American College of Physicians: Internal Medicine — Doctors for Adults ®

Advertisement

After beating cancer, survivors need a medical home

From the May ACP Internist, copyright © 2009 by the American College of Physicians

Janet Colwell

With the good news that many more women are surviving breast cancer due to improved detection and treatment comes some unsettling findings about follow-up care. As writer Bonnie Darves reports, breast cancer survivors often drift away from their primary care physician for years after their diagnosis. Without ties to a “medical home,” patients rely on specialists for non-cancer-related care that their internist is most qualified to provide.

When the internist is out of the loop, ongoing health issues such as diabetes, hypertension or depression can be overlooked. And the situation can persist for years as patients undergo increasingly complex treatment regimens. Experts weighing in on the issue endorse a shared care model, which sounds a lot like how things are supposed to work in a patient-centered medical home, with the primary care physician coordinating care and maintaining open lines of communication with specialists and others involved in their patient’s health.

For now, widespread implementation of the medical home style of care is still a distant possibility. The unfortunate reality is that many internists remain frustrated by continued low reimbursements and increasingly burdensome paperwork, leading many to reconsider their options. The current primary care shortage has boosted demand for locum tenens, according to recent survey results reported in Stacey Butterfield’s cover story. Locum tenens work attracts doctors for many reasons, including the opportunity to travel, to practice in a variety of settings and to try out jobs that may become permanent. But some are just escaping the daily grind. As one doctor put it, “Now I do medicine—period.”

Also in this issue, don’t miss the latest commentary by Jerome Groopman, FACP, and Pamela Hartzband, FACP, on a reader-submitted case about an 87-year-old woman referred for hospice placement after sudden decline. Our commentators discuss how falling back on stereotypes instead of spending time investigating symptoms can lead to attribution errors. Once again, cognition plays a much larger role than tests or procedures in getting to the right diagnosis.

Don’t forget to join us on our blog and Web site. We look forward to hearing from you.

Sincerely,
Janet Colwell

Top

This is a printer-friendly version of this page

Print this page  |  Close the preview

Share

 
 

Internist Archives Quick Links

ACP JournalWise

Reviews of the World's Top Medical Journals—FREE to ACP Members!

New CME Option: Internal Medicine 2014 RecordingsACP JournalWiseSM is mobile optimized with optional email alerts! Get access to reviews from over 120 of the world’s top medical journals alerting you to the highest quality, most clinically relevant new articles based on your preferred areas of specialty. ACP Members register your FREE account now!

New CME Option: Internal Medicine 2014 Recordings

New CME Package

New CME Option: Internal Medicine 2014 RecordingsIncludes 75 of the most popular sessions in internal medicine and the subspecialties. Stream the sessions, answer brief quizzes and earn CME credit. See details.