De huisarts: spil in de nazorg voor patiënten met kanker?

Background: The last twenty years have seen an enormous increase in the number of long-term survivors of cancer, and it has been suggested that the follow-up care of these patients should be shifted from secondary to primary care, with general practitioners having a coordinating role. We investigated the opinions of primary care professionals and in this article evaluated whether general practitioners are ready for this central role. Method: The opinions of 53 primary care professionals, including 15 general practitioners, were investigated in the period 2008-2010. In-depth interviews were held with 35 participants (11 general practitioners); the other 18 participants (4 general practitioners) took part in a focus group discussion. Results: General practitioners preferably approach patients with treated cancer as ‘normal’ patients with chronic disorders. They also prefer to harness the patient’s strengths and abilities and tend not to provide structured follow-up care or to refer the patient to other primary care professionals. Conclusion: After treatment, patients with cancer often have not only physical disabilities but also specific emotional and social problems. Good follow-up care thus requires that general practitioners actively maintain their relationship with the patient, take the initiative to raise and discuss patient’s problems, and proactively organize help and care. This is in sharp contrast to the ‘demand-driven’ approach of many general practitioners, who often adopt a wait-and-see attitude.(aut. ref.)