Out of 15,639 emails sent for the survey, 3599 were undeliverable. Of the remaining 12,039 GPs that received an email invitation, 742 visited the survey website and 606 (5.0%) completed the survey, as shown in Fig. 1. The completion rate was 81.7%.

Participants’ mean age was 58.5 (± 8.3) years. The sample consisted of 351 male GPs (57.9%) and 249 female GPs (41.1%). The majority, n = 282 (46.5%), had individual practices (KV-Sitz). Closely followed by physicians working in a group practice (Gemeinschaftspraxis; n = 245, 40.4%). Most respondents, n = 365 (60.2%), had over 20 years of professional experience working as a GP. A total of 315 respondents indicated that they possessed additional qualifications. These were chosen as follows: medicinal tumor therapy (n = 5, 0.8%), psychotherapy (n = 58, 9.6%), naturopathic medicine (n = 121, 20.0%), special pain therapy (n = 27, 4.5%), and palliative medicine (n = 153, 25.3%); 134 (22.1%) GPs did not have any additional qualification. Besides the ones given, another very common additional qualification—cited through the type-in function in the comment section—was emergency medicine (n = 68, 21.5%).

The main reasons for consultation were often issues stemming from the cancer or its respective treatment (n = 369, 60.9%). Nevertheless, 30.9% of GPs reported that cancer patients seek advice about problems experienced independent of their cancer diagnosis, where the cancer is a secondary diagnosis. However, with this patient group, their secondary cancer diagnosis often comes up during the consultation (n = 385, 63.5%). In contrast, others reported that the past cancer diagnosis always (n = 131, 21.6%) or sometimes (n = 64, 10.6%) comes up. Moreover, this survey represented GPs who were treating more than 15 cancer patients (n = 292, 48.2%) at the time of the survey as well as GPs who were seeing those patients a couple of times per month (n = 292, 48.2%). Besides 126 GPs reporting that they see their patients once a month, there were still 74 (12.2%) and 91 (15.0%) GPs stating that this patient group visits once or even multiple times a week, respectively.

In terms of the patients’ expectations towards the GP, these seemed to be relatively outbalanced, without much prioritization: psycho-oncologic support (n = 451, 74.4%) as well as treating the patient without transferring him/her to another specialist (n = 410, 67.7%) seem to be the most relevant duties of GPs. This is closely followed by survivorship care (n = 316, 52.1%) as well as transferal to another specialist (n = 278, 45.9%).

A majority of GPs displayed confidence in understanding cancer-related symptoms (54.6%) and addressing patients’ needs (53.8%; Fig. 2a,b, respectively).

Participants’ knowledge about the symptoms (a) and needs (b) of cancer patients

Participants in the study generally reported positive evaluations of the SAPV, with nearly half (48.8%) giving the maximum rating of 5/5 for their services. Additionally, the quality of communication with these networks was rated highly, with 39.6% of participants assigning a positive rating. The data provide a clear view of GPs’ involvement in palliative care, with most respondents (72.3%) expressing a positive assessment of their level of participation. However, communication between GPs and oncologic specialists was reported as an area with varied responses. Furthermore, GPs reported that they are only moderately (n = 276, 45.6%) to a little (n = 158, 26.1%) involved. Just over one third (36.6%) disagreed that the communication is smooth, while half of the participants (50.8%) agreed. Moreover, knowledge regarding follow-up care plans was evenly split, with 41.5% feeling well informed and an equal proportion not feeling informed enough, highlighting differences in perceived information levels (Fig. 3).

Participants disagreeing/agreeing with statements about their involvement in palliative care

GPs reported varied levels of involvement (Fig. 4a) and confidence (Fig. 4b) in managing follow-up care for radiation therapy, with 45.5% moderately involved and 42.5% moderately confident. Notably, a mere 3.9% reported very strong engagement in patient aftercare, and only 4.3% expressed a high degree of certainty in addressing radiation-induced complications.

General practitioners’ self-assessment of follow-up care of patients receiving radiation therapy (RT). a Degree of involvement, b degree of feeling confident in managing RT patients

A significant majority of the survey participants, comprising 408 individuals or 67.3% of the total respondents, clearly indicated a need for further education in radiation-therapy side effects.

Respondents were content with the number of oncology patients they were treating (n = 544, 89.8%). While 37.8% find the work with cancer patients not burdensome, the majority (n = 321, 53.1%) find it a little burdensome, compared to 0.1% who perceive it as very burdensome.

The preferred method of communication among these respondents was via the medical report, with 73.9% (n = 448) using this channel and other modalities such as telephone (n = 63, 10.4%) and email/fax (n = 49, 8.1%) being less commonly employed.

Lastly, GPs perceive their main tasks to be focused on direct medical care on a one-on-one basis (n = 276, 45.6%). Besides, other tasks seem to be ranked as having a similar level of importance: coordination and communication with the respective oncologist (n = 117, 19.3%), psycho-oncologic care (n = 89, 14.7%), sociomedical support (n = 67, 11.1%).

A total of 343 respondents used the open-text response option in the final question of the survey. Through thematic analysis, it was evident that several key factors significantly influence the daily professional life of GPs. Besides insufficient staffing and time constraints, these factors encompassed issues related to deficient communication and an undervaluation of their role in the healthcare system.

Firstly, a prominent concern was the communication gap between GPs and specialists, particularly oncologists in university hospitals. GPs reported that they often receive incomplete information or encounter delays in getting medical reports. Sometimes, they would get lab results without sufficient context. Even when medical reports were received, GPs faced the challenge of deciphering the myriad of abbreviations used by various medical specialties.

Secondly, the survey also noted differences in physician–patient interactions across different settings. For example, in MVZs patients are seen by any available doctor, which can be stressful for both patients and doctors. Doctors must quickly familiarize themselves with new patients’ histories, while patients lack a consistent and personal relationship with a single specialist who is thoroughly familiar with their case.

Thirdly, general practitioners feel that their role is often misunderstood or undervalued by their other specialist colleagues. GPs bring to the table a unique long-standing relationship with their patients, fostering a level of trust that is difficult to replicate. GPs have expressed frustration about being left out of ongoing care plans and not being kept informed by other specialists, who tend to take over patient care quite swiftly.

Despite this, the comprehensive care that GPs provide, including ongoing and follow-up care and their psychological and psychosocial support, is undervalued. The established doctor–patient relationship is crucial and often missing in other medical specialties. For instance, during chemotherapy, there is often no consistent point of contact for the patient, a gap which GPs could fill.

GPs also note the necessity of providing accurate and ample information about psychosocial support and alternative therapies, ensuring that patients are legally informed to make shared decisions about their treatment. While palliative care networks are seen as valuable, there is a call for more room to accommodate individual patient wishes within the treatment protocol.

Some GPs offered potential solutions, which were consolidated into the following focal points: introduction of electronic medical reports (e-medical reports), provision of additional training for both GPs and oncologists, and inclusion of family members in the care process.

In addition to electronic records, patients should be provided with a clear and concise follow-up plan and an information sheet about their treatment, copies of which would be included in their medical reports, keeping GPs fully informed. Another suggestion is to facilitate more immediate access to physicians. Implementing coordination checkpoints could solve the issue of managing this information, streamlining the transfer and collection of patient data.

Moreover, the necessity of ongoing education was a significant concern raised. There is a call for comprehensive training programs to address knowledge gaps on both sides: GPs are eager to deepen their understanding of the side effects associated with specific treatment regimens. Furthermore, while GPs are committed to addressing the psychological aspects of cancer care, there is a consensus that oncologists could enhance patient experience by receiving additional training focused on the emotional impacts of cancer treatment. Such educational advancement could be facilitated through mutual training sessions in which GPs and oncologists share insights and expertise.

Lastly, the critical role of involving and transparently communicating with the patient’s family and relatives must not be overlooked. Beyond their decision-making input, relatives can provide invaluable support, as they often know the patient intimately and can more effectively convey the patient’s preferences. This knowledge is crucial for both the GP and the oncologist. Establishing ambulatory counseling centers focused on social medicine could be beneficial in facilitating this aspect of care.