title: Oncologists' perceived barriers to an expanded role for primary care in breast cancer survivorship care.
abstract: Concern exists about the sustainability of traditional, oncologist-led models of breast cancer survivorship care. However, many oncologists are hesitant about deferring survivorship care to primary care providers (PCPs). Our objective was to examine oncologists' perceptions of the role PCPs play in breast cancer survivorship and the rationale underlying these perceptions. One-on-one interviews with medical, radiation, and surgical oncologists in Wisconsin were conducted (n = 35) and transcribed. Data analysis was performed using an inductive approach to content analysis. Oncologist-perceived barriers included: PCP's level of experience with cancer care; Lack of PCP comfort in providing survivorship care; Existing demands on PCPs' time; Patient preference for oncology-led survivorship care. Oncologists described familiarity and trust in individual PCPs as factors that could mitigate barriers and lead to increased PCP involvement in survivorship care. Although a number of perceived barriers to PCP participation in survivorship were identified by Wisconsin oncologists, our findings support the direction of ongoing initiatives to facilitate PCP involvement. Our findings also suggest that early PCP involvement in survivorship may increase PCP comfort and patients' trust in PCPs in this role. The identified barrier most challenging to address may be the limited capacity of the current primary care system to manage follow-up for breast cancer survivors.
authors.affiliation: Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Neuman@surgery.wisc.edu.|University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin. Neuman@surgery.wisc.edu.
authors.forename: Heather B
authors.initials: HB
authors.lastname: Neuman
authors.affiliation: University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.|Division of General Internal Medicine, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Elizabeth A
authors.initials: EA
authors.lastname: Jacobs
authors.affiliation: Denver Public Health, Denver Health and Hospital Authority, Denver, Colorado.
authors.forename: Nicole M
authors.initials: NM
authors.lastname: Steffens
authors.affiliation: School of Nursing, Institute for Clinical and Translational Research, University of Wisconsin-Madison, Madison, Wisconsin.
authors.forename: Nora
authors.initials: N
authors.lastname: Jacobson
authors.affiliation: University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.|Department of Medicine, Division of Hematology and Oncology, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Amye
authors.initials: A
authors.lastname: Tevaarwerk
authors.affiliation: Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.|University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Lee G
authors.initials: LG
authors.lastname: Wilke
authors.affiliation: Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Jennifer
authors.initials: J
authors.lastname: Tucholka
authors.affiliation: Wisconsin Surgical Outcomes Research Program, Department of Surgery, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.|University of Wisconsin Carbone Cancer Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin.
authors.forename: Caprice C
authors.initials: CC
authors.lastname: Greenberg
mesh_terms: D001943:Breast Neoplasms / Q000453:epidemiology*; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D010465:Perception; D010819:Physician's Role; D011159:Population Surveillance; D011320:Primary Health Care; D017741:Survivors
keywords: Breast cancer; cancer surveillance; cancer survivorship; primary care