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Healio
December 11, 2008
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ASCO releases Workforce Strategic Plan

The recommendations will address looming oncology workforce shortage.

A five-year strategic plan to recruit, train and prepare the next generation of oncologists envisions a world in which physicians are better communicators who lead teams of cancer care professionals.

The ASCO Workforce Advisory Group identified oncology care delivery, the training pipeline for new oncologists and ASCO’s own workforce structure as areas in need of revision and laid out specific changes for each. The group aims to counteract a predicted shortfall in the number of available oncologists.

The plan was published in a recent issue of Journal of Oncology Practice.

“These are the things ASCO would like to do — to work in these areas to help solve what looks like a projected workforce shortfall,” said Michael Goldstein, MD, the advisory group’s co-chair and an oncologist at Beth Israel Deaconess Medical Center in Boston. “The first one is to look at various modes of practice that could increase productivity without diminishing the patient experience. One of the major areas there is the use of nonphysician practitioners, such as nurse practitioners and physician assistants.”

Goldstein said that the number of oncologists is expected to increase by 14% in the next 12 years but the demand for those physicians will increase by 48%. Due to the expected deficit, he said the next generation will work as managers as much as physicians, and that requires new skills. He added that nurse practitioners and physician assistants will play a greater role.

“In the short term, what we need to do is create strategic liaisons with the people who are training nurse practitioners and physician assistants to see if we can help develop curriculum in oncology,” he said. “We have to aggressively seek to employ those people in our practices. The oncologist of the future will need more communication skills and team leadership skills because the oncologists themselves will be a short-supply commodity, so their reach and expertise will have to be diffused over a larger group of people.”

The society wants to increase the number of oncologists by increasing the number of physicians who choose to go into internal medicine and who choose to specialize in oncology. Goldstein acknowledged there are some things, such as the number of medical school slots available, over which ASCO has little control, but said there are ways to capture more of the available pool of medical students.

“We’re trying to make efforts to reach out to medical students and internal medicine residents to get them interested in oncology early in the year,” he said. “Even if the pool doesn’t increase, if we can attract an increased percentage of the pool we will produce more oncologists.”

The strategic plan calls on ASCO to provide grant money to study possible alternative work options such as shared practices, focused clinical work and evening and weekend clinics. The advisory group also recommends that the society conduct pilot projects testing innovative practice models, examine issues facing oncologists reentering clinical practice or delay retirement and form partnerships with medical professionals in other disciplines that “optimize integrated survivorship care.”

“What we hope for in the future is to have a group of oncologists who are better trained to work as team leaders and communicators, to have practices that are staffed with nonphysician professional providers like nurse practitioners and physician assistants as well as pharmacists, infusion nurses and nutritionists, all in a team to deliver really good cancer care, and to have the patient have a good experience,” Goldstein said. “We don’t want increased productivity and efficiency to lead to less satisfaction for the patient.

“It’s a complex issue and there’s no one solution to all of this. Even if the government threw a lot more money at this tomorrow, the problem wouldn’t go away because of the time lag necessary to train and set up the right kind of practices. This is going to require help from everybody who takes care of a cancer patient.” – by Jason Harris

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