title: Overcoming communication challenges in integrative supportive cancer care: The integrative physician, the psycho-oncologist, and the patient.
abstract: BACKGROUND
  Complementary/integrative medicine (CIM) services are increasingly being integrated into conventional supportive cancer care, presenting a number of challenges to communication between healthcare professionals (HCPs). The purpose of the present study was to explore the impact of the communication between integrative physicians (IPs) trained in CIM and social workers (SWs) working as psycho-oncologists in the same oncology setting. We examine whether IP-SW communication correlates with the number of patient-SW sessions, as provided within the oncology department.
  
  
  METHODS
  SW-IP communication, defined as a summary of the IP consultation sent to the patient's SW, was compared to SW-patient communication, defined as the number of psycho-oncology treatment sessions.
  
  
  RESULTS
  Of 344 patients referred by their oncology HCP for IP consultation, 91 were referred by an SW and 253 by an oncologist or nurse. IP-to-SW summaries were provided for 150 patients referred by a non-SW HCP (43.6%), and for 91 of SW-referred patients (26.5%). In all, 32 patients referred to the IP had no psycho-oncology interaction with an SW; 58 only one meeting; and 254 with ≥2 interactions, with 119 having >6 sessions. SW-patient interactions were greater with higher rates of IP-SW communication, for both patients referred by an SW (79.1%) and those referred by a non-SW HCP (77.3%) when compared to patients for whom no summary was provided (64.1%; p= 0.02).
  
  
  CONCLUSIONS
  A greater level of IP-SW communication, measured by the provision of an IP summary to the patient's SW, was found to correlate with a higher rate of SW-patient interactions. The use of a structured two-way referral-summary between IPs and SWs has the potential to advance the SW-patient psycho-oncology interaction, within an integrative supportive cancer care setting.
authors.affiliation: Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel; Complementary and Traditional Medicine Unit, Department of Family Medicine, Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel; Clalit Health Services, Haifa and Western Galilee District, Israel. Electronic address: eranben@netvision.net.il.
authors.forename: Eran
authors.initials: E
authors.lastname: Ben-Arye
authors.affiliation: Social-Work Service, The Oncology Service and Lin Medical center, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Efrat
authors.initials: E
authors.lastname: Shavit
authors.affiliation: Social-Work Service, The Oncology Service and Lin Medical center, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Haya
authors.initials: H
authors.lastname: Wiental
authors.affiliation: Department of Internal Medicine, Bnai-Zion Hospital, Haifa, Israel; The Department for Complementary/Integrative Medicine, Law and Ethics, The International Center for Health, Law and Ethics, Haifa University, Israel.
authors.forename: Elad
authors.initials: E
authors.lastname: Schiff
authors.affiliation: Integrative Oncology Program, The Oncology Service, Lin Medical Center, Clalit Health Services, Haifa and Western Galilee District, Israel; Social-Work Service, The Oncology Service and Lin Medical center, Clalit Health Services, Haifa and Western Galilee District, Israel.
authors.forename: Olga
authors.initials: O
authors.lastname: Agour
authors.affiliation: Tal Center for Integrative Medicine, Institute of Oncology, Sheba Medical Center, Tel Hashomer, Israel.
authors.forename: Noah
authors.initials: N
authors.lastname: Samuels
mesh_terms: D003142:Communication; D000529:Complementary Therapies / Q000379:methods / Q000523:psychology*; D005260:Female; D006801:Humans; D055048:Integrative Medicine / Q000379:methods; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000523:psychology* / Q000628:therapy*; D000072103:Oncologists / Q000523:psychology*; D005791:Patient Care / Q000523:psychology; D010820:Physicians / Q000523:psychology*; D011369:Professional-Patient Relations; D011446:Prospective Studies; D012017:Referral and Consultation
keywords: Communication; Complementary medicine; Multi-disciplinary team; Psycho-oncology; Supportive care