Oncology Rounds

Juggling workforce concerns in your cancer center? You're not alone.

by Aasheen Qadri and Emily Heuser

Cancer programs are juggling rising patient volumes and increasingly specialized roles—both of which contribute to the rising demand for oncology providers. The oncology workforce, which with a median age of 51 years for practicing oncologists is already older than other specialties, faces unique challenges with staffing, capacity, and burnout that contribute to program leaders' concerns for future growth.

To learn more about these and other challenges, we surveyed over 125 cancer programs in our 2019 Trending Now in Cancer Care survey—and here's what we found out.

Staff shortages, retention are top-of-mind for cancer program leaders and planners

Thirty-two percent of survey respondents ranked workforce planning, which includes managing staff shortages, staff recruitment, and staff retention, within the top five biggest threats to future program growth at their organization. Managing physician and staff burnout was selected as a top five threat by 21% of respondents, suggesting that recruiting and maintaining staff numbers is a larger workforce challenge than managing the quality of staff experience. These rankings are perhaps unsurprising, given that oncology performs better in staff engagement and burnout management compared to other service lines—though not perfect, this is an area where oncology is already doing relatively well.

Three quarters of cancer leaders concerned with workflow inefficiencies

When asked about typical workday concerns, survey respondents overwhelmingly cited workflow inefficiencies (75%), followed by concerns about heavy workload (58%), complaints from staff about their workloads and burnout (58%), and lack of work-life balance (40%). It's interesting to note that staff burnout and heavy workloads are within the top three concerns for a typical workday, despite not ranking as a major threat to the future of program growth. This suggests that staff engagement and burnout should demand more heightened attention from cancer program leaders but may be currently viewed as less threatening than other financial concerns.

We also asked about the top five concerns related to workforce planning. Clinician burnout was the most commonly cited concern, with 58% of respondents selecting it as one of their top five concerns, followed by challenges with staff engagement (54%), siloed communication between departments (47%), and challenges reaching top-of-license practice (47%). Clinician workforce shortages also ranked highly, with 42% of respondents including it as one of their top five concerns, while non-clinician burnout and workforce shortages were less of a top concern. We anticipate concerns about workforce shortages increasing as patient volumes rise and physicians continue to age.

Planned addition of clinician roles across the next year

Concerns about clinician burnout and overall staff engagement make even more sense when you consider bandwidth concerns and patient access to various staff roles. Medical oncologists and oncology nurses were perceived to have the least bandwidth by survey respondents. Accordingly, the most common staff additions planned for the next year include medical oncologists (52% of respondents plan to add) and oncology nurses (44% of respondents plan to add).

In addition to clinician roles, many respondents reported concerns about patient access to a variety of roles that are typically major patient satisfiers. Forty-nine percent of respondents cited concerns about the bandwidth of financial advocacy staff, whose roles have grown even more important in light of the rising costs of cancer care. Cancer programs realize that they need to take more responsibility for helping patients navigate the financial burden of cancer but continue to struggle in meeting patient demand. Despite this, only 32% of respondents plan to add more financial advocacy staff within the next 12 months.  

Check out our financial navigation resources to learn how to you can better support your patients

Use our staffing model research to craft a cohesive and collaborative cancer care team

In general, cancer programs view staffing as a high-priority area of investment, not as an opportunity to cut costs. When asked about their biggest opportunities for cost savings, survey respondents were least likely to select not hiring or replacing clinical staff (6%), reducing non-clinical staff (4%), or freezing salaries (2%). Interestingly, non-clinical staff ranked higher as an opportunity for cost savings in our 2018 survey, suggesting that the importance of non-clinical staff in the oncology space has increased. Workforce dynamics will be a continued area of focus in the future, and cancer programs should be prepared to adapt employee recruiting and management strategies to reflect the needs of patients and current staff members.

For more information on the 2019 Trending Now in Cancer Care survey, check out the Oncology Roundtable's insights and the Association of Community Cancer Centers' blog.

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