical oncology because they transition patients back and forth, we tend to keep patients throughout their course […] I think the way, maybe medical oncology less, surgical oncology more, but the way the specialty sees themselves in other fields, they’re all too happy to disposition the patient to another provider, hoping that the patient will stick with that provider, but we in GYN oncology, and that’s one of the things I liked about the field, like to retain that patient through the whole breadth of their experience I actually like managing a lot of the symptom stuff, because if I’m managing that I can number one know when my treatments are working, I know when to back off, I know when to stop. If someone else is managing all that then I’m not really managing her recurrence. It’s sort of a philosophical thing that I sort of picked up in training, that it’s actually part of my job.

View

Representative Quotes

Increases utilization of palliative care

I think our patients may be more willing to see the supportive care team, especially if we’re recommending that they go, because I think that they have much more, I wouldn’t say better relationship but I think we have a longer relationship with them than say a medical or surgical oncologist who only sees them for kind of periods of time.

Whereas in GYN oncology I really feel like we are those people, again, from time of diagnosis to end of life. And you know, these are often women who we have a long standing relationship with, with both the patient and their families, and I think that, I would imagine that sometimes makes kind of the introduction of palliative care, or the concept of palliative care, or hospice care, or addressing goals of care, actually a little bit easier for us, than for some other cancer care providers, because we have such long relationships with these people

Because we do surgery and because we do chemo and because we do the long term follow up for our patients and we know them so well, I think it in many ways it just makes it easier to have very frank conversations with patients about things like involvement of palliative care

Decreases utilization of palliative care

I think we bond with our patients much more and there’s more of a relationship than there might be with surgical oncology or medical oncology because they transition patients back and forth, we tend to keep patients throughout their course […] I think the way, maybe medical oncology less, surgical oncology more, but the way the specialty sees themselves in other fields, they’re all too happy to disposition the patient to another provider, hoping that the patient will stick with that provider, but we in GYN oncology, and that’s one of the things I liked about the field, like to retain that patient through the whole breadth of their experience

I actually like managing a lot of the symptom stuff, because if I’m managing that I can number one know when my treatments are working, I know when to back off, I know when to stop. If someone else is managing all that then I’m not really managing her recurrence. It’s sort of a philosophical thing that I sort of picked up in training, that it’s actually part of my job.