Communication between physicians and with patients suffering from breast cancer

BACKGROUND: The communication between GP and specialists is vital for thepatient suffering from breast cancer. OBJECTIVES: The aim of this study wasto investigate (i) the speed and type of communication between GPs,specialists and patients with breast cancer, and (ii) the problems that GPsencounter in the communication with specialists concerning these patients.METHOD: In April 1995, 246 Dutch GPs from the Zwolle region (600 000inhabitants) were invited to complete a questionnaire, using theinformation from the medical record and focusing on the last patientconsulted with a confirmed diagnosis of breast cancer. RESULTS: Validreplies were received from 150 (61 %) GPs. The median period betweeninitial referral date and receipt of the definite diagnosis from thesurgeon was 4 weeks. After the patient's first appointment with thesurgeon, the GPs received reports for 24% of the patients within 3 days;for 31% within 3-7 days; and for 16% of the patients after more than 2weeks. After the first consultation between patient and surgeon, 68 (45%)of the 150 GPs reported that the patient contacted them; at this stage only30 (20%) of these GPs had received a report from the surgeon. Thirty-one(21%) GPs did not contact the patient after receival of the definitediagnosis. GPs stated that the communication on patients with breast canceris too slow (49%), or not frequent enough (25%); 25% of GPs found that thedistribution of tasks between them and the specialists are not welldescribed. CONCLUSION: In the diagnostic stage of breast cancer thecommunication between GPs, specialists and patients varies widely, is tooslow and is incomplete. An effect of this unsatisfactory communication isthat the patient herself is the messenger of the bad news.