Journal of Clinical Oncology, Vol 14, 2612-2621, Copyright © 1996 by American Society of Clinical Oncology
Status of the medical oncology workforce. The American Society of Clinical Oncology
PURPOSE: A survey was designed to determine accurately the number of
full-time equivalent medical oncologists in the United States, to determine
how medical oncologists in different work settings divide their
professional activities, and to determine whether medical oncology
represents a primary care specialty in the minds of practicing oncologists.
METHODS: A questionnaire was mailed to the 4,239 members of the American
Society of Clinical Oncology (ASCO) who identified themselves as medical
oncologists or hematologists/oncologists and were current residents of the
United States. Follow-up letters, which included a second copy of the
questionnaire, were sent to nonresponders. A third mailing, followed by a
telephone reminder, was sent to a randomly selected subset of 300
nonresponders to be certain that the initial responders were similar in
practice patterns and attitudes to those individuals who had not initially
completed the survey. RESULTS: A total of 2,540 physicians responded to the
first mailing and an additional 187 to the second (64% response rate); a
further 196 individuals who were directly contacted completed the survey
document. Practitioners appear to see 160 to 200 different patients per
month and to devote approximately 72% of their time to patient care
activities. Research and teaching comprised only 3% to 4% of professional
time for physicians in private practice or Health Maintenance Organization
(HMO) settings, in contrast to 16% for those who worked in community
hospitals. Medical oncologists frequently serve the role of principal care
giver while patients are undergoing cancer treatment. However, medical
oncologists devote minimal time providing primary care services to patients
and, if required to increase their clinical volume, would prefer to care
for more cancer patients than enhance their primary care activities. It is
estimated that the present full-time equivalent number (ie, the
conglomorate number of oncologists based on 100% professional effort
devoted to clinical care) of medical oncologists is approximately 3,600
individuals. This translates into 1.8 medical oncologists per 100,000 adult
Americans. CONCLUSION: The medical oncology community devotes the majority
of its time to providing oncologic patient care and does not provide or
appear to wish to provide what the public defines as primary care. The
survey estimate of 1.8 medical oncologists per 100,000 adult Americans is
in close accord with HMO estimates of the number of desired oncologists.
Consequently, the supply appears consistent with the anticipated demand.
There does not appear to be an oversupply of medical oncologists in the
United States.
