Coordination of Care for Breast Reconstruction Patients: A Provider Survey

Abstract

Objectives Communication between medical oncologists (MO) and plastic surgeons (PS) is important to optimize outcomes for breast cancer patients seeking breast reconstruction. We sought to evaluate knowledge MO and PS have of each other’s fields, roles expected of each other, and frequency of communication. Methods A cross-sectional survey was conducted in a convenience sample of MO and PS. The survey included knowledge questions about reconstruction and chemotherapy, questions about provider and patient responsibilities for timely chemotherapy initiation, and questions about communication with other specialties. Results MO and PS had similar knowledge scores (MO 59%, PS 56%, p=0.5), but both lacked knowledge about aspects of the other specialty’s field related to breast reconstruction. The MO and PS agreed on the MO’s degree of responsibility for timely chemotherapy initiation (MO mean 4.6, PS mean 4.4 out of 5, p =0.2). However, they disagreed about the PS’s responsibility for timely chemotherapy initiation (MO mean 3.8, PS mean 3.0, p=0.01). Communication occurred about 2.5 times more often for patients with complications than uncomplicated patients (p<0.0001). Conclusion MO and PS have deficits in knowledge about each other fields and differ in their opinion regarding the burden of responsibility in ensuring timely chemotherapy initiation suggesting room for improvement in communication and understanding.