Oncologist-Advanced Practice Provider Dyad: A Roadmap for Creating Synergy and Better Patient Care

In oncology, a team-based approach for the optimal care of a patient with cancer is vital.Ensuring comprehensive care tailored to a patient's specific needs and wishes can be achieved through a team including advanced practice providers (APPs), nurses, social workers, pharmacists, dieticians, and the multidisciplinary team of oncology physicians.All these members are integral to the most effective care delivery in oncology.Since the mid-1990s, integration of APPs into oncology has expanded.In community practices, increasing service demand, wide geographic coverage, growing clinical research portfolios, and rising patient volumes have made APP participation essential to sustaining growth.The physician-APP relationship should be one of collegial collaboration where the APP has a critical role in enhancing patient care.There is no one-size-fits-all formula for collaboration between physicians and APPs in cancer care, especially given the different roles that are played by APPs in medical, radiation, and surgical oncology.We offer several perspectives that can be considered in building effective and efficient teams that support the patients and the clinicians involved. ONCOLOGIST PERSPECTIVETraditionally, oncologists are trained to diagnose, treat, and manage cancer.However, the role of a practicing oncologist has changed over the decades, influenced by the explosive growth of scientific knowledge, 1 workforce shortages, 2,3 increasing administrative burden, 4 and the growing demand for services for cancer survivors.The oncologist's perspective is ideally one of collaboration with the APP.Since they form a dynamic team, the roles complement each other as follows.Initial treatment planning is typically the role of the oncologist.They leverage specialized knowledge of the cancer care continuum-diagnosis, treatment, and supportive care-and are responsible for developing the comprehensive treatment plan.The APP, as a collaborative partner, may assist by gathering patient history and data, further educating the patient and caregivers regarding the treatment plan, and monitoring for side effects, treatment responses, and interventions.As a collaborative team, both the physician and the APP can be responsible for ongoing patient care.The APP or physician may manage routine follow-up and monitor side effects.The oncologist and APP may be involved in high-level decision making or addressing complex situations.Promoting quality care delivery at the clinic level relies on physician engagement and emphasis on evidence-based protocols.Physicians and APPs can collaborate in identifying priorities for practice quality improvement.The success of quality program initiatives depends upon clear communication and support from all team members.Multiple studies and clinical examples demonstrate that this thoughtful physician-APP model leads to improvements in patient care quality, such as reduced hospitalization rates, higher treatment completion rates, and greater satisfaction among patients and team members.5,6 Interdisciplinary coordination and communication are key elements of cancer care.A medical oncologist often serves as the primary oncologist overseeing the broader cancer care team.