ACRO's responce:
Shortfall in the Number of Medical
Oncologists to Reach 34% in 2020.
Published: November 14, 2007 by Paul J. Schilling, M.D., FACRO
The demand for Medical Oncologists will rise by 48%, but the supply will only rise 14%, creating a 34% shortfall in the number of Medical Oncologists needed in the workforce by 2020. These conclusions come from a study performed by the American Association of Medical Colleges and reported in the Journal of Oncology practice (1).
The 2020 forecast was performed using data from the 2005 American Medical Association master file to establish the number of Medical Oncologists needed in the US. The number of patients projected in the year 2020 was forecasted by the National Cancer Institute cancer incidence and prevalence projections. The number of patient visits was determined from the National Cancer Institute analysis of Surveillance, Epidemiology and End Results (SEER) database. There was no adjustment for the ever lengthening regimens of palliative or adjuvant chemotherapy, nor was there any adjustment for patients with metastatic cancers who may live longer as the result of palliative treatment, thus requiring increased patient visits in the future.
In the article "Future Supply and Demand for Oncologists: Challenges to Assuring access to Oncology Services" Dr. Erikson Salsberg proposes the increased use of nurse practitioners, physician assistants and delays in retirement for current Medical Oncologists. He also proposed increased use of primary care physicians to monitor patients during and after chemotherapy.
ACRO wonders if it would not be a good time for Radiation Oncologists to develop a more comprehensive role in the management of cancer patients. We are fully trained and capable of providing informed guidance for virtually all solid-tumor oncology and could easily direct the medical care for cancer patients during all aspects of their disease. Given the need, there is every reason to for Radiation Oncologists see cancer patients in consultation, and design a program for work up and management of their malignancy even if it did not initially include delivery of radiation therapy.
One of our most respected mentors and a long time leaders in Radiation Onocology, Dr. Luther Brady, teaches residents that we are first and foremost cancer physicians who use radiation to treat cancer and that radiation treatment just happens to be one very effective form of cancer therapy. As with the other oncology disciplines there is no reason Radiation Oncologist cannot oversee the oncology patient care plan and give proper guidance to the cancer patient for surgery, chemotherapy, immunotherapy, and palliative care.
We urge Radiation Oncologists to "step up to the plate" and provide more consultative services, more direct patient care, and more cancer patient care general oversight than ever before. This new and important role may be one of the most important challenges for our specialty and, when realized, it would benefit countless cancer patients by 2020.
Paul J. Schilling, M.D., FACRO
Community Cancer Center of North Florida, Gainesville
Reference:
1. Erikson Salsberg et al, Future Supply and Demand for Oncologists: Challenges to Assuring Access to Oncology Services. Journal of Clinical Oncology Practice 2007, pages 10-12.
