Family physicians’ expertise in cancer mostly involves screening and diagnosis, while medication administered by medical and/ or surgical oncologists. However, as the long-term survival of patients with cancer improves, the important care role of primary health care clinicians in survivors of childhood and adult cancers become increasingly recognized. The National Cancer Institute forecasted that in 2019, cancer survivors numbered 16.9 million, or about 5 percent of the U.S. population. During the past few years, American Family Physician has published clinical its consideration of the American Cancer Society’s guidelines on primary care for survivors of prostate cancer, colorectal cancer, and breast cancer. The American Academy of Family Physicians’ policy on Cancer Care has been recommended that “the physician personnel, including family physicians, should be educated about its optional protocol for survivorship management.”
A recent qualitative study published in the Annals of Family Medicine found that the reality on the ground is more complex than current guidelines and policy show. Dr. Benjamin Crabtree and colleagues recorded interminable interviews with 38 clinicians in 14 U.S. primary health care traditions that had been previously recognized for workforce innovation by the Robert Wood Johnson Foundation. In these interviews, clinicians were “asked to describe how they examined their persona in cancer survivorship, the actions of when and where to refer cases, and knowledge about new primary care-friendly survivorship caution guidelines.”
Analysis of the interviews uncovered a lack of consensus about the role of primary care in cancer survivorship. For speciman, several clinicians felt that follow-up cancer care was alone the responsibility of oncologists, but the majority expressed that providing this care fell within their purview. However, they reported drawbacks wandering from insufficient learning/ education to “an uneasy relationship with oncology” and a lack of clarity about when attention “couldve been” transitioned from the oncologist to primary care.
Clinicians too contended about whether cancer survivors should be treated as a “distinct patient population”( asking a systematic health system approach) or like any other patient with a chronic disease. The researchers theorized that these dissimilar thoughts indicated an “identity crisis” about their charge roles for these patients 😛 TAGENDSeveral clinicians conveyed desegregated rulings, affirmed themselves, hovered on their posture, or delayed when asked about their/ primary care’s role in cancer survivorship attention. In detail, some clinicians struggled to talk about cancer survivorship at all in their interviews . … These clinicians, with an name based on delivering whole-person, comprehensive, coordinated upkeep, was reported to touched a wall of identity disorder when confronted with a rapidly deepening highly specialized knowledge base and a highly variable group of cases referred to as “cancer survivors.”Options for resolving this identity crisis, according to the researchers, could involve developing brand-new cancer-focused curricula for primary care residency programs and continuing medical education; erecting more well-defined management boundaries between primary care and oncology; and/ or having their professional organizations “consider coproducing and translating new knowledge about care for cancer survivors that primary care clinicians can prioritize, personalize, and integrate to address patients’ needs and values within a shared decision-making framework.” With the population of cancer survivors expected to increase by 30 percentage over the next decade, clarifying the suitable character of family physicians remains an urgent national need .** This post firstly is available on the AFP Community Blog.
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