title: The primary care provider (PCP)-cancer specialist relationship: A systematic review and mixed-methods meta-synthesis.
abstract: Although they are critical to models of coordinated care, the relationship and communication between primary care providers (PCPs) and cancer specialists throughout the cancer continuum are poorly understood. By using predefined search terms, the authors conducted a systematic review of the literature in 3 databases to examine the relationship and communication between PCPs and cancer specialists. Among 301 articles identified, 35 met all inclusion criteria and were reviewed in-depth. Findings from qualitative, quantitative, and disaggregated mixed-methods studies were integrated using meta-synthesis. Six themes were identified and incorporated into a preliminary conceptual model of the PCP-cancer specialist relationship: 1) poor and delayed communication between PCPs and cancer specialists, 2) cancer specialists' endorsement of a specialist-based model of care, 3) PCPs' belief that they play an important role in the cancer continuum, 4) PCPs' willingness to participate in the cancer continuum, 5) cancer specialists' and PCPs' uncertainty regarding the PCP's oncology knowledge/experience, and 6) discrepancies between PCPs and cancer specialists regarding roles. These data indicate a pervasive need for improved communication, delineation, and coordination of responsibilities between PCPs and cancer specialists. Future interventions aimed at these deficiencies may improve patient and physician satisfaction and cancer care coordination. CA Cancer J Clin 2017;67:156-169. © 2016 American Cancer Society.
authors.affiliation: Assistant Professor, Department of Surgery, University of Michigan Comprehensive Cancer Center, Ann Arbor, MI.
authors.forename: Lesly A
authors.initials: LA
authors.lastname: Dossett
authors.affiliation: Postdoctoral Fellow, Department of Health Outcomes and Behavior, Moffitt Cancer Center and Research Institute, Tampa, FL.
authors.forename: Janella N
authors.initials: JN
authors.lastname: Hudson
authors.affiliation: Associate Professor, Department of Surgery and Center for Health Outcomes and Policy, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Arden M
authors.initials: AM
authors.lastname: Morris
authors.affiliation: Associate Member, Comprehensive Breast Program, Moffitt Cancer Center and Research Institute, Tampa, FL.
authors.forename: M Catherine
authors.initials: MC
authors.lastname: Lee
authors.affiliation: Professor, Department of Family Medicine, University of South Florida Morsani College of Medicine, Tampa, FL.|Senior Member, Department of Health Outcomes and Behavior and Comprehensive Breast Program, Moffitt Cancer Center and Research Institute, Tampa, FL.
authors.forename: Richard G
authors.initials: RG
authors.lastname: Roetzheim
authors.affiliation: Professor, Department of Family Medicine, University of Michigan Health System, Ann Arbor, MI.
authors.forename: Michael D
authors.initials: MD
authors.lastname: Fetters
authors.affiliation: Senior Member, Department of Health Outcomes and Behavior, Moffitt Cancer Center and Research Institute, Tampa, FL.|Professor, Department of Oncologic Sciences, Morsani College of Medicine, University of South Florida, Tampa, FL.
authors.forename: Gwendolyn P
authors.initials: GP
authors.lastname: Quinn
mesh_terms: D001291:Attitude of Health Personnel; D002983:Clinical Competence; D003266:Continuity of Patient Care; D006801:Humans; D007400:Interprofessional Relations; D008495:Medical Oncology; D010819:Physician's Role; D011320:Primary Health Care
keywords: cancer; cancer care; cancer specialist; communication; general practitioner; models of care; oncologist; primary care provider (PCP); shared care