Anticipated Shortage of Oncologists Will Strain Ability to Provide Quality Cancer Care

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An update of the ASCO 2007 oncology workforce study found that the Patient Protection and Affordable Care Act, when fully implemented, may “modestly exacerbate” anticipated workforce shortages, increasing the demand for oncologists and radiation oncologists by 500,000 visits per year. “Unless oncologist productivity can be enhanced, the anticipated shortage will strain the ability to provide quality cancer care,” the authors of the updated analysis wrote in the Journal of Oncology Practice.

“Beginning in 2012, 16,347 oncologists and radiation oncologists were active and supplying 15,190 full-time equivalents of patient care,” the researchers reported. They defined a full-time equivalent as “the expected number of patient visits that an average oncologist or radiation oncologist engaged full time in clinical care would provide in a year.”

Summarizing their analysis, the authors noted, “Without consideration of the Affordable Care Act, overall demand for oncologist services is projected to grow 40% (21,255 [full-time equivalents]), whereas supply may grow only 25% (18,997 [full-time equivalents]), generating a shortage of 2,258 [full-time equivalents] in 2025. When fully implemented, the [Affordable Care Act] could increase the demand for oncologists and radiation oncologists by 500,000 visits per year, increasing the shortage to 2,393 [full-time equivalents] in 2025.”

Closing the gap between baseline supply and demand projections by the year 2025 would require increasing entering residency and fellowship positions by 210 for oncology and 120 for radiation oncology between 2014 and 2022, the authors estimated. “Because it is unlikely that the US health system will expand physician training programs so dramatically on such a short time horizon, strategies to improve the productivity of oncologists and radiation oncologists should be considered and evaluated to mitigate the shortfall,” they wrote.

Among those possible strategies is more collaborative and coordinated care by oncologists, radiation oncologists, and advanced practitioners with oncology-specific training. “This scenario may be the most likely strategy to increase supply because the funding to increase fellowship training slots is uncertain,” the authors noted.

The updated study was supported by Susan G. Komen for the Cure and ASCO. The authors represented the Lewin Group in Falls Church, Virginia; ASCO; South Texas Oncology and Hematology in San Antonio; the Scripps Clinic in La Jolla, California; Memorial Sloan Kettering Cancer Center in New York; and Beth Israel Deaconess Medical Center in Boston.

Yang W, et al: J Oncol Pract 10:39-46, 2014.