Table 3.
Primary care physician perceptions throughout the stages of cancer
| Cancer stage | Respondents' perceptions (agree) | n (%) | 95% CI |
|---|---|---|---|
| Peri-diagnosis | Cancer-related diagnostic tests NOT done in timely fashion (N = 468) | 163 (34.8) | (30.7, 39.3) |
| MRIs NOT done in a timely fashion | 125 (76.7) | ||
| CT scans NOT done in a timely fashion | 107 (65.6) | ||
| Biopsy results NOT received in a timely fashion | 82 (50.3) | ||
| Don't know procedure for referring patients to RCP (N = 461) | 179 (38.8) | (34.5, 43.4) | |
| Where to call unclear | 110 (61.5) | ||
| What tests to order prior to referral unclear | 106 (59.2) | ||
| Who to call unclear | 139 (77.7) | ||
| Coordination/Access to services for cancer patients needs improvement (N = 439) | 211 (48.1) | (43.4, 52.7) | |
| Cancer system navigation program is required (N = 460) | 371 (80.7) | (76.8, 84.0) | |
| Recommend a Coordinator model* | 176 (47.4) | ||
| Recommend an Advisor model§ | 48 (12.9) | ||
| Recommend a Shared model¶ | 130 (35.0) | ||
| Unsure or recommend other model | 17 (4.6) | ||
| Active treatment | Manage patients' common symptoms related to cancer or its treatment as problems arise (N = 452) | 348 (77.0) | (72.9, 80.6) |
| Continue to manage patients' other medical issues (N = 469) | 461 (98.3) | (96.6, 99.2) | |
| Provide patients with information about their cancer and cancer treatments (N = 461) | 262 (56.8) | (52.3, 61.3) | |
| Involved with patients in decision-making process about cancer management (N = 458) | 257 (56.1) | (51.5, 60.6) | |
| Know how to contact a provider within RCP involved in patients' care (N = 459) | 345 (75.2) | (71.0, 78.9) | |
| Have difficulty reaching RCP providers to discuss patient (N = 457) | 83 (18.2) | (14.9, 22.0) | |
| Feel inadequately informed by RCP regarding significant changes in patients' health status (N = 454) | 99 (21.8) | (18.2, 25.8) | |
| Feel inadequately informed by RCP regarding changes in patients' medications or treatments (N = 460) | 78 (17.0) | (13.8, 20.7) | |
| Feel inadequately informed by RCP regarding next steps in patients' care (N = 460) | 87 (18.9) | (15.6, 22.8) | |
| Follow-up | Encourage cancer patients to follow-up at practice upon completion of cancer treatment (N = 468) | 420 (89.7) | (86.6, 92.2) |
| Easy to connect patients back to RCP if recurrence of initial cancer diagnosis is suspected (N = 434) | 397 (91.5) | (88.4, 93.8) | |
| Feel adequately informed by RCP regarding what is involved in follow-up of cancer patients upon being discharged from oncologist care (N = 461) | 362 (78.5) | (74.5, 82.0) | |
| Palliative | Know who to contact to obtain palliative care services for patients (N = 461) | 350 (75.9) | (71.8, 79.6) |
| Refer to publicly funded home care (N = 473) | 233 (49.3) | (44.8, 53.8) | |
| Refer to palliative care physicians (N = 473) | 143 (30.2) | (26.3, 34.5) | |
| Refer to hospital palliative care (N = 473) | 89 (18.8) | (15.5, 22.6) | |
| Refer to residential hospice (N = 473 | 74 (15.6) | (12.6, 19.2) | |
| Refer to palliative care team/network (N = 473) | 50 (10.6) | (8.1, 13.7) | |
| Main resource used is Myself (N = 473) | 31 (6.6) | (4.6, 9.2) | |
| RCP responsive to requests for advice (N = 374) | 300 (80.2) | (75.9, 83.9) | |
| General | Overall, felt there is good coordination of care between practice and RCP (N = 452) | 389 (86.1) | (82.5, 89.0) |
| In general, satisfied with the way information is exchanged between practice and RCP across trajectory of care (e.g., quality, timeliness, completeness, etc.) (N = 460) | 398 (86.5) | (83.1, 89.4) | |
| Interested in attending multidisciplinary case conferences on patients (N = 456) | 207 (45.4) | (40.9, 50.0) | |
| Accessed Cancer Centre's web portals as a source of information (N = 463) | 39 (8.4) | (6.2, 11.3) | |
| Attended educational sessions to increase knowledge regarding cancer care (N = 469) | 304 (64.8) | (60.4, 69.0) | |
| Current method of remuneration adequately compensates me for the care I provide to my cancer patients (N = 454) | 244 (53.7) | (49.1, 58.3) |
CI = confidence interval; CT = computed tomography; MRI = magnetic resonance imaging; PCP = primary care physicians; RCP = regional cancer program.
*
Coordinator model – navigation program becomes responsible for coordinating appointments and the PCP practices are informed but not responsible for care.
§
Shared model – navigation program helps coordinate patient appointments and the PCP practices coordinate care.
¶
Advisor model – navigation program provides PCPs with advice, and physician practices coordinate care and appointments.