46 Background: The active role of a primary care physician has been shown to improve outcomes for patients in all areas of health management. Cancer care is rapidly evolving as a result of major advances in cancer genomics and the production of new, mostly oral, chemotherapeutic agents targeted to specific patients. The estimated number of cancer survivors is expected to dramatically increase in the next decade. One good example of a new model of cancer care that relies upon the steady presence and involvement of the primary care physician is the care of patients with non-metastatic breast cancer. The current model of breast cancer care includes the primary physician identifying a lesion, obtaining required imaging, making a preliminary diagnosis of presumptive breast cancer, referring to the surgeon and/or oncologist, then resuming care of the patient post survivorship. In the new model of care described here, oncologists play a peripheral role and once therapy is initiated, care by the primary care physician in an integrated, team-oriented, system becomes ideal. Methods: Via a shared care model in which the primary physician is trained to provide direct oncologic care for the patient. They will thereafter initiate a survivor plan that will allow the patient to return to their own medical ecosystem with the least delay and compromise. The primary physician is anticipated to actively direct care for the cancer patient including prescribing recommended cancer treatment, managing medication side effects, and making appropriate referrals when necessary. Results: see below Conclusions: There is good evidence that outcomes by a primary care physician throughout the entire breast cancer treatment phase are comparable to care provided by oncologists in the current model. When the primary care physician is given the right tools and empowered to lead the care for the patient, improved compliance, improved psychosocial quality, and appropriate survivorship follow up can be achieved. With the ability to care for all aspects of their patient’s needs, both biomedical and emotional, the primary physician can, and should, start taking a more active and holistic role in providing care for their patients. Never was this more true then now.
Pediatric skin diseases in primary care: Diagnostic dilemmas a primary physician may face
