An Aging Patient Population, and too Few Oncologists

ABSTRACT: No challenge is greater than addressing the dramatic shortfall of oncologists predicted by the ASCO-commissioned Workforce Study.

Joseph S. Bailes,
MD, Editor

The Census Bureau predicts that the population of Americans aged 65 years and older will double between 2000 and 2030. Considering the inevitable age-related increase in the need for comprehensive oncology services, no challenge is greater than addressing the dramatic shortfall of oncologists predicted by the ASCO-commissioned Workforce Study.

In short, the study found that demand for oncology services is expected to rise 48% between 2005 and 2020. During the same period, the supply of oncologist services is expected to grow only by 14%, translating to a shortage of between 2,550 and 4,080 oncologists. That amounts to roughly one-fourth to one-third of the 2005 number of US oncologists.

Moreover, 60% of respondents to a 2005 survey of fellows who were completing their oncology training rated work-life balance as being extremely important in determining their post-training plans.

According to the study, this cultural shift may eventually lead to younger oncologists working shorter hours and, in turn, lowering visit capacity, further exacerbating the impending crisis.

This dilemma has been long in the making, and there is no single solution at hand. Also, the shortfall in cancer care specialists could actually be greater than the current projections. Therefore, it is essential that we keep this issue on the front burner of our policy discussions.

Addressing the Problem

The ASCO task force has identified several potential opportunities to address the impending gap between supply and demand: Increasing the number of training slots and making broader use of other practitioners such as NPs and hospice care providers. These efforts will help, but much more needs to be done by ASCO, the advocacy community, and policy-makers on the Hill.

The country is facing a potential crisis, but dedicated efforts over the next several years can certainly minimize the impact on our patients posed by a shortfall of cancer doctors. Although we need to find ways to motivate more of the best and brightest into the field of oncology, we also need to find ways to make better use of our limited supply of oncologists.