Nurse Practitioners and Physicians Assistants Are Effective Solution for Future Oncology Services Demands

One effective way to manage the projected oncology workforce shortage is to increase the role of nurse practitioners and physician assistants in oncology practices, according to a new American Society of Clinical Oncology (ASCO) study, “Study of Collaborative Practice Arrangements” (SPCA), published September 15, 2011 in the Journal of Oncology Practice.

“This study shows that practices are extending oncology services by promoting a collaborative practice with nurse practitioners and physicians’ assistants. In pediatric oncology, nurse practitioners are already an integral part of our practice and are indispensable,” said Michael P. Link, MD, President of ASCO.

A 2007 ASCO study estimated a shortage of up to 4000 cancer specialists by 2020. Over the next decade, the need for oncologist visits is expected to rise by 48%, yet the number of oncologists will grow by only 14%. This is due to the fact that Americans aged 65 and older will double by 2030. Plus, survivors of and those living with cancer will increase by 81%.

To determine if the increased use of non-physician practitioners (NPPs) in an oncology practice was a possible solution for narrowing the gap between oncology services supply and demand, ASCO commissioned the SPCA in 2009. Thus, an independent national survey was conducted involving 226 community and hospital-based oncology practices. Results of the survey identified 33 diverse practices for participation in a subsequent survey of physicians, NPPs, and patients. After the second round of surveys, additional information was collected via focus groups and individual interviews with NPPs.

The practice model prevalent in both survey results is one in which the patients are routinely seen by the NPP independently of the physician, but with the physician always present in the office. In the second survey involving the 33 diverse practices, almost all of the patients (98%) acknowledged that they were seeing an NPP instead of a physician, and their overall satisfaction was high at 92.5%. Furthermore, there was a 19% increase in productivity in practices where the NPPs see a wide range of patients and work with all practice physicians compared to practices in which NPPs work solely with one or more physicians in the practice.

“Patients’ high degree of satisfaction with the care they received, as well as professionals’ satisfaction with the delivery of cancer services, shows that coordinated and integrated cancer care provided by both oncologists and non-physician providers is a very successful model,” said Dean Bajorin, MD, co-chair of ASCO’s Workforce Advisory Group. “Additional measures such as establishing formal oncology training for nurse practitioners and physician’s assistants will help us enhance efficiency and patient experience as oncology practices address the increased demand for cancer services nationwide.”

Source: ASCO.