• Rachel Sue-A-Quan, Anna Sorensen, Samantha Lo, Ashley Pope, Nadia Swami, Gary Rodin, Breffni Hannon, Kirsten Wentlandt, and Camilla Zimmermann.
• Department of Supportive Care (R.S.A.Q., A.S., S.L., A.P., N.S., G.R., B.H., K.W., C.Z.), University Health Network, Toronto, Ontario, Canada.
• J Pain Symptom Manage. 2023 Aug 1; 66 (2): 9310193-101.

ContextEarly palliative care (EPC) is widely recommended but its implementation may be challenging.ObjectivesWe conducted a qualitative analysis of Canadian palliative care physicians' opinions about conditions necessary to provide EPC.MethodsA survey assessing attitudes and opinions regarding EPC was distributed to physicians providing primary or specialized palliative care, as identified by the Canadian Society of Palliative Care Physicians. The survey included an optional final section for respondents' general comments; we screened these for relevance to our study aims and conducted a thematic analysis of relevant comments.ResultsOf 531 completed surveys, 129 (24%) respondents provided written comments, of whom 104 mentioned conditions they felt to be necessary to provide EPC. Four key themes were identified: 1) Clear delineation of roles of primary and specialized palliative care physicians-all physicians should be empowered to provide primary palliative care, with specialists providing additional support; 2) Shared care with needs-dependent referral-primary and specialized palliative care physicians should work collaboratively, with referral to specialized palliative care based on need rather than on prognosis; 3) Adequate resources to support primary palliative care-education, financial incentives, and collaboration with interdisciplinary team members such as nurses and specialized providers were specifically mentioned; 4) Addressing the misconception that palliative care equals end-of-life care-there was particular emphasis on education of both healthcare providers and the public.ConclusionChanges are necessary at the level of palliative care referral systems, providers, resources, and policy to enable implementation of EPC.Copyright © 2023 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

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