NEWS
More involvement of GPs needed in cancer care
Dr Martin de Villiers CEO of ICON
The role of the GP in the diagnosis,
management and follow-up care
of cancer patients in SA needs a
complete review to improve the
quality of care and support these
patients and their families are getting,
and bring down the excessive costs of
cancer treatment.
However, one of the main obstacles
in GPs’ involvement in cancer care
has been medical schemes’ oncology
benefit designs that largely excluded
family practitioners in the continuum
of cancer care. This is now changing
with the assistance of organisations
such as the Independent Clinical
Oncology Network (ICON) that
are working closely with medical
schemes in redesigning oncology
benefits to fully include GPs as part of
the multidisciplinary team responsible
for timeous diagnosis, management,
follow-up and palliative care when
required, said ICON CEO, Dr Martin de
Villiers.
Addressing the 280 doctors who
attended the Gauteng GP Forum’s
recent update conference at
Gallagher Estate, Dr de Villiers said
one of the objectives of ICON is to
leverage the unique position of the
family practitioner and other primary
carers, including social workers,
home nurses and psychologists
in the community to improve
every aspect of care through a
multidisciplinary approach. Currently,
most of the treatment and followup of cancer patients takes place at
specialist level, excluding GPs from
communication and decision making
relating to patients’ treatment plans
and follow-up care, Dr de Villiers said.
It is estimated that in each GP
practice in the country, at least four
patients will be newly diagnosed
with cancer each year, while at
least 16 will be cancer survivors,
depending on the location of the
practice and the age of the practice’s
patient population. However, in many
practices, the suspicion of cancer is
very low, resulting in many patients
being diagnosed too late, adding to
the costs of treatment. This needs
to change as a matter of urgency,
requiring GPs to ensure that they
familiarise themselves with the early
symptoms of cancer, identify patients
who are at risk, encourage them to
undergo screening on a regular basis,
and, when diagnosed, keep in close
contact with the treating oncologist,
following-up with patients when
treatment is completed and becoming
closely involved in the care of patients
with terminal disease.
“It is estimated that
in each GP practice in
the country, at least
four patients will be
newly diagnosed with
cancer each year”
“GPs need to put processes in place
to enable them to identify patients
who are at risk for developing cancer,
such as those with a family history of
breast, ovarian, or colorectal cancer.
They need to document it, modify the
screening and surveillance needs of
those patients, refer, follow-up and
be the coordinators of the care and
support terminal patients and their
families receive,” Dr de Villiers said.
“It is a big role that has not been
fulfilled sufficiently, just because we
didn’t have the benefits to support
it.”
ICON, in collaboration with the
University of Stellenbosch, is
currently presenting a short
course on cancer care for family
practitioners, which it hopes the
IPA Foundation will use as one of its
criteria for GP reimbursement. For
more information on the course,
visit www.cancernet.co.za
4 MEDICAL CHRONICLE NOVEMBER/DECEMBER 2013