Background: In 2009 ASCO released a policy statement recommending integration of palliative care as part of comprehensive cancer care. The various needs of cancer patients and the complex organization of health care makes this integration challenging. With this idea in mind, we conducted focus groups with oncologists and oncology nurses to identify the barriers to providing palliative care within oncology. Methods: We conducted 11 focus groups with oncologists and their nursing staff at 5 sites throughout Southeast Michigan to explore their care of patients with incurable and advanced cancer. Physicians and nurses were interviewed separately. Interviews were taped, transcribed, and analyzed using cross-case comparison. Transcripts were reviewed by multiple readers to: 1) develop a coding scheme, 2) identify themes, and 3) design an interpretive model. Results: Oncologists and their nursing staff acknowledge the importance of providing high quality palliative care to their patients. Multiple barriers that affect their abilities to provide the quality of palliative care that they desire for their patients were discussed. These issues include 1) Time limitations for discussion of symptoms and advance care plans during office visits; 2) Limited access to secondary supports (e.g. palliative care physicians, social workers, and psychiatrists) available and difficulty coordinating a timely referral; 3) Limited availability of effective case management and telephone care for coordinated patient communication between visits. Conclusions: Oncologists and their nursing staff value and acknowledge the importance of providing their patients with high-quality palliative care but multiple limitations in the organization of oncology care prevent them from doing so. Allowing longer visits, access to secondary supports, and effective case management may improve the quality of palliative care offered within outpatient oncology.