Challenges patients face in getting primary referral with an oncologist

There are over 2 million new cancer diagnosis per year (as reported by the Canadian Cancer Society and the National Cancer Institute); and one out of two people will develop cancer in their lifetime. These numbers seem staggering; however, we have to keep in mind that in part the new cancer diagnosis rates are increasing because new diagnostic tools and preventative programs are emerging allowing for earlier detection of cancers. While this is good news for the cancer patients, the stress on our healthcare system of referring patients to cancer doctors for diagnoses and treatment is at its highest with waiting times averaging 84 days (~3 months). Therefore, the main issues that patients complain about is wait times, and in many cases wait times related to decisions regarding reported treatment strategies and seeking second opinions. There is a clear gap in physician time and available patient support to expedite patient diagnosis by physicians. This gap also translates over to referrals for those patients who would like to seek secondary expert opinions for their cancer diagnosis and treatment options. 

In the past year it also became very evident that when a disruptive event occurs, like the Corona virus (COVID-19) outbreak, our healthcare system is unable to handle the care of the highly vulnerable, such as cancer patients. These patients are at the highest risk of contracting COVID-19 due to the underlying malignancy or anticancer therapy that may be decreasing their immune-responsiveness.  They have an estimated twofold increased risk of contracting the virus and 4- to 10-fold increase in death due to the infection than the general population. We have an urgent need to make changes to clinical care as cancer patients frequently visit the hospital for treatment and disease surveillance. 

Legacy technology systems that are in place for patient record sharing and capacity of healthcare providers to implement technologies that would enable doctor-cancer patient communication in a safe and timely manner are still lacking. These gaps are not only felt by patients, but effects family members and society at large. One means that patient could gain the required care is via virtual doctor-patient communication.  This is not only feasible, but it should be the way moving forward! Patients should have the option of taking charge of their own care and having options for virtual or in-person care that is safe and fast. 

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