The changing ratio of cancer patients/survivors to oncologists
Hester Hill Schnipper, LICSW, OSW-C Program Manager Emeritus, Oncology, Social Work
FEBRUARY 12, 2020
There is enough to worry about in Cancer World without adding a concern about the available number of clinicians to care for us. A recent article in the Journal of the American Medical Association (JAMA), said this: The growth in the number of patients with cancer and cancer survivors in the United States is greatly outpacing the number of clinicians available to care for them. Although age-adjusted cancer incidences and mortality rates are decreasing in the United States, population growth and aging have contributed to a substantial increase in patients requiring cancer care and survivorship care.
The very good news about improving cancer treatments is that more and more of us are surviving the disease and going on to have long and healthy lives. In 2016, there were 15.5 million cancer survivors in the United States. The estimate is that in 2026, there will be 20.3 million. Most people can, after a number of years, stop seeing their cancer doctors and comfortably continue their medical care with their PCPs or other specialists. The understanding is that, should there be a cancer-related worry, they can come back. Some people, due to more complicated care of other medical issues or long-lasting side effects from cancer treatment, do need to continue with their oncologists. And some people just like the reassurance of checking in with their oncologist once a year even if there is no pressing medical reason to do so.
In the not-so-distant future, this may become apparent with longer wait times, less frequent appointments once treatment has been concluded, and more crowded waiting areas. I hear that there are now sometimes waiting lists for chairs in the Infusion Area, and I know that hiring experienced chemotherapy nurses is challenging.
Most of us are aware of the changes in health care and the growing pressures on health care providers to deliver the best care in the very fast-paced environment. Mostly gone are the days when we could spend a comfortable 45 minutes or an hour with our oncologist, talking both about our health and our lives. We miss this, but I promise you that our doctors miss it, too. One of the rewards of working in Oncology, and this is true for nurses and social workers as well, is the long-term relationships that we develop with our patients. In so many medical specialties, patients visit a doctor only a few times and then never need to see her/him again. Oncologists, and oncology social workers, treasure the connections with people whom we have known for years and shared our lives.
The anticipated shortage of oncology clinicians is greater is some parts of the country than others. In Boston, there are always more professionals interested in any job than can possibly be hired. In more rural or seemingly less desirable areas, that is not the case. We know that the first large group of oncologists and other clinicians, who were trained in the 1970s and 1980s, are retiring, and equal numbers of young people are not opting for this specialty.
This is not a crisis at this time, but it is a problem that will have to be addressed in the future. At this point, consider this only FYI.