BY CINDY BORGMEYER
Family physicians know that delivering high-quality patient care requires far more than a "paint-by-numbers" approach. You'd expect that view to be supported in an assessment of how family physicians connect with and care for their patients with cancer.
Well, now that view has won support.
The results of pre- and post-intervention surveys -- in which family physicians ranked their knowledge and skills levels before and after the 2002 Annual Clinical Focus on care of cancer patients -- show many areas in which FPs improved and a few in which they said they'd like more training.
ACF is the Academy's yearlong initiative designed to bring members state-of-the-art information on a specific medical topic.
Survey respondents answered questions about cancer prevention, detection and treatment, as well as queries regarding their ability to support patients with cancer and to manage health and psychosocial issues faced by cancer survivors.
Perhaps not surprisingly, areas in which respondents thought their knowledge and performance had improved were primarily those involving their clinical and analytical skills. Areas in which they desired more education tended to be those in which they perceived their performance to be tied to patients' behaviors and sometimes to the efforts of others on the cancer care team.
Prevention Treatment
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"That tends to be the more difficult part of any of this: It's not writing a prescription for chemo -- it's how you change behaviors," says Stephen Spann, M.D., of Houston, ACF medical director.
Further confounding the issue is the constant flux and growing volume of clinical screening recommendations as new research evidence is generated, he adds. "Every time we turn around, there's something new. There's no way to get through all of this information; it would take hours out of every day."
Overall, survey respondents reported increased confidence in knowing lifestyle and environmental risk factors for the five most common cancers -- lung, prostate, breast, colon and skin -- after completing the ACF year. They were less confident, however, when it came to knowing which primary and secondary preventive interventions to use for risk reduction or detection of those cancers.
Respondents also reported greater confidence in their ability to manage the care of patients with cancer, including treating side effects of commonly used cancer therapies. They expressed less confidence, however, in their ability to provide overall psychological support to their patients with cancer. "Again," says Spann, "this is something you can't learn from reading a book."
Although respondents said they were more confident in their ability to work with oncologists in managing cancer patients' care after the ACF, they were less confident about working within a multidisciplinary, team approach to cancer management that included such services as home health and hospice care.
What may be most helpful in reviewing these data, says Spann, is to look at the big picture -- consider the long-term effects of the ACF program.
"I think the long-term potential benefits of the ACF program include the fact that there is a careful and systematic review of new evidence in topical areas of great importance to family physicians," he says. "Each year we cover a new area, and often there are linkages to topics covered in previous years, as well as ongoing updates to those earlier topics."
To reach writer Cindy Borgmeyer, e-mail cborgmey@aafp.org.
FP Report is published by the
AAFP News Department.
Copyright © 2003 by
American Academy of Family Physicians.
Pre-survey
Post-survey