RT Journal Article
SR Electronic
T1 Recent Innovations in Primary Care Cancer Survivorship Roles
JF The Journal of the American Board of Family
                Medicine
JO J Am Board Fam Med
FD American Board of Family Medicine
SP 399
OP 408
DO 10.3122/jabfm.2023.230223R1
VO 37
IS 3
A1 Hemler, Jennifer R.
A1 Crabtree, Benjamin F.
A1 O’Malley, Denalee
A1 Howard, Jenna
A1 Mikesell, Lisa
A1 Kurtzman, Rachel
A1 Bates, Benjamin
A1 Hudson, Shawna V.
YR 2024
UL http://www.jabfm.org/content/37/3/399.abstract
AB Background: Despite 2 decades of cancer survivorship research, policy, and advocacy, primary care in the United States has not fully integrated survivorship care into its generalist role. This manuscript describes innovative roles primary care physicians have adopted in survivorship care and how these roles emerged.Methods: We conducted qualitative in-depth interviews with a snowball sample of 10 US primary care physician innovators in survivorship care. Interviews were recorded and professionally transcribed. Our team met weekly as interviews were completed to review transcripts and write summaries. We analyzed data using an immersion-crystallization process.Results: Innovators did not receive formal survivorship training but gained knowledge experientially and through self-guided education. All worked in academic primary care and/or cancer centers; context strongly influenced role operationalization. We delineated 4 major role-types along a spectrum, with primary care generalist orientations at one end and cancer generalist orientations at the other. Primary care generalists applied survivorship guidelines during regular visits (“GENERALISTS+”) or focused on cancer treatment effects amid other comorbidities during blocked clinic time (“oncoGENERALISTS”). Cancer generalists focused on cancer-related sequalae during and after treatment; some provided continuity care to survivors (“ONCOGENERALISTS”), while others incorporated unmet primary care needs into survivorship consults (“ONCOgeneralists”).Conclusions: Primary care survivorship innovations are occurring in academic primary care and cancer centers settings in the US. To move beyond the work of individual innovators, systematic investments are needed to support adoption of such innovations. For wider diffusion of survivorship care into community primary care, additional strategies that include primary care survivorship education and workforce development are needed to facilitate risk-stratified and shared-care models.