While some oncologists are willing and able to act as primary care physicians, surveys have shown that most are not. A recent survey of cancer survivors and their doctors revealed discrepancies in expectations for many aspects of care. My husband and I had to quickly find the right oncologist for me in the area and a new primary care doctor. It was difficult to make such a change when faced with cancer, anxious and frightened by the road ahead.
But I knew I wanted someone I would always see for appointments who was “my doctor” and who was part of the same healthcare system as the oncologist we found. The requirements of your health plan will determine whether you need to see your primary care physician (PCP) and get a referral to see an oncologist. Most point-of-service (POS) plans require you to see your PCP before you can get a referral to an oncologist. In general, with most PPO or indemnity plans, you don't need to see your family doctor or PCP first. The best resource is your member benefit summary brochure. Patients' perception of PCP involvement in their cancer care was significantly related to the time elapsed since the last PCP visit, whether they had seen the PCP since the cancer diagnosis, whether the PCP provided on-call service, and satisfaction with the general medical care provided by the PCP.
Many cancer patients also value their PCP for emotional and family support, for providing primary care, and for coordinating care with other health care providers. This study reported that many PCPs already provide exclusive care for healthy cancer survivors, especially after 5 years of diagnosis. Shaw has seen many oncologists renew a patient's diabetes or blood pressure prescription because the patient hasn't seen their PCP in years. Perre calls for a shared model and its goal is to reduce the disconnect that can develop between the patient and their primary care physician during treatment. With more and more cancer patients surviving the disease, both medical oncologists and primary care physicians must treat the medical care of their cancer patients as a long-term, rather than a short-term need, Dr. Most preferred a PCP to direct preventive care (77%) and management of chronic or comorbid diseases (83%).
We need to find ways to support the role of primary care physicians to participate more actively throughout cancer care. In addition, patients who receive the care they want are more likely to follow their doctors' recommendations and are satisfied with their medical care. PCPs often provide easier access, less travel time, and more personalized care than a busy cancer center. Well, patients may find attending the oncology clinic distressing, and often the focus of visits is not providing the best evidence-based survival care. Several models have been proposed for providing survival care, having survival clinics within the cancer center, community survival clinics managed by PCPs, and survival care in the primary care setting. There needs to be better clarification of the roles played by primary care providers, which obviously changes during the continuum of care toward survival, a period in which the primary care provider can be more involved.
