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The Biggest Threats to the Oncology Workforce

Op-Med is a collection of original articles contributed by Doximity members.
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Much has been said and written about the predicted shortage of physicians in the U.S.

Studies have focused on Primary Care doctors and specialists including obstetricians/gynecologists, psychiatrists, and cardiologists.

The latest study, released by Doximity, the social network for healthcare professionals where I also work, focused on another specialty: oncologists.

The study raised the question of whether the sheer volume of cancer cases will soon outpace the number of practicing oncologists. By examining a combination of factors including the aging physician workforce and an increased demand for oncology services, findings from the study indeed raise concern around how cancer patients will be cared for in the future.

Doximity's social network allowed us to draw on the profiles of more than 20,696 licensed oncologists and to pinpoint how shortages may impact geographic areas. The study is the first of its kind to examine how the trend could play out in major cities across the country and the various demographic factors contributing to the problem.

The conclusion? Several cities in the U.S. may experience a shortage of oncologists within the next decade. The Doximity report looked at the top 10 metro areas at highest risk of an oncologist shortage. They include:

  1. Miami, Florida.
  2. Virginia Beach, Virginia.
  3. Tampa, Florida.
  4. Washington, D.C.
  5. Sarasota, Florida.
  6. Tucson, Arizona.
  7. Las Vegas, Nevada.
  8. New Orleans, Louisiana.
  9. Raleigh, North Carolina.
  10. Providence, Rhode Island.

The looming shortage of oncologists poses serious problems for the entire healthcare system, as demand for cancer treatment is expected to outpace the number of oncologists entering the workforce.

The National Cancer Institute (NCI) estimated that 1,735,350 new cases of cancer will be diagnosed in the U.S. this year. In addition, breast cancer remains the second-leading cause of death in women, with an estimated 266,120 new cases of invasive breast cancer to be diagnosed this year.

"A shortage of oncologists in the future could, in some cases, lead to delays in between diagnosis and beginning treatment," says Chandler Park, M.D., an expert oncologist with American Society of Clinical Oncology (ASCO) University in Alexandria, Virginia.

The study goes on to examine retirement trends, the percentage of state-trained specialists and prevalence of breast cancer on a city-by-city basis. In half of the metropolitan statistical areas (MSAs) surveyed, over 20% of practicing oncologists are over the age of 65, an important factor in the estimated shortage.

According to ASCO, there is a projected 40% growth in overall demand for oncologist services accompanied by a shortage of 2,200 oncologists by 2025.

Additional findings from the report include:

A looming wave of retiring oncologists:

In many of the metro areas, a large number of oncologists are already approaching retirement age.

The metro areas with the highest number of oncologists ages 65 and older are: Miami, Florida; Los Angeles, California; Detroit, Michigan; Tucson, Arizona and New Orleans, Louisiana.

Those with the lowest number of retiring oncologists are: Nashville, Tennessee; Charlotte, North Carolina; Cleveland, Ohio; Phoenix, Arizona and Houston, Texas.

A 2-fold variation in breast cancer rates across metros:

Doximity looked at the breast cancer rates of women in the MSAs who are between the ages of 40-75, and found a variance from 227 to 337.5 (per 100,000).

The metro areas with the highest numbers of women with breast cancer are: Virginia Beach, Virginia; Buffalo, New York; Rochester, New York; Hartford, Connecticut; and Boston, Massachusetts.

Those with the lowest number of women with breast cancer are: Las Vegas, Nevada; Tucson, Arizona; Riverside, California and San Antonio and Houston, Texas.

Our study was drawn from Centers for Medicare & Medicaid Services data, board certification data and self-regulated data on more than 20,000 full-time, board-certified oncology providers. Responses were mapped across MSAs, and the top 50 MSAs were selected by the population of women above age 40 according to Census data.

The age-adjusted breast cancer incidence data comes from the 2014 U.S. Cancer Statistics and the Centers for Disease Control and Prevention's WONDER Database.

To read the full report, visit doximity.com/oncologist_workforce_study.

Amit Phull, M.D., is vice president of strategy and insights at Doximity. He heads up the medical content team and works on behavioral analytics and strategic partnerships. He is an Emergency Medicine physician at the San Francisco VA Medical Center and a part-time Emergency Medicine faculty member at Northwestern University in Chicago.

All opinions published on Op-Med are the author’s and do not reflect the official position of Doximity or its editors. Op-Med is a safe space for free expression and diverse perspectives. For more information, or to submit your own opinion, please see our submission guidelines or email opmed@doximity.com.

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