Journal of General Internal Medicine

, Volume 24, Issue 9, pp 1029–1036 | Cite as

The Role of Primary Care Physicians in Cancer Care

  • Carrie N. Klabunde
  • Anita Ambs
  • Nancy L. Keating
  • Yulei He
  • William R. Doucette
  • Diana Tisnado
  • Steven Clauser
  • Katherine L. Kahn
Original Article

ABSTRACT

BACKGROUND

The demand for oncology services in the United States (US) is increasing, whereas a shortage of oncologists looms. There is the need for a better understanding of the involvement of primary care physicians (PCPs) in cancer care.

OBJECTIVE

To characterize the role of PCPs in cancer care, compare it with that of oncologists, and identify factors explaining greater PCP involvement in cancer care.

DESIGN

National survey of physicians caring for cancer patients conducted by the Cancer Care Outcomes Research and Surveillance Consortium.

PARTICIPANTS

1694 PCPs; 1621 oncologists.

MEASUREMENTS

Questionnaires mailed during 2005 and 2006 examined the participation of physicians in 12 aspects of care for cancer patients.

MAIN RESULTS

Over 90% of PCPs fulfilled general medical care roles for patients with cancer such as managing comorbid conditions, chronic pain, or depression; establishing do-not-resuscitate status; and referring patients to hospice. Oncologists were less involved in these roles. Determining the treatment preferences of individual patients and deciding on the use of surgery were the only cancer care roles in which ≥50% of PCPs participated. Twenty-two percent of PCPs reported no direct involvement in cancer care roles while 19% reported heavy involvement. PCPs who were aged ≥50 years, were internists or geriatricians, taught medical students, saw more cancer patients, or experienced referral barriers fulfilled more roles. Rural practice location was not associated with greater PCP involvement in cancer care.

CONCLUSIONS

PCPs across the US have an active role in cancer patient management. Determining the optimal interface between PCPs and oncologists in delivering and coordinating cancer care is an important area for future research.

KEY WORDS

primary care cancer treatment practice patterns health care delivery 

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Copyright information

© Society of General Internal Medicine 2009

Authors and Affiliations

  • Carrie N. Klabunde
    • 1
  • Anita Ambs
    • 1
  • Nancy L. Keating
    • 2
    • 3
  • Yulei He
    • 3
  • William R. Doucette
    • 4
  • Diana Tisnado
    • 5
  • Steven Clauser
    • 1
  • Katherine L. Kahn
    • 5
    • 6
  1. 1.Applied Research Program, Division of Cancer Control and Population SciencesNational Cancer InstituteBethesdaUSA
  2. 2.Division of General Internal MedicineBrigham and Women’s HospitalBostonUSA
  3. 3.Department of Health Care PolicyHarvard Medical SchoolBostonUSA
  4. 4.Division of Clinical and Administrative PharmacyUniversity of IowaIowa CityUSA
  5. 5.Division of General Internal MedicineUniversity of California, Los AngelesLos AngelesUSA
  6. 6.RAND CorporationSanta MonicaUSA

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