Practice Patterns: Young Oncologists Seek Benefits of Larger Practices, Hospitalist Jobs

Victoria Stern, MA


December 17, 2014

In This Article

Oncologists Feel Financial Pressure

Oncology practices cited financial pressures as the greatest threat to their ability to continue providing high-quality care, according to the 2013 American Society of Clinical Oncology (ASCO) National Oncology Census.[5] Many respondents also said they were cutting back on support staff or clinical research, or were sending patients to hospitals to receive chemotherapy as a result of cost pressures.

Additionally, a survey conducted by two healthcare software companies, CareCloud and QuantiaMD, found that the top worries for physicians in private practice included declining reimbursement (65%) and rising costs (57%), such as those associated with the adoption of EMRs (26%).[6] Of the 5000 physicians surveyed, 36% anticipated a decline in profits for private practices within the year, while only 22% predicted a positive trend.

Such financial concerns may have begun to emerge after the federal government enacted the Medicare Modernization Act of 2003, which significantly lowered the Medicare reimbursement formula for chemotherapy drugs, leaving many smaller oncology clinics and private practices unable to survive financially.

"Oncologists saw very quickly how one decision from the federal government could drastically reduce their income level," said Futch. "This was one of the first shockwaves that went through the oncology community that made many oncologists less risk-averse and more likely to seek employment with more stability."

These government cuts pushed many oncology practices to combine with larger entities or shut down. According to the census, two thirds of small practices surveyed said they may need to close, merge, or sell in the next year, and between 2012 and 2013, the number of private community practices fell by approximately 25%, from 335 to 253. Another recent study[7] published in Health Affairs found that, among physicians filing Medicare claims, 35.6% worked in groups of more than 50 in 2011, up from 30.9% in 2009. Similarly, the ASCO census reported that the average practice size increased from a median of 15 physicians in 2013 compared with 9 in 2012, and that 26% of practices surveyed said they would probably affiliate with a community hospital within the year, compared with 15% in 2012.


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