ASCO Launches Oncology Practice Census

How many oncologists are in private practice and how many are employed by hospitals and academic medical centers in the United States? No one knows the answer for sure, but ASCO is undertaking an ambitious national effort to determine where oncologists are practicing these days.

Online Survey

ASCO’s Assessment of the Evolution & Status of Oncology Practices (AESOP) task force recently created a detailed online survey in a concerted effort to obtain concrete data regarding where oncologists are currently working. The task force is working with State University of New York (SUNY) Albany’s Center for Health Workforce Studies on the project.

A letter explaining the Oncology Practice Census was mailed to the practices of all ASCO members in June, as well as to oncology practices in the National Provider Identifier Registry and practices in ASCO-affiliate databases—more than 4,600 practices in all.

Ongoing Tracking

The goal: to begin gathering comprehensive data to benchmark where oncologists are practicing, and to develop a system to monitor shifts and trends in the oncology care delivery system over time, said Anupama Kurup, MD, of Providence Cancer Center (Hematology & Oncology Care Clinic - West) and Co-Chair of the AESOP task force.

“Anecdotally, we know many of our colleagues have been shifting away from the private practice, either affiliating loosely with an academic medical center or hospital, or completely closing up shop to become part of a larger organization,” Dr. Kurup said. “But we don’t know how many, and it’s been happening so rapidly. ASCO felt it was important to gather data to benchmark the current medical landscape, confirm this phenomenon, and also identify underlying causes.”

Online Survey Takes
15 Minutes

The Oncology Practice Census is addressed to practice managers, should take just 15 to 20 minutes to fill out online, and asks questions such as:

• How is your practice owned?
• Over the past 12 months, has your practice become affiliated with another entity, experienced layoffs for oncology physicians, and/or changed the mix of patients it treats?
• In the next 12 months, how likely is your practice to become affiliated with an academic medical center, a community, hospital, or another practice?

To encourage practice managers to give the survey priority, ASCO is offering generous Amazon.com gift cards to the first 300 practice managers who complete the survey for their practice.

The AESOP task force hopes to compile all the data in August and submit the results to be published in a peer-reviewed journal later this year.  In addition, the online survey tool enables practices to update their information year-round in order to keep the database current, accurate, and relevant, said Dr. Kurup.

Goal Is to Better Serve Oncologists and Patients

The overall purpose of collecting data on where each oncologist is practicing is to better serve ASCO members and ultimately our members’ patients. The data also will support ASCO’s evidence-based advocacy on Capitol Hill.

Said Michael Neuss, MD, Chief Medical Officer for Vanderbilt-Ingram Cancer Center and a member of ASCO’s Clinical Practice Committee who helped develop the survey, “Your practice environment determines your needs in terms of services and knowledge base. ASCO really wants to know where their members are practicing in order to best support them, and in turn, their patients.”

Anticipated Access Problem

One concern about the migration of oncologists to urban centers is that if too many get pulled out of community-based practices where most cancer care takes place, what will become of the patients in those communities? ASCO wants to keep a close eye on this issue in order to anticipate and address potential access issues.

The survey will also try to determine the reasons why oncologists are shifting the where’s and how’s of practice. Dr. Kurup said that it’s likely a combination of a number of factors: the changing of the payment model for drugs; the advent of health-care reform and the effects that has had on practitioners; the health insurance sector; the downturn in the U.S. economy; the overall effects of managed care; and the need for practices to adopt and maintain expensive electronic health records systems. But until we have the evidence-based data, we can’t be certain, she added.

Change Is Happening Fast

Regular follow-up with practices will be key to a true understanding of the ever-changing landscape. “This ongoing census will enable ASCO to keep its finger on the pulse, and to better understand and communicate the effects of policy on oncologists and the way they practice,” said Dr. Kurup.

One thing is certain, even without solid data yet in hand, according to Dr. Neuss: The way oncologists work is already shifting, and ASCO will need to shift its focus along with it.

“Five years from now, ASCO’s offerings that support practitioners will have changed greatly,” he predicts. “Right now, ASCO is working to help people run their practices. But how many oncologists will even have an independent practice in five years is a question. If more independent oncologists become employees of larger health systems, ASCO will need to refocus its efforts to support the physicians as valued parties within the management of these organizations.”

For questions about how to participate in the Oncology Practice Census or assistance in using the online data collection tool, contact Guy Forte, director of Information Management at the Center for Health Workforce Studies at (518) 402-0250 or by e-mail at chws@health.state.ny.us. ■