Cancer care: what role for the general practitioner?

Author: Jon D Emery

Med J Aust 2008; 189 (9): 535. || doi: 10.5694/j.1326-5377.2008.tb02169.x
Published online: 3 November 2008

To the Editor: The 21 July 2008 “general practice” issue of the Journal raises a number of important issues about the future of generalist medical care, including the role of the general practitioner in the care of cancer patients. The editorial by Weller and Harris acknowledges the importance of multidisciplinary teams, including the full gamut of primary care practitioners, in meeting the diverse needs of people with cancer, from diagnosis to long-term “survivorship”.1 Jiwa et al propose a new model of an “integrated primary care hub” — with a “cancer care coordinator” — as a possible solution to the challenges of providing good team-based care.2 However, creating an entirely new disease-centred role would seem to ignore much of the debate in the rest of the general practice issue. Multiple morbidity is an emerging reality in Australia, and it is a fact that many survivors of cancer will die from other chronic conditions. Disease-specific care coordinators are currently being promoted as the new model for delivering chronic disease management to the community, but how many of these care coordinators will be needed for patients such as those described by Britt et al?3 And who will coordinate the coordinators?

Gunn et al make a strong case for the generalist primary care medical practitioner as the overarching coordinator of care.4 We must stop seeing our patients through the eyes of our disease-centred hospital colleagues. Instead, we must create new mechanisms that will allow the experts in generalism — GPs — to move away from predominantly “reactive, consultation-based medicine”4 to high-quality integrated care planning in coordination with other members of the primary care team.

1. School of Primary, Aboriginal and Rural Health Care, University of Western Australia, Perth, WA.

Correspondence: jon.emery@uwa.edu.au

Weller DP, Harris MF. Cancer care: what role for the general practitioner [editorial]? Med J Aust 2008; 189: 59-60. 0_CHDBFFAC
Jiwa M, Saunders CM, Thompson SC, et al. Timely cancer diagnosis and management as a chronic condition: opportunities for primary care. Med J Aust 2008; 189: 78-82. 0_pgfId-1966884
Britt HC, Harrison CM, Miller GC, Knox SA. Prevalence and patterns of multimorbidity in Australia. Med J Aust 2008; 189: 72-77. 0_CBBDBJHF
Gunn JM, Palmer VJ, Naccarella L, et al. The promise and pitfalls of generalism in achieving the Alma-Ata vision of health for all. Med J Aust 2008; 189: 110-112. 0_CBBCEIBG

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