Patients’ Experiences in a Dialogue-Based Outpatient Clinic Embedded Within Routine Oncology Care

Objectives

Contemporary oncology has achieved remarkable advances in biomedical treatment while increasingly emphasizing patient-centered care. Nevertheless, routine oncology consultations must address multiple competing clinical priorities, potentially limiting opportunities for patients’ experiences to become visible. To address this gap, we established a Dialogue-Based Outpatient Clinic, a complementary patient-directed consultation model embedded within routine oncology care. This study explored the dimensions of patients’ experiences that became visible through this consultation model.

Methods

We conducted a qualitative study of 44 consecutive patients who attended a Dialogue-Based Outpatient Clinic embedded within routine oncology care between 2021 and 2023. Patients attended the clinic either on their own initiative or following a recommendation from a healthcare professional who recognized that they were struggling. Regardless of how they came to the clinic, patients independently determined the consultation agenda.

Results

Of the 44 patients, 13 (29.5%) sought biomedical information regarding diagnosis, treatment, or adverse effects, whereas 31 (70.5%) discussed concerns extending beyond biomedical issues. Reflexive thematic analysis of these 31 patients identified four interconnected themes: (1) making sense of a cancer diagnosis within one’s own life; (2) negotiating treatment in relation to personal values and life priorities; (3) being treated for disease but not seen as a person; and (4) reconstructing life and identity through the cancer journey. Across all themes, patient-directed dialogue consistently revealed how patients understood cancer within the broader context of their lives rather than as an isolated biomedical condition.

Conclusions

Patient-directed dialogue within routine oncology care revealed dimensions of patients’ experiences that may be less readily recognized in conventional consultations. A complementary consultation model that allows patients to determine the agenda may provide opportunities for these experiences to become clinically recognizable.

Practice implications: Integrating patient-directed consultations into routine oncology care may provide clinicians with opportunities to recognize and address patients’ concerns that might otherwise remain outside the usual consultation agenda.