Some eligible patients with financial hardship may not be referred to assistance programs because cancer care providers do not know the full extent of patients' needs. This article describes barriers cancer care providers face in identifying patients who have financial concerns by using qualitative data from 21 interviews with providers from one Canadian province. Interviews were audio recorded, transcribed verbatim, and analyzed with a thematic approach. Four major themes emerged: no standardized approach existed for assessing needs, family members rather than patients may have better awareness of financial concerns, patients may not be forthcoming about financial concerns, and financial concerns may change over time. Adopting a standardized assessment protocol that routinely screens patients at multiple times during their care, educating patients about out-of-pocket costs, and educating providers to identify and assess financial need may enable more patients to access available financial resources. Although the Canadian and U.S. healthcare systems are different, concerns about out-of-pocket costs may be similar.

Introduction:In Canada, a larger proportion of rural residents than urban residents do not have a regular physician. In addition to lacking physicians, many rural communities also have a high rate of physician turnover. In order to discover the effect of this we compared health status, lifestyles, preventative care, and perceptions of the health system among rural residents with a regular doctor, those who did not have a regular doctor, and those whose regular doctor changed.

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