"When patients have cancer, they stop seeing me" – the role of the general practitioner in early follow-up of patients with cancer – a qualitative study

Abstract

BackgroundThe role of the general practitioner (GP) in cancer follow-up is poorly defined. We wanted to describe and analyse the role of the GP during initial follow-up of patients with recently treated cancer, from the perspective of patients, their relatives and their GPs.MethodsOne focus group interview with six GPs from the city of Bodø and individual interviews with 17 GPs from the city of Tromsø in North Norway. Text analysis of the transcribed interviews and of free text comments in two questionnaires from 91 patients with cancer diagnosed between October 1999 and September 2000 and their relatives from Tromsø.ResultsThe role of the GP in follow-up of patients with recently treated cancer is discussed under five main headings: patient involvement, treating the cancer and treating the patient, time and accessibility, limits to competence, and the GP and the hospital should work together.ConclusionThe GP has a place in the follow-up of many patients with cancer, also in the initial phase after treatment. Patients trust their GP to provide competent care, especially when they have more complex health care needs on top of their cancer. GPs agree to take a more prominent role for cancer patients, provided there is good access to specialist advice. Plans for follow-up of individual patients could in many cases improve care and cooperation. Such plans could be made preferably before discharge from in-patient care by a team consisting of the patient, a carer, a hospital specialist and a general practitioner. Patients and GPs call on hospital doctors to initiate such collaboration.

Automated telephone follow-up after breast cancer: an acceptability and feasibility pilot study

“…For these patients, there remains the option of partnership with general practice whereby their attendance at clinic could be avoided, but they could still have some examination in primary care. This both reduces workload at clinic and has the potential to address GP concerns that they lose touch with their patient after a diagnosis of breast cancer as their care is all delivered centrally (Anvik et al, 2006). Among participants, this novel method of follow-up was acceptable, with almost 80% agreeing that there were benefits to this type of follow-up over traditional clinic visits.…”

Patient, Primary Care Physician and Specialist Expectations of Primary Care Physician Involvement in Cancer Care

“…Primary care physicians (PCP) involvement is frequently interrupted when patients are followed by oncology teams. [1][2][3][4][5] At the treatment phase, patients often consider specialists as their regular physician, 6,7 leading to a loss of continuity of care with their PCP. 2,6,[8][9][10][11] PCPs may feel disengaged in their role 12, making it difficult to take back the responsibility for patient care at the advanced phase 13, especially without access to all relevant information.…”

“…2,6,[8][9][10][11] PCPs may feel disengaged in their role 12, making it difficult to take back the responsibility for patient care at the advanced phase 13, especially without access to all relevant information. 2,4,5,7,11,[13][14][15][16][17][18][19] As PCPs are recognized as key players in providing continuous and comprehensive care, [20][21][22][23] Eligible patients were informed of the study by the oncology team. Those who agreed to be contacted by the research team were invited to participate and signed an informed consent form.…”

Cancer survivors’ preference for follow-up care providers: a cross-sectional study from the population-based PROFILES-registry

“…Regarding cancer survivors' preferences for follow-up care, some qualitative studies have been conducted showing conflicting results regarding cancer survivors' preferences for follow-up care provided by general practitioners or oncology nurses [11][12][13]. In general, it seems that cancer survivors prefer follow-up care provided by medical specialists instead of follow-up care provided by general practitioners or oncology nurses [11,13].…”

“…In general, it seems that cancer survivors prefer follow-up care provided by medical specialists instead of follow-up care provided by general practitioners or oncology nurses [11,13]. At the same time, cancer survivors favor the holistic approach of general practitioners, taking various aspects, such as long-term side effects and comorbid disorders, into account [12].…”