title: Physician preferences and attitudes regarding different models of cancer survivorship care: a comparison of primary care providers and oncologists.
abstract: OBJECTIVE
  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
  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.
authors.affiliation: Division of Medical Oncology, British Columbia Cancer Agency, Vancouver, BC, Canada.
authors.forename: Winson Y
authors.initials: WY
authors.lastname: Cheung
authors.forename: Noreen
authors.initials: N
authors.lastname: Aziz
authors.forename: Anne-Michelle
authors.initials: AM
authors.lastname: Noone
authors.forename: Julia H
authors.initials: JH
authors.lastname: Rowland
authors.forename: Arnold L
authors.initials: AL
authors.lastname: Potosky
authors.forename: John Z
authors.initials: JZ
authors.lastname: Ayanian
authors.forename: Katherine S
authors.initials: KS
authors.lastname: Virgo
authors.forename: Patricia A
authors.initials: PA
authors.lastname: Ganz
authors.forename: Michael
authors.initials: M
authors.lastname: Stefanek
authors.forename: Craig C
authors.initials: CC
authors.lastname: Earle
mesh_terms: D000328:Adult; D000368:Aged; D001291:Attitude of Health Personnel; D003266:Continuity of Patient Care; D003661:Decision Support Techniques; D006801:Humans; D008495:Medical Oncology; D008875:Middle Aged; D009369:Neoplasms / Q000401:mortality / Q000534:rehabilitation*; D010820:Physicians / Q000523:psychology*; D058007:Physicians, Primary Care / Q000523:psychology* / Q000706:statistics & numerical data; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D013038:Specialization; D011795:Surveys and Questionnaires; D015996:Survival Rate; D000078329:Workforce