Projected supply of and demand for oncologists and radiation oncologists through 2025: an aging, better-insured population will result in shortage.
OBJECTIVE
The American Society of Clinical Oncology (ASCO) published a study in 2007 that anticipated a shortage of oncologists by 2020. This study aims to update and better assess the market for chemotherapy and radiation therapy and the impact of health reform on capacity of and demand for oncologists and radiation oncologists.


METHODS
The supply of oncologists and radiation oncologists, by age, sex, and specialty, was projected through 2025 with an input-output model. The Medical Expenditure Panel Survey, commercial claims, and Medicare claims were analyzed to determine patterns of use by patient characteristics such as age, sex, health insurance coverage, cancer site, physician specialty, and service type. Patterns of use were then applied to the projected prevalence of cancer, using data from the SEER Program of the National Cancer Institute.


RESULTS
Beginning in 2012, 16,347 oncologists and radiation oncologists were active and supplying 15,190 full-time equivalents (FTEs) of patient care. Without consideration of the Affordable Care Act (ACA), overall demand for oncologist services is projected to grow 40% (21,255 FTEs), whereas supply may grow only 25% (18,997 FTEs), generating a shortage of 2,258 FTEs in 2025. When fully implemented, the ACA could increase the demand for oncologists and radiation oncologists by 500,000 visits per year, increasing the shortage to 2,393 FTEs in 2025.


CONCLUSIONS
Anticipated shortages are largely consistent with the projections of the ASCO 2007 workforce study but somewhat more delayed. The ACA may modestly exacerbate the shortage. Unless oncologist productivity can be enhanced, the anticipated shortage will strain the ability to provide quality cancer care.
The Lewin Group, Falls Church; American Society of Clinical Oncology, Alexandria, VA; South Texas Oncology and Hematology, San Antonio, TX; Scripps Clinic, La Jolla, CA; Memorial Sloan-Kettering Cancer Center, New York, NY; and Beth Israel Deaconess Medical Center, Boston, MA.
Wenya
W
Yang
James H
JH
Williams
Paul F
PF
Hogan
Suanna S
SS
Bruinooge
Gladys I
GI
Rodriguez
Michael P
MP
Kosty
Dean F
DF
Bajorin
Amy
A
Hanley
Ashley
A
Muchow
Naya
N
McMillan
Michael
M
Goldstein
D000368:Aged; D005260:Female; D006301:Health Services Needs and Demand / Q000706:statistics & numerical data* / Q000639:trends; D006280:Health Workforce / Q000706:statistics & numerical data* / Q000639:trends; D006801:Humans; D007348:Insurance, Health / Q000191:economics; D008297:Male; D008495:Medical Oncology / Q000639:trends; D006278:Medicare / Q000191:economics; D008875:Middle Aged; D008962:Models, Theoretical; D009369:Neoplasms / Q000191:economics / Q000628:therapy; D010820:Physicians / Q000706:statistics & numerical data*; D018787:Radiation Oncology / Q000639:trends; D018426:SEER Program / Q000706:statistics & numerical data; D012955:Societies, Medical; D014481:United States