Preferences for Primary Care Physician–Led Follow-up Cancer Care
| Theme | Subtheme | Illustrative Quotes |
|---|---|---|
| Order routine tests for cancer follow-up n=26, 62% | Keeping track of screenings | “Primary doctor—she keeps an eye, also, on my PSA. And if—and I always ask her how’s the PSA. And tells me it’s fine, and she gives me the readings. And I’m sure if it elevates in any way, she would tell me so” (PS 18). “[My primary care physician is involved in cancer follow-up] As far as paperwork. In other words, I request certain papers sent to him, or certain examinations be sent to him” (PS 17). |
| Screening for late- term effects of treatment | “[My primary care physician] does do something for cancer follow-up. He does those EKG’s…because I had the radiation or the chemo…. Well, the last time that I was there he sent me for a stress test because I had the chemotherapy and the radiation. He told me that. Because it’s going to affect my heart…. He does it about twice a year” (PS 6). “I was having a lot of backache, and being that I had the cancer background, [my primary care physician] sent me for an MRI and everything. And they usually make sure I have my bone density scan and stuff like that” (PS 51). | |
| Provide secondary or supple- mental care n=16, 38% | Primary care physicians could be a part of follow- up team | “So, it’s almost like you need a primary with this survivorship plan in hand that’s been viewed and had input from all of your other doctors. Here’s the roadmap, and the primary care is going to help guide you along that line” (PS 14). “I mean, I kind of space them out so that I’m seeing a doctor every 6 months…. I see my primary care doctor for my physical and then I’m off 6 months for the [cancer center]…. So that way I feel like I’m being watchful, at a 6-month time frame. Then I go see the gynecologist like 3 months later” (PS 5). |
| Primary care physicians are first- stop doctors or gatekeepers | “My primary care…gets my blood work. Now, if something’s wrong with my blood work, then I would go to a specialist” (PS 10). “If there’s a concern…if it’s out of the norm, I go see my primary care physician right away. She is quite diligent so I trust her. …[I]f something were to come up, [my urologic surgeon] would still be there hopefully or somebody in his place that you know I can go to and the records would still be available” (PS 2). “You know, as far as [my obstetrician-gynecologist] examining me [for follow-up care], because examining the breast is part of what he does, I mean it’s possible that he could detect something between my visits [to the oncologist]. And, uhh, you know, in that case [it is fine, but] just to go to him for the [follow-up] treatment of the cancer, no” (PS 9). | |
| When enough time has passed n=9, 21% | During an extended survivorship period | “Well, basically, at the point I’m at now, [transitioning to a primary care physician] would probably be fine. Because I’m more comfortable with it now and I kind of have a feeling that…this is gonna be 5 years in November and after that period of time, your other doctor is quite familiar with it” (PS 19). “After I had talked to the surgeon, and they told me like, uh, there was really nothing they could do for me, that the rest was up to myself, you know, I felt like, hey, if they…if I’m in that state, and I have no PSA level that’s showable, then I could ask to go to my family doctor and let him just keep a check on the PSA levels” (PS 16). |
| When reintegrated into noncancer population | “Once I’m not taking any medications [laughter] I don’t think I need to go to see someone specifically, so I don’t know whether at that point it would even be considered follow-up care…” (PS 1). “Well, as Dr Z. [urologic surgeon] explained, [I need follow-up for] 20 years…I might, uh, when I get my physical every year, include a PSA, and when [my primary care physician] gets the information, rather than go away to [cancer center], you know, if he gets the results, and if he’s satisfied or if he’s not satisfied, I’ll call, then I’ll get in touch with Dr Z. again” (PS 34). |
EKG=electrocardiogram; MRA=magnetic resonance imaging; PS=participating survivor; PSA=prostate-specific antigen.