The general practitioner as coordinator in Danish cancer treatment? Ann Dorrit Guassora, MD, PhD Rikke Dalsted, PhD-fellow, sociologist, reg, Nurse Thorkil Thorsen, sociologist, PhD 16 th Nordic Congress of general practice Copenhagen May 2009

 Coordination of health-care often seen as a ”one person” task as for example ”tovholder”  The general practitioners in Denmark suggested to carry out a coordinating function  GPs lose contact with cancer patients after referral Background

Aim of the project To investigate the role of the GP in everyday coordination of cancer treatment

METHODS Qualitative research design. 12 individual interviews with patients 2 focus group with the patients’ GPs 1 focus group with hospital doctors 2 focus groups with nurses at hospital 1 focus group with home care nurses Done in the period from fall fall 2008

 GP was not active as coordinator Saw their role, if any, as psycho-social support and dialogue- partners Other health care professionals did not see the GP as having a central role during the cancer treatment  Patients active part Change decisions of treatment The majority of patients did not feel any need for the GP during their treatment Relatives often “case-managers” Preliminary results

 Coordination between hospitals and wards Information to the patient regarding prognosis and plans for treatment differed between departments Plans about treatment and care were made between doctors and nurses in different hospital wards  GPs did not have access to these decision processes Preliminary results

The role of the GPs in everyday coordination in cancer treatment is limited Conclusion

 Is coordination in cancer treatment best improved by having one appointed part in the health care system as coordinator?  Challenge to the ”one coordinator” idea - Illness trajectory (Strauss 1991, 1997) The total organization of actions Reciprocal impart Discussion

Ann Dorrit Guassora, MD, PhD Rikke Dalsted, PhD-fellow, sociologist, Reg, Nurse Thorkil Thorsen, sociologist, PhD