Effective Collaboration Between PCPs, Oncologists Enhances Patient Care: Mark Fendrick, MD

Patients benefit from the full range of expertise when primary care providers and oncologists collaborate, as they receive necessary evidence-based care, avoid unnecessary services, and achieve better outcomes, according to Mark Fendrick, MD, director of the Center for Value-Based Insurance Design at the University of Michigan and co-editor in chief of The American Journal of Managed Care^®.

He moderated a panel discussion on this topic yesterday at the Patient-Centered Oncology Care® (PCOC) conference in Nashville, Tennessee, titled "Passing the Baton: Building Relationships With Primary Care."

This transcript has been lightly edited; captions were auto-generated.

Transcript

To begin, why is the connection between primary care physicians and oncologists so critical for patient outcomes?

As a primary care physician, I've learned over my years of practice how important it is to have an ongoing relationship with specialists like oncologists. Whether it be assistance in diagnosis or helping people through treatments, as well as surveillance and survivorship, the communication and data information sharing between [primary care providers] and specialists is critical.

One of the specific areas that we discussed at the PCOC session on the relationship between primary care and oncology is what we call cancer screening purgatory, the time between when a patient gets a positive cancer screen but has not been given a diagnosis. Is it the role of the primary care provider to make sure that the appropriate diagnostic tests and staging are done, or is there a role for oncologists, as well?

I think the consensus from our very engaging panel was the more the team can come together, the more we take advantage of the expertise of various types of clinicians, the better the patient's outcome will be in the fact that they'll get the services they need, not get services that they don't need, and, hopefully, get the interventions that are evidence-based that'll improve their outcomes in the end.

What makes a handoff between primary care and oncology successful? Where do transitions most often break down?

Transitions are important, particularly when you look at the specific patient type. First, you have the individuals who are diagnosed with cancer who need information about appropriate treatment and have that treatment delivered. Often, it's a medical oncologist. Often, we need radiation specialists, as well as surgeons, to get the best evidence-based care.

If the primary care provider is going to remain on the team, it's critical to have a back-and-forth flow of information about what's going on with the cancer that comes from the cancer providers, but also the need to understand comorbidities, other medications, and the need for the cancer providers to know how to most effectively treat that patient, but understand potential side effects, drug-drug interactions, or contraindications to particular types of treatments.