Family physicians and cancer care - Palliative care patients' perspectives

OBJECTIVE To explore factors that affect the integrity of palliative cancer patients' relationships with family physicians and to ascertain their perceptions of their FPs' roles in their care. DESIGN Qualitative study using grounded-theory methods, taped semistructured interviews, and chart reviews. SETTING Two palliative care hospital wards in Winnipeg, Man. PARTICIPANTS A purposeful sample of 11 men and 14 women. METHOD Qualitative content analysis of interview transcripts. MAIN FINDINGS Cancer care is organized in a sequential, parallel, or shared manner between FPs and cancer specialists, with sequential care a common outcome if patients' relationships with their FPs wane. Cancer patients can lose contact with FPs because of patient or physician relocation, distrust over delays in diagnosis, failure to perceive a need for FPs, poor communication between FPs and specialists, and a lack of FP involvement in the hospital. People with cancer value FPs for being accessible through prompt appointments and telephone contact; for providing emotional and family support; and for referral, triage, and general medical care. CONCLUSION Family physicians can enhance care of cancer patients. Contact with FPs can be maintained by ensuring good communication between specialists and FPs, defining a clear role for FPs, addressing concerns about delays in diagnosis, and referring patients back to FPs, particularly after hospitalization.