ABSTRACT
The purpose of this study is to assess the knowledge base of primary care residents in the state of Oklahoma regarding radiation oncology. For this study, primary care resident physicians were defined as those training in Family Medicine or Internal Medicine. Primary Care residency programs within the state of Oklahoma were identified through the Accreditation Council for Graduate Medical Education (ACGME) website. Residency programs were in both urban and rural communities. Program directors were contacted to set up a didactic session. A 1-hour lecture covering introductory topics in radiation oncology as well as case-based learning topics pertaining to radiation oncology in the primary care setting was delivered. Residents were given a pre- and post-lecture survey. Ten residency programs, with a total of 281 residents, extended an invitation for didactics. Given the ongoing COVID-19 pandemic, some programs requested that the lecture be delivered virtually. A total of 122 residents completed the pre-lecture survey;51.6% were female, 41.7% were interns, 39.2% were second year residents, and 17.5% were third year residents. A total of 50.8% of respondents attended medical school in Oklahoma and 30.3% attended an allopathic medical school. Over half of trainees stated that they had no exposure to didactics covering radiation oncology during the pre-clinical years of medical school (66.1%). A similar number of residents (65.5%) stated that there were no structured radiation oncology rotations in medical school during clinical years. An overwhelming majority of residents felt that the pre-clinical curriculum did not adequately cover radiation oncology (95.9%). Residents reported that most training facilities had radiation oncology services at their disposal (73.3%);however, only 60.3% of residents had previously interacted with a radiation oncologist. When asked about their level of confidence in consulting a radiation oncologist, 63.6% of residents stated that they did not feel confident while 24% felt neutral, 12.4% felt somewhat confident, but none of the residents surveyed felt confident. Following the lecture, 63.3% of responding residents felt confident or somewhat confident consulting radiation oncology, while only 8.8% felt not confident. Additionally, 98.5% of respondents felt this lecture was beneficial to their resident education. The majority of respondents felt medical school curriculum does not adequately cover radiation oncology. Nobody in the pre-lecture survey felt confident consulting a radiation oncologist. Most trainees felt this lecture was beneficial to their training. This study highlights a gap in medical knowledge and identifies areas of collaboration between radiation oncologists and primary care physicians regarding patient co-management. [ FROM AUTHOR] Copyright of International Journal of Radiation Oncology, Biology, Physics is the property of Pergamon Press - An Imprint of Elsevier Science and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)
ABSTRACT
Introduction: This study aims to look at the trends in our head and neck cancer patient population over the past 5 years with an emphasis on the past 2 years to evaluate how the coronavirus disease 2019 (COVID-19) pandemic has impacted our disparities and availability of care for patients, especially those living in rural areas. An additional aim is to identify existing disparities at our institution in the treatment of head and neck patients and determine solutions to improve patient care. Materials and Methods: A retrospective chart review was performed to identify patients who were consulted and subsequently treated with at least one fraction of radiation therapy at our institution with palliative or curative intent. Patient demographic information was collected including hometown, distance from the cancer centre based on zip-codes and insurance information and type of appointment (in-person or telehealth). Rural-urban continuum codes were used to determine rurality. Results: A total of 490 head and neck cancer patients (n = 490) were treated from 2017 to 2021. When broken down by year, there were no significant trends in patient population regarding travel distance or rurality. Roughly 20-30% of our patients live in rural areas and about 30% have a commute > 50 miles for radiation treatment. A majority of our patients rely on public insurance (68%) with a small percentage of those uninsured (4%). Telehealth visits were rare prior to 2019 and rose to 5 and 2 visits in 2020 and 2021, respectively. Conclusions: Head and neck cancer patients, despite rurality or distance from a cancer centre, may present with alarmingly enough symptoms despite limitations and difficulties with seeking medical attention even during the COVID-19 pandemic in 2020. However, providers must be aware of these potential disparities that exist in the rural population and seek to address these.