Background

Underserved cancer patients have a higher burden of chronic medical conditions, which increase the likelihood of poor outcomes and challenge the delivery of high-quality cancer care. Health outcomes may be improved by increased partnership between a patient’s oncologist and their primary care provider (PCP).

Methods

Oncologists and PCPs in a large public safety-net hospital system in Houston, TX completed surveys assessing demographics, attitudes, and satisfaction regarding the shared care of patients with cancer and chronic medical conditions.

Results

Eighteen oncologists (39% minority, 72% female) and 25 PCPs (23% minority, 77% female) were assessed. Both oncologists and PCPs reported moderate levels of interprofessional collaboration and felt that existing processes to facilitate coordination of care and comorbidity management were inadequate (independent samples t-tests with all p-values = n.s.). Eighty-one percent of PCPs preferred to co-manage side effects of cancer-directed therapy with oncologists, but 100% of oncologists preferred to be responsible for this activity (χ²=23.08, p<.001). Forty percent of oncologists were interested in either co-managing late-effects of cancer treatment with PCPs or having PCPs be solely responsible for this activity, as opposed to 86% of PCPs who preferred to co-manage these late effects with oncologists (χ²=26.74, p<.001). Oncologists and PCPs both expressed interest in sharing responsibility for cancer surveillance, depending on the patient’s risk for recurrence (χ²=1.62, p=.30).

Conclusions

Oncologists and PCPs were similarly dissatisfied with comorbidity management in cancer patients but differed in their attitudes towards care coordination. Oncologists were resistant to sharing responsibilities of toxicities during and after cancer treatment, but more accepting of PCPs assuming follow-up care for lower-risk patients. PCPs were open to increased collaboration with oncologists in the joint care of cancer patients. Additional investigation is needed to identify barriers to provider collaboration and opportunities for more effective shared care.