Breast Cancer Patients More Satisfied When Specialists Share Care Management

Release Date: December 15, 2011 | By Katherine Kahn, Contributing Writer
Research Source: Health Services Research

KEY POINTS

  • Breast cancer patients are more satisfied with the care they receive from doctors who report actively co-managing care with other specialists, compared with doctors who manage patients’ treatment independently or simply refer them to another doctor.
  • Physicians in HMOs, who have greater access to other doctors than physicians in solo practice, are more likely to actively consult with other doctors in breast cancer treatment.
  • Doctors who encountered barriers to referral because of provider network restrictions were less likely to collaborate with other doctors about patient care.
Follow us on Facebook

Patients with breast cancer report greater satisfaction with care when their cancer doctor co-manages their care with other specialists. However, some specialists are more likely than others to share decision-making with other physicians, finds a new study in Health Services Research.

“Breast cancer is typically a condition that is managed by multiple specialists. Often a surgeon is involved as well as a medical oncologist, radiologist and primary care physician,” said Katherine Kahn, M.D., of the David Geffen School of Medicine at UCLA and senior author of the study.

For certain tasks associated with breast cancer diagnosis and treatment, co-management—where two or more physicians actively consult with one another—might be the best approach. However, the extent to which specialists use co-management in breast cancer care is unknown.

Researchers surveyed 347 breast cancer specialists, including medical oncologists, radiation oncologists and surgeons, about their usual practice style for 10 clinical tasks associated with breast cancer care. The specialists answered questions about whether they manage common breast cancer treatment tasks independently, co-manage tasks with other physicians or refer patients to other providers. Radiation oncologists reported co-managing more tasks, followed by surgeons and medical oncologists.

To examine patient outcomes, the researchers identified satisfaction ratings from 411 patients matched to a surveyed medical oncologist. Patients gave higher ratings to medical oncologists who actively co-managed decision making—rather than simply referring patients to another specialist—in four different areas: choosing type of breast surgery, decisions about radiation, treatment of lymphedema (limb swelling after breast surgery) and treatment of depression.

“Patients wanted to have one physician that they identified as coordinating their care—as co-managing, not just referring them out—and connected to all of the information that was relevant to the decision making for the patient,” Kahn said.

Certain factors were associated with the co-management of patients. Physicians in HMOs who have greater access to other clinicians than physicians in solo practice were more likely to co-manage patients. Physicians who received financial incentives to expand their own services or who encountered barriers to referral because of provider network restrictions were less likely to collaborate with other doctors about patient care.

“Perhaps one way of going forward is to look at this from the patient’s perspective,” said Richard Wender, M.D., chairman of the department of family medicine at Jefferson Medical College and past president of the American Cancer Society.

“What patients want is the sense that they are being cared for in a continuous way,” Wender added. “We in the cancer care community increasingly recognize that we have a fundamental professional and ethical responsibility to take a patient-centered approach to cancer care. That means that the same kinds of interdisciplinary team thinking that has been applied to some other chronic illnesses must consistently be applied to cancer care.”

TERMS OF USE: This story is protected by copyright. When reproducing any material, including interview excerpts, attribution to the Health Behavior News Service, part of the Center for Advancing Health, is required. While the information provided in this news story is from the latest peer-reviewed research, it is not intended to provide medical advice or treatment recommendations. For medical questions or concerns, please consult a health care provider.

###

For More Information:


Reach the Health Behavior News Service, part of the Center for Advancing Health, at (202) 387-2829 or hbns-editor@cfah.org.

Health Services Research is the official journal of the Academy Health and is published by John Wiley & Sons, Inc. on behalf of the Health Research and Educational Trust. For information, contact Jennifer Shaw, HSR Business Manager at (312) 422-2646 or jshaw@aha.org. HSR is available online at http://onlinelibrary.wiley.com/journal/10.1111/(ISSN)1475-6773/

Rose, D. E., D. M. Tisnado, M. L. Tao, J. L. Malin, J. L. Adams, P. A. Ganz, and K. L. Kahn. (2011). Prevalence, Predictors, and Patient Outcomes Associated with Physician Co-management: Findings from the Los Angeles Women’s Health Study. Health Services Research, doi: 10.1111/j.1475-6773.2011.01359.x

Tags for this article:
Cancer   Medical/Hospital Practice   Women's Health  



Comments on this article
Please note: CFAH reserves the right to moderate all comments posted to the Health Behavior News Service. Any inappropriate postings will be removed.

No comments have been entered yet.