PCPS and Survivorship Care

Hester Hill Schnipper, LICSW, OSW-C Program Manager, Oncology Social Work

OCTOBER 30, 2017

This article from JAMA News identifies a real problem. We are all aware of the increasing focus on survivorship care, that is the attention we need from our doctors after cancer. The specifics vary depending on the particular cancer and received cancer treatment, but there are potential medium and long term side effects that should be spotted and treated if they appear.

The catch is that most cancer survivors don't see their cancer doctors very often (and this is appropriate for all concerned), so the assumption is that our PCPs know what to think about. Even looking at advanced primary care practices, it turns out this is a naive assumption. The take home message for us is that, once again, we need to be our own best advocates. We need to know the specifics of the care we received and how to monitor ourselves going forward.

Research Finds Cancer Survivorship Care Lacking in Advanced Primary Care Practices

Author: Christina Mattina

A new case study of 12 advanced primary care practices finds that none provided comprehensive cancer survivorship care, which the authors attributed to insufficient information systems and difficulties identifying survivors.

According to the research, published in JAMA Internal Medicine, primary care practices overseas have seen the benefits of providing high quality cancer survivorship care to their patients, but few studies have examined whether these models have been integrated into community based primary care settings in the United States. By conducting a case study of 12 such practices, the researchers hoped to evaluate the extent of integration as well as any barriers to further implementation.

Of the 12 practices in the study, all but 3 were recognized as level 3 patient centered medical homes by the National Committee for Quality Assurance. Researchers conducted interviews with practice staff and leadership and also directly observed practice workflows. Staff were asked about the general culture at the practice as well as more specific questions about cancer survivorship care.

The researchers observed that none of the practices provided comprehensive cancer survivorship services, and they identified 3 main barriers to implementing such care. First, clinicians were confused about what made cancer survivorship a distinct clinical category, as many reported treating cancer survivors like any other patient with a history of chronic illness. Patients with cancer often did not receive followup from primary care after being referred to oncology, and “survivorship remained a concept with little practical meaning in the primary care setting,” the authors wrote.

Read more: http://www.ajmc.com/newsroom/research-finds-cancer-survivorship-care-lacking-in-advanced-primary-care-practices

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