Further evidence cross-specialty collaboration leads to better outcomes for patients.
“I can tell that we are gonna be friends” – The White Stripes
Older people typically have well-established relationships with their GP. In some cases, they will have had the same doctor their entire adult life. This places the GP in a unique position, playing a key role in managing chronic health conditions and corralling specialists on an ad hoc basis.
But how do GPs interact with oncologists when an older person has cancer?
This is one of the hot topics discussed on the latest episode of The Medical Republic Podcast, featuring Dr Michael Krasovitsky, a medical oncologist from the Kinghorn Cancer Centre at St Vincent’s Hospital Darlinghurst, and Dr Paul Viray, a consultant geriatrician and medical oncology registrar who works across several sites in Melbourne including Latrobe Regional Hospital, Alfred Health, and Cabrini Health.
Dr Krasovitsky was full of praise for GPs, referring to an advertising campaign the RACGP ran in 2016.
“The tagline was, ‘I’m not just your GP. I’m your specialist in life’, and that is such a powerful and potent message,” he told The Medical Republic Podcast.
“General practitioners are the specialist in their patient’s life. [They are] the fulcrum around which every [other] specialty works. I work closely with a lot of general practitioners and am constantly impressed by how much they get done in what is an extremely demanding specialty.”
Dr Krasovitsky feels having well established and respectful relationships with GPs is critical to helping vulnerable patients.
“I recently had an older Italian patient, who was an absolutely marvelous woman, with breast cancer. Her first language was Italian, and she was finding it quite difficult to engage with the community.
“I spoke to the general practitioner, and we came up with a list of social outing groups that might be available. They helped me navigate how to link her in with that network, which ultimately proved to be a really good thing for her.”
However, Dr Krasovitsky felt there was still room for improvement in how GPs and specialists collaborated and communicated.
“I hope that as our information technology systems improve we may be able to [communicate] with GPs in a more timely manner, rather than waiting four weeks for a discharge summary or a letter.”
Dr Viray agreed GPs play a crucial role in coordinating multidisciplinary teams of specialists. But he also acknowledged the challenges in getting everyone a seat at the table.
“Ideally, we’d love to have a representative from every team in all our MDMs … GPs, pharmacists, nursing, physio [and] occupational therapists. But the practicalities of that is something that’s been hard to do.
“I can barely get myself in as a geriatrician [with dual training in medical oncology] to talk about the geriatric needs of our patients, but it’s [even harder] for my colleagues to get in – let alone a GP or all the other important members providing MDT care for an older person.”
If you are interested in joining or would like more information about the Clinical Oncology Society of Australia’s Geriatric Oncology Community of Practice, please contact Dr Paul Viray via thevirayway@gmail.com.
