Providing cancer care

Posted on Thursday, February 16, 2017

Family doctors have an important and expanding role to play in managing cancer in patients that often goes beyond screening and diagnosis to treatment, survivorship and palliative care. The overlap between family medicine and oncology provides an opportunity for family doctors to take on active role in cancer care and have a significant and meaningful impact to oncology patients. Dr. Anna Wilkinson, the Director of the Family Practice Oncology PGY3 Enhanced Skills Program at the DFM, describes her experiences as a General Practitioner in Oncology and her work to support family physicians across the country in providing cancer care to their patients and communities.

Early in her career as a family doctor, a move to Kingston led Dr. Wilkinson to an opportunity with the Cancer Centre there. “It was one of those serendipity things,” she explains, “I saw the opening and decided to try it. I had always loved the complexities of internal medicine, and it seemed like a good fit.” A graduate of the Civic Unit herself, Dr. Wilkinson is now a member of the Ottawa Hospital Civic Family Health Team and she also works as a General Practitioner in Oncology, currently functioning as a hospitalist for admitted oncology patients. This is a challenging and demanding position, caring for patients admitted with complications of cancer or their cancer treatment. Often patients are in crisis, as their treatment is no longer working, and the decision has to be made to change goals of care to palliation. “As family doctors, we’re really trained to talk to our patients and talk to their families, and are encouraged to be good communicators,” says Dr. Wilkinson, describing a skill set that she says is a major strength given the nature of her work. “While medical oncologist may focus on the chemotherapy, family doctors bring a really strong perspective on the importance of the whole patient and their family.”

The balance that family physicians help to provide is part of a collaborative approach to treating and managing oncology patients. Dr. Wilkinson describes ongoing communication with patients’ oncologist, where information and recommendations for every patient are continuously shared. “It is a very, very collaborative environment,” she says, “which is one of the things I love about it.” Family medicine and oncology are two fields that frequently intersect, and Dr. Wilkinson also provides input as a family physician on guideline development for referrals and cancer screening for nation-wide applications.

Through connections in the Canadian Association of General Practitioners in Oncology (CAGPO), Dr. Wilkinson was invited to take on a role as the Ontario Representative with the CFPC Communities of Practice in Family Medicine Cancer Care Committee. Established in 2014, the committee meets several times a year to promote advocacy, networking, health policy, education and continuing professional development in cancer care for family physicians across the country. “Family doctors don’t get a lot of oncology training, but all of them will have to look after a subset of their patients who have cancer,” says Dr. Wilkinson, describing a general deficiency in education for family physicians in oncology care. Efforts to remedy this have included several talks at the Family Medicine Forum, coordinating ongoing education and continuing professional development for practicing family doctors, and the development of education modules for family medicine residents. The aim is to provide key information to family doctors, preparing them to field questions and concerns from patients diagnosed with cancer, and help to provide a clearer picture of what their diagnosis means.

Many resources are available to residents and practicing physicians looking for information on cancer care for their patients. Cancer Care Ontario, which has a helpful drug information database that describes side effects and symptom management for cancer treatment drugs, and the National Comprehensive Cancer Network contain information, tools and guidelines on cancer treatment and palliative care for patients and physicians. The education module for family medicine residents that Dr. Wilkinson worked on developing has also been delivered at the Civic Unit. “Residents are always welcome to come and do an elective with me,” adds Dr. Wilkinson, “it’s an opportunity to gain valuable experience and see if it is a field they might be interested in.”

“For me, working as a GP Oncologist has been really fulfilling,” says Dr. Wilkinson, “It’s really a field where you have a lot of impact, and have a lot of really personal connections with your patients. I never come home and think I didn’t make a difference.”

For more information on the PGY3 FP Oncology program, please visit our website.

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