Is the consolidation of private oncology practices continuing at full throttle? What are the barriers to using nonphysician practitioners (NPPs), and are they the solution to the expected oncologist shortage? Can enhanced team-based care solve some of the problems in cancer treatment? At the annual meeting of the American Society of Clinical Oncology (ASCO), three clinicians discussed these and other practice issues at a session titled, "Trends, Anecdotes, and Predictions: Oncology Practices Today."
National Oncology Census
Anupama Acheson, MD, past chair of the ASCO Clinical Practice Committee, and an oncologist at Providence Cancer Canter, Portland, Oregon, presented results from the 2014 ASCO National Oncology Census.[1] Several years ago, members of the oncology community began voicing concerns about significant shifts in oncology care from private practices to academic- and hospital-based practices. In response, ASCO launched the first annual National Oncology Census in 2012. The aim of the census was to understand where hematologists and oncologists were practicing and the different characteristics and challenges they faced, including economic constraints, competition, and administrative burden.
The 2014 survey involved 1253 respondents from 974 practices.[1] The largest number of respondents hailed from physician-owned practices, followed by hospital/health system-owned practices and academic practices.[1] "More than 70% of responding practices said they were unlikely to be making any major shifts, with only 4% of practices planning to close or sell and only 5% planning to buy another practice," said Dr Acheson. In terms of the physician-owned practices, 6% planned to close or merge, 7% planned to sell, and 4% planned to buy another practice. The census showed that younger oncologists are far more likely to work for larger practices than smaller ones.
Figure 1.
In the last 3 years of the annual census, the biggest concerns voiced by oncologists have been payer issues, cost pressures, competitive pressures, and drug pricing.
"Hospital-based and private practices tended to indicate financial pressures being their biggest concern, while academic practices tended to indicate that research and staffing issues as well as competitive pressures were their concerns," said Dr Acheson.
Figure 2.
With each successive year of the ASCO National Oncology Census, there has been a shift away from private practice, but there is less change than in previous years. "The 2014 census appears to show that the rate of the shift has slowed, with less practices planning major shifts," said Dr Acheson. "I think this reflects that there has already been a significant shift away from private practice to the aligned and consolidated, with few private practices remaining in the United States."
Figure 3.
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Cite this: Practice Trends for Community Oncologists - Medscape - Jun 26, 2015.
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