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Cancer Care for the Whole Patient: Meeting Psychosocial Health Needs
in psychosocial health needs and services could also be improved bya public–private collaboration aimed at (1) identifying and supportingthe implementation of strategies for collecting better information aboutcurricular content and methods addressing psychosocial health care; (2)identifying, refining, and broadly disseminating information to health careeducators about workforce competency models and curricula relevant toproviding psychosocial health services; (3) further developing faculty skillsto teach psychosocial health care using evidence-based teaching strategies;and (4) strengthening accreditation standards pertaining to psychosocialhealth care in education programs and health care organizations.
A LARGE AND DIVERSE WORKFORCE
Currently, a large and diverse workforce either comes into contact with cancer patients and their families through the provision of cancer care or exists as a potential resource for these individuals. This considerably diverse workforce comprises distinct, although at times overlapping, sectors, including (1) clinicians who are involved principally in the provision of biomedical health care services; (2) mental health and counseling professionals; and (3) providers of other psychosocial services, such as information, logistical or material support, and financial assistance. This latter sector includes a large volunteer and peer support component.
A wide variety of licensed providers deliver some psychosocial health services: allopathic physicians (such as those practicing oncology, internal medicine, family medicine, pediatric hematology-oncology, and pediatrics), nurses, mental health professionals (such as psychiatrists, clinical psychologists, counselors, social workers, and pastoral counselors), and other social workers. Some of these providers deliver care exclusively to people diagnosed with cancer on the basis of their specialization in oncology or employment in programs devoted to serving these individuals. Others provide care to people diagnosed with cancer as just one segment of their total patient populations. For example, a previous Institute of Medicine (IOM) report, From Cancer Patient to Cancer Survivor: Lost in Transition, notes that primary care physicians provide the greatest amount of ambulatory cancer care in the United States (IOM and NRC, 2005).
Tables 7-1 and 7-2 provide estimates of the numbers of selected providers of various types who serve cancer patients and can play a role in either providing or ensuring the provision of psychosocial health services. Table 7-1 shows the number of physicians in various specialties certified by the American Board of Medical Specialties (ABMS)2 or with membership in
Initial certification, a process that evaluates the training, qualifications, and competence of physician specialists at the outset of their careers, is a major focus of ABMS and its Member Boards (Horowitz et al., 2004). Nearly 85 percent of licensed U.S. doctors are certified by at least one ABMS member board (ABMS, 2007).