Heather Hanks1, P Craig Veitch, Mark F Harris. 1. Rural Health Research Unit, School of Medicine, James Cook University, Townsville, Queensland, Australia. heather.hanks@jcu.edu.au
Abstract
OBJECTIVE: To identify and compare the roles of urban, rural and remote general practitioners (GPs) in colorectal cancer (CRC) management. DESIGN: Semistructured interviews exploring GP views of their role in CRC management. SETTING: Urban, rural and remote general practices in north Queensland. PARTICIPANTS: Fifteen GPs in urban, rural and remote practice. MAIN OUTCOME MEASURES: Self-reported roles in the management of CRC patients and factors influencing these roles. RESULTS: All GPs, regardless of location of practice, played a role in diagnosis, referral, postoperative care, psychosocial counselling, follow up and palliative care. Involvement in treatment of CRC patients was only performed by remote GPs. In general, rural and remote GPs played greater roles in care coordination, clinical and psychosocial care. Rural and remote GPs were more heavily involved throughout the entire illness progression when compared with their urban counterparts. CONCLUSIONS: The results of this study indicate that rural and remote GPs in north Queensland play a greater role than urban GPs in the management of CRC. In order to maintain and enhance the roles of rural and remote GPs in CRC care, appropriate guidelines and remuneration should be provided. Palliative care support might also be useful to rural and remote GPs.
OBJECTIVE: To identify and compare the roles of urban, rural and remote general practitioners (GPs) in colorectal cancer (CRC) management. DESIGN: Semistructured interviews exploring GP views of their role in CRC management. SETTING: Urban, rural and remote general practices in north Queensland. PARTICIPANTS: Fifteen GPs in urban, rural and remote practice. MAIN OUTCOME MEASURES: Self-reported roles in the management of CRC patients and factors influencing these roles. RESULTS: All GPs, regardless of location of practice, played a role in diagnosis, referral, postoperative care, psychosocial counselling, follow up and palliative care. Involvement in treatment of CRC patients was only performed by remote GPs. In general, rural and remote GPs played greater roles in care coordination, clinical and psychosocial care. Rural and remote GPs were more heavily involved throughout the entire illness progression when compared with their urban counterparts. CONCLUSIONS: The results of this study indicate that rural and remote GPs in north Queensland play a greater role than urban GPs in the management of CRC. In order to maintain and enhance the roles of rural and remote GPs in CRC care, appropriate guidelines and remuneration should be provided. Palliative care support might also be useful to rural and remote GPs.
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