Healthcare Workers’ Views on Approaches to Discussing Alternative Treatment Options in Multidisciplinary Cancer Care

Purpose Information about curative treatment options with comparable efficacy (e.g. surgery or radiation) is often not fully provided to patients when those options fall outside the scope of practice of the oncologist(s) who directly see a patient. This study evaluates healthcare workers’ views on the acceptability of this approach compared to others. Methods An electronic survey was sent to all physicians, trainees, nurses, therapists, researchers, and administrators at a cancer center. Respondents were asked to imagine being diagnosed with a potentially life-threatening illness that can be treated and cured in two standard ways, with similar efficacy but different side-effect profiles and impact on short- and long-term quality-of-life (Procedure A performed by Doctor A; Procedure B performed by Doctor B). Likert-type scales ranging from one (completely unacceptable) to five (completely acceptable) assessed Doctor A’s approach to discussing treatment options in each scenario. Results In this study, 266 individuals responded to the questionnaire (response rate 16%). The mean (standard deviation) Likert-type score was 1.58 (±0.93) for Approach #1 where Doctor A only presents Procedure A; 1.75 (±0.98) for Approach #2 where Doctor A presents both options but favors Procedure A; 2.54 (±1.35) for Approach #3 where Doctor A presents both options but favors Procedure A despite offering a referral to Doctor B to discuss Procedure B; and 4.75 (±0.76) for Approach #4 where Doctor A routinely refers all patients to Doctor B so each treatment option is discussed with the physician who performs each. Each of these differences were statistically significant (p<0.01). Conclusion A balanced, multidisciplinary approach to discussing treatment options is strongly favored by a variety of sampled healthcare workers. This is consistent with improving quality of healthcare delivery and patients' experience.