Wednesday, March 14, 2007

March 14, 2007 - A Doctor Shortage?

News articles about the aging of my own "baby boomer" generation abound. The news media has been sounding that particular drumbeat for so long, I hardly notice it any more. Yet, one article I saw today made me sit up and take notice.

It comes from Newsweek, and has to do with a predicted shortage of oncologists in the years to come. It's not that the absolute numbers of these specialists is decreasing (although the article does talk about "a slowing growth in the supply"). The bigger issue is that the demand for their services is going up.

Three factors seem to be exacerbating the problem. First, as we boomers age, there are getting to be more older people in general – and we all know that, statistically speaking, the likelihood of contracting cancer increases with age. Second, people who do have cancer are living longer – a good thing, to be sure, but it also means that oncologists' relationships with their patients are continuing over much longer periods. Third, as cancer treatment becomes more complex, fewer and fewer family-practice physicians are directly involved in treating cancer patients. Nearly all cancer patients are now being referred to oncologists, who manage most aspects of their care.

As the doctor shortage worsens, it will become harder to get an appointment with an oncologist in the future. Some oncologists may begin referring patients back to their primary-care physicians for some aspects of their care, with the oncologist consulting from a distance – although the continuing trend toward highly-specialized cancer treatments makes this move problematic.

The Newsweek article also reports on a troubling personal characteristic of many younger doctors entering the oncology field today: they evidently don't have as strong a work ethic as their elders. Younger oncologists see significantly fewer patients per week, on the average. Some are intending to retire early, and others are seeking to work part-time during certain phases of their careers.

I'm aware of how hard Dr. Lerner works to keep up with his roster of patients – and, in talking with other cancer survivors, I hear similar stories about their own doctors. The need is great, and growing bigger all the time. The medical establishment is only just beginning to wake up to this looming problem, and to take steps to address it (increasing the number of oncology residency slots in teaching hospitals, for example).

A year ago, slogging though chemotherapy side effects, I was wondering whether my treatments would succeed in putting me into remission. The fact that I now have the luxury of worrying whether, years into the future, I'll still be able to get in to see my oncologist speaks volumes about how far I've come. Yet, it's a worry, all the same.