Traditionally, there were GPs
and there were specialists and never the twain was meant
to meet. These days, however, the lines are becoming more
and more blurred. Given the high prevalence of cancer,
it's rare for new developments in oncology to escape mention
in national news. Much less reported, but no less important
though is the new breed of specialist GPs who work behind
the scenes with cancer patients -- the GP oncologists.
"[Cancer] is a disease that seems to affect
people as they age, so there will be more patients,
unfortunately, who present with cancers in the next
decade or two. I think as cancer care becomes more complex,
where GPs fit in the acute management of chemotherapy
and radiation [needs to be clarified]," says Dr
Michael Touchie, a GP at the Ottawa Regional Cancer
Centre and Co-chair of the Canadian Association of General
Practitioners in Oncology (CAGPO).
This latest physician association was created last year
by a group of GPs -- then referred to as 'clinical assistants'
-- working within Ontario's nine regional cancer centres.
After banding together to collectively renegotiate their
contracts with Cancer Care Ontario during its overhaul
of the cancer care delivery system, these doctors redefined
their roles, created the term General Practitioners
in Oncology (GPO) and founded CAGPO.
According to the organization's website, a GPO is "a
general practitioner who provides oncology care in the
primary care setting, a general practitioner in oncology
at a cancer centre or an oncology associate (a physician,
other than an oncologist, who holds Royal College of
Physicians and Surgeons of Canada certification and
provides oncology care)." Dr Touchie says CAGPO
represents all GPs involved and interested in oncology
-- whether delivering palliative care to cancer patients
full-time or treating the occasional cancer patient
in their practice.
He stresses the important role CAGPO plays by providing
GPs with an opportunity to exchange ideas, especially
considering the drastically different healthcare budgets
and methods of cancer care delivery between provinces.
Also, the majority of GPs who deal with cancer regularly
in their community work outside large cancer centres
and don't get to interact with oncologists, who are
in short supply across the country. "We let [GPs]
that may feel isolated in delivering care to cancer
patients know that they aren't alone and that there
are many others who share their experiences," he
says.
Dr Lucie Blouin admits she has experienced that sense
of solitude. She became the first GPO at the Peterborough
Regional Health Centre in Ontario last year, filling
some of the community's cancer care needs after its
only oncologist retired. "When [I heard] about
[CAGPO] I thought it would be a wonderful opportunity
to speak with others who are in the same sort of situation
as myself," she says.
"I've been able to provide
continuing care, obviously not at the same capacity
as a medical oncologist, but it still allows cancer
patients to receive care close to home. Patients are
assessed by a medical or radiation oncologist and decisions
are made about treatment. If it's chemotherapy, depending
on the protocol, I am able to deliver some of that treatment
here in Peterborough so they don't have to keep travelling
back and forth to the big cancer centres," explains
Dr Blouin.
One of the big benefits of becoming a member of CAGPO
for Dr Blouin was to find out what the founding members
had included in their contracts to use as a basis for
her own negotiations. "They were able to negotiate
not just the wage that would be earned, but things like
benefits and the availability of benefits, continuing
medical education support -- both for time off and for
some financial help in attending conferences -- and
all sorts of other issues," she says.
Providing GPOs with a forum to discuss issues, such
as the latest cancer therapies, at CAGPO's annual conference
is one of the organization's initial successes. However,
Dr Blouin believes that to keep attracting new members,
the organization will have to continue advocating proper
recognition of the important role that GPOs fill, linking
family medicine and oncology.
Dr Touchie says he measures success in a different way,
"Supporting patients with cancer is very rewarding.
It gives you a good feeling when you know that you've
made the way a little bit easier for somebody who's
going through tough times."
If you're interested in attending
the summer 2005 CAGPO conference in New Brunswick, check
out the organization's website at www.cos.ca/cagpo.
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