Physician preferences and attitudes regarding different models of cancer survivorship care: A comparison of primary care providers and oncologists

Winson Y. Cheung, Noreen Aziz, Anne Michelle Noone, Julia H. Rowland, Arnold L. Potosky, John Z. Ayanian, Katherine S. Virgo, Patricia A. Ganz, Michael Edward Stefanek, Craig C. Earle

Research output: Contribution to journalArticle

57 Citations (Scopus)

Abstract

Purpose: New strategies for delivering cancer follow-up care are needed. We surveyed primary care providers (PCPs) and oncologists to assess how physician attitudes toward and self-efficacy with cancer follow-up affect preferences for different cancer survivorship models. Methods: The survey of physician attitudes regarding the care of cancer survivors was mailed to a randomly selected national sample of PCPs and oncologists to evaluate their perspectives regarding physician roles, knowledge about survivorship care processes, and views on cancer surveillance. Multinomial logistic regression models were constructed to examine how physician attitudes towards, and self-efficacy with, their own skills affected preferences for different cancer survivorship care models. Results: Of 3,434 physicians identified, a total of 2,026 participants provided eligible responses: 938 PCPs and 1,088 oncologists. Most PCPs (51 %) supported a PCP/shared care model; whereas, the majority of specialists (59 %) strongly endorsed an oncologist-based model (p < 0.001). Less than a quarter of PCPs and oncologists preferred specialized survivor clinics. A significant proportion of oncologists (87 %) did not feel that PCPs should take on the primary role of cancer follow-up. Most PCPs believed that they were better able to perform breast and colorectal cancer follow-up (57 %), detect recurrent cancers (74 %), and offer psychosocial support (50 %), but only a minority (32 %) was willing to assume primary responsibility. PCPs already involved with cancer surveillance (43 %) were more likely to prefer a PCP/shared care than oncologist-based survivorship model (OR, 2.08; 95 % CI, 1.34-3.23). Conclusions and Implications for Cancer Survivors: PCPs and oncologists have different preferences for models of cancer survivorship care. Prior involvement with cancer surveillance was one of the strongest predictors of PCPs' willingness to assume this responsibility.

Original languageEnglish (US)
Pages (from-to)343-354
Number of pages12
JournalJournal of Cancer Survivorship
Volume7
Issue number3
DOIs
StatePublished - Sep 1 2013
Externally publishedYes

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Primary Health Care
Physicians
Neoplasms
Self Efficacy
Oncologists
Logistic Models
Physician's Role
Aftercare
Colorectal Neoplasms
Breast Neoplasms

Keywords

  • Cancer
  • Care models
  • Physician
  • Preferences
  • Survivorship

ASJC Scopus subject areas

  • Oncology
  • Oncology(nursing)

Cite this

Physician preferences and attitudes regarding different models of cancer survivorship care : A comparison of primary care providers and oncologists. / Cheung, Winson Y.; Aziz, Noreen; Noone, Anne Michelle; Rowland, Julia H.; Potosky, Arnold L.; Ayanian, John Z.; Virgo, Katherine S.; Ganz, Patricia A.; Stefanek, Michael Edward; Earle, Craig C.

In: Journal of Cancer Survivorship, Vol. 7, No. 3, 01.09.2013, p. 343-354.

Research output: Contribution to journalArticle

Cheung, WY, Aziz, N, Noone, AM, Rowland, JH, Potosky, AL, Ayanian, JZ, Virgo, KS, Ganz, PA, Stefanek, ME & Earle, CC 2013, 'Physician preferences and attitudes regarding different models of cancer survivorship care: A comparison of primary care providers and oncologists', Journal of Cancer Survivorship, vol. 7, no. 3, pp. 343-354. https://doi.org/10.1007/s11764-013-0281-y
Cheung, Winson Y. ; Aziz, Noreen ; Noone, Anne Michelle ; Rowland, Julia H. ; Potosky, Arnold L. ; Ayanian, John Z. ; Virgo, Katherine S. ; Ganz, Patricia A. ; Stefanek, Michael Edward ; Earle, Craig C. / Physician preferences and attitudes regarding different models of cancer survivorship care : A comparison of primary care providers and oncologists. In: Journal of Cancer Survivorship. 2013 ; Vol. 7, No. 3. pp. 343-354.
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abstract = "Purpose: New strategies for delivering cancer follow-up care are needed. We surveyed primary care providers (PCPs) and oncologists to assess how physician attitudes toward and self-efficacy with cancer follow-up affect preferences for different cancer survivorship models. Methods: The survey of physician attitudes regarding the care of cancer survivors was mailed to a randomly selected national sample of PCPs and oncologists to evaluate their perspectives regarding physician roles, knowledge about survivorship care processes, and views on cancer surveillance. Multinomial logistic regression models were constructed to examine how physician attitudes towards, and self-efficacy with, their own skills affected preferences for different cancer survivorship care models. Results: Of 3,434 physicians identified, a total of 2,026 participants provided eligible responses: 938 PCPs and 1,088 oncologists. Most PCPs (51 {\%}) supported a PCP/shared care model; whereas, the majority of specialists (59 {\%}) strongly endorsed an oncologist-based model (p < 0.001). Less than a quarter of PCPs and oncologists preferred specialized survivor clinics. A significant proportion of oncologists (87 {\%}) did not feel that PCPs should take on the primary role of cancer follow-up. Most PCPs believed that they were better able to perform breast and colorectal cancer follow-up (57 {\%}), detect recurrent cancers (74 {\%}), and offer psychosocial support (50 {\%}), but only a minority (32 {\%}) was willing to assume primary responsibility. PCPs already involved with cancer surveillance (43 {\%}) were more likely to prefer a PCP/shared care than oncologist-based survivorship model (OR, 2.08; 95 {\%} CI, 1.34-3.23). Conclusions and Implications for Cancer Survivors: PCPs and oncologists have different preferences for models of cancer survivorship care. Prior involvement with cancer surveillance was one of the strongest predictors of PCPs' willingness to assume this responsibility.",
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AU - Cheung, Winson Y.

AU - Aziz, Noreen

AU - Noone, Anne Michelle

AU - Rowland, Julia H.

AU - Potosky, Arnold L.

AU - Ayanian, John Z.

AU - Virgo, Katherine S.

AU - Ganz, Patricia A.

AU - Stefanek, Michael Edward

AU - Earle, Craig C.

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AB - Purpose: New strategies for delivering cancer follow-up care are needed. We surveyed primary care providers (PCPs) and oncologists to assess how physician attitudes toward and self-efficacy with cancer follow-up affect preferences for different cancer survivorship models. Methods: The survey of physician attitudes regarding the care of cancer survivors was mailed to a randomly selected national sample of PCPs and oncologists to evaluate their perspectives regarding physician roles, knowledge about survivorship care processes, and views on cancer surveillance. Multinomial logistic regression models were constructed to examine how physician attitudes towards, and self-efficacy with, their own skills affected preferences for different cancer survivorship care models. Results: Of 3,434 physicians identified, a total of 2,026 participants provided eligible responses: 938 PCPs and 1,088 oncologists. Most PCPs (51 %) supported a PCP/shared care model; whereas, the majority of specialists (59 %) strongly endorsed an oncologist-based model (p < 0.001). Less than a quarter of PCPs and oncologists preferred specialized survivor clinics. A significant proportion of oncologists (87 %) did not feel that PCPs should take on the primary role of cancer follow-up. Most PCPs believed that they were better able to perform breast and colorectal cancer follow-up (57 %), detect recurrent cancers (74 %), and offer psychosocial support (50 %), but only a minority (32 %) was willing to assume primary responsibility. PCPs already involved with cancer surveillance (43 %) were more likely to prefer a PCP/shared care than oncologist-based survivorship model (OR, 2.08; 95 % CI, 1.34-3.23). Conclusions and Implications for Cancer Survivors: PCPs and oncologists have different preferences for models of cancer survivorship care. Prior involvement with cancer surveillance was one of the strongest predictors of PCPs' willingness to assume this responsibility.

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