On the supply side, of particular concern are the large number of aging physicians heading into retirement. These physicians are being replaced with a new generation of doctors who prefer to work part-time or in specialties, such as dermatology or neurology, that are less likely to have demanding on-call responsibilities. “Generation X individuals see [fewer] patients. They typically place a greater premium on lifestyle factors than their older counterparts, so that would decrease the amount of supply,” said Dr. Dean Bajorin, Member of the Memorial Sloan-Kettering Cancer Center and Professor of Medicine at Weill Medical College of Cornell University (Hauer et al., 2008).

Although statistics from the Bureau of Labor indicate that health care jobs are going to grow more than twice as fast as non–health care jobs in the next decade, physicians represent a decreasing share of that expanding health workforce (Center for Health Workforce Studies et al., 2008). Mr. Salsberg noted that some health professions, such as nurse aides and home health aides, require a minimal amount of education and training and, as a result, large numbers of these professionals can be graduated quickly to respond to the increasing demands on the health care system. Unfortunately, this is not the case for physicians, who require between 10 and 16 years of education and training. “We’re trying to look at what are the needs going to be in 2015 and 2020, because unless we act now, we’re not likely to meet those future needs,” Mr. Salsberg said.

Assessing the future needs of physicians who provide oncology care includes assessing the future needs of physicians outside of oncology. As Mr. Salsberg noted, a large percentage of patients with cancer do not see oncologists for their cancer care and chemotherapy, because of the unequal geographic distribution and difficulty in accessing an oncologist (Erikson et al., 2007). In addition, a large number of physician sub-specialties besides oncology are involved in treating cancer patients, including gastroenterology, surgery, dermatology, radiology, urology, gynecology, hematology, pathology, pulmonology, and internal or family medicine. Shortages of physicians in many specialties will affect the quality of cancer care.

SHORTAGE OF PHYSICIANS

Many health specialties, including oncology, currently report a shortage of physicians. Despite an expected 21 percent increase in medical school enrollments between 2002 and 2012, the number of residencies has only increased 8 percent over the past 5 years (Salsberg et al., 2008). Dr. Bajorin,



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