The role of the hematologist/oncologist as a primary care provider

To determine the role of the hematologist-oncologist as a primary care provider, a survey was administered to a consecutive sample of 238 hematology-oncology patients. Patients were selected at random from the outpatient hematology-oncology clinics at three institutions: 66.1% from a university medical center, 22.5% from a private hospital, and 11.4% from a health maintenance organization-affiliated clinic. A total of 73 (30.9%) respondents reported they would see their hematologist-oncologist (heme/onc) for routine illnesses, such as sinus or bladder infections. Of the respondents who did not have a family doctor, the percentage increased to 45.5%. Of those patients who had other medical problems, such as hypertension or diabetes, 46 (43.0%) were followed by their heme/onc for these other medical problems. If the respondent did not have a family doctor, the percentage increased to 66.0%. Patients at the university medical center more frequently did not have a family doctor and used their heme/onc for primary care to a greater degree than patients at the private hospital and health maintenance organization (HMO)-affiliated clinic. A total of 55.9% of the respondents reported having the best physician-patient relationship with their heme/onc, whereas only 8.5% had the best relationship with their family doctor. The heme/onc does provide primary care for their patients. If the patient does not have a family doctor, the amount of primary care administered by the heme/onc greatly increases. It is likely that patients rely on their heme/onc for this care because of the close physician-patient relationship that develops as a result of the frequent clinic visits required by many patients with cancer or blood disorders.