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ASTRO Radiation Oncologist Workforce Study Shows Demographic Shifts

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The newest study of America’s radiation oncologist workforce finds that gender and racial gaps have narrowed slightly, although persistent and growing geographic disparities point to a need for more equity in access to radiation therapy care. The survey found that fewer radiation oncologists are practicing in rural communities, and that these doctors are more likely to retire in the coming years. Results of the American Society for Radiation Oncology (ASTRO) 2017 Radiation Oncologist Workforce Study were published by Fung et al in the International Journal of Radiation Oncology • Biology • Physics, and an infographic summarizing the results is also available.

ASTRO conducts workforce studies to identify trends in provider demographics, employment, and technology use, as well as to assess the profession's ability to meet patient needs. The 2017 survey was conducted online, and findings reflect responses from 1,174 radiation oncologists representing 726 practices (31% response rate).

Key Findings

Shift from rural to suburban and urban locations: Nearly 9 in 10 radiation oncologists work in urban or suburban communities (47% and 41%, respectively). Since the previous workforce survey in 2012, the proportion of rural radiation oncologists declined from 16% to 13%, indicating that rural access to radiation therapy services may be under threat.

The trend may be exacerbated by disproportionately more physicians leaving the rural workforce and fewer new physicians taking positions in these communities. Nearly 30% of radiation oncologists in rural communities plan to retire or reduce hours in the next 5 years, compared to 18% of urban/suburban physicians. Moreover, surveys of recent radiation oncology graduates point to growing demand for jobs in major cities coupled with waning demand for those in smaller cities.

Movement toward gender equity: The number of female radiation oncologists edged up 3% from the previous survey, from 26% to 29%. Women also are more common in newer cohorts within the workforce; female physicians were 33% of radiation oncologists under age 40, 30% of those in their 40s and 50s, and 22% of those aged 60 and up.

Shift from private practice to academic hubs: Radiation oncologists also are shifting from working primarily in private practice to treating patients at academic centers and hospitals. The 2017 survey marks the first time that fewer than half of these doctors work in private practice (38%), with 41% practicing at academic/university centers and 17% at nonacademic hospitals.

Widespread adoption of new technology: 95% of practices offer hypofractionated radiation therapy, providing their patients a more convenient treatment option without increasing the risk of side effects or the cancer returning. The most common tumors for hypofractionation include breast tumors (94% of practices), bone metastases (92%), and brain metastases (74%). Clinics also increased adoption of advanced technologies and techniques for providing radiation therapy treatments, such as stereotactic radiation and real-time image guidance.

“In some ways, the radiation oncology workforce is changing to look more like the patients we treat. The modest but noticeable increases in the number of women and racial/ethnic minorities, for example, indicate that our field is moving toward more equity,” said Claire Y. Fung, MD, Chair of the ASTRO Workforce Subcommittee, which conducted the study, and a radiation oncologist at Beth Israel Deaconess Medical Center. “The shifts in employment patterns and the movement from rural practices to urban hubs, however, point to possible areas of disparity in access to care. Studies such as this one help ASTRO and other health-care groups recognize these threats and address them proactively.”

Disclosure: The study authors’ full disclosures can be found at redjournal.org.

The content in this post has not been reviewed by the American Society of Clinical Oncology, Inc. (ASCO®) and does not necessarily reflect the ideas and opinions of ASCO®.


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