Patients want the best treatment at the lowest cost; if they are not paying for it, because either insurance or the government is, every patient wants the best doctor in the world. For cancer survivors, that includes seeing a specialist even if they may not need it.

Nearly one-third of office visits for cancer are handled by primary care physicians, yet this study finds cancer survivors have concerns about seeing their primary care physician for cancer-related follow-up care.

Exploring survivor preferences through in-depth interviews with 42 cancer patients, researchers found 52 percent expressed strong preferences to receive follow-up from their cancer specialists. They described several barriers to the primary care physician's engagement in follow-up, including

1) lack of cancer expertise
2) limited or no involvement with original cancer care
3) lack of care continuity.

38% of participants believed there was a role for primary care clinicians in cancer follow-up care, suggesting these opportunities:

1) performing routine preventive screening tests
2) supplementing cancer-related specialist care
3) providing follow-up medical care when "enough time had passed" or the survivors felt they could reintegrate into the non-cancer population.

These findings, the authors assert, point to a need for primary care to engage meaningfully in the case management of the growing population of cancer survivors. They call for future research and interventions that address both patient and patient-perceived physician knowledge gaps related to cancer follow-up care.

Paper" Adult Cancer Survivors Discuss Follow-up in Primary Care: 'Not What I Want, But Maybe What I Need' by Shawna V. Hudson, PhD September/October 2012 Annals of Family Medicine