Department of Radiation Oncology, Taussig Cancer Institute, Cleveland Clinic, Cleveland, Ohio.
Department of Radiation Oncology, University of Maryland School of Medicine, Baltimore, Maryland.
Int J Radiat Oncol Biol Phys. 2023 Jul 1;116(3):484-490. doi: 10.1016/j.ijrobp.2023.02.056. Epub 2023 Mar 8.
Over the past decade, concerns have arisen in radiation oncology regarding potential workforce supply and demand imbalance. The American Society for Radiation Oncology commissioned an independent analysis in 2022, looking at supply and demand in the United States radiation oncology workforce and projecting future trends for 2025 and 2030. The final report, titled Projected Supply and Demand for Radiation Oncologists in the U.S. in 2025 and 2030, is now available. The analysis included evaluating radiation oncologist (RO) supply (new graduates, exits from the specialty), potential changes in demand (growth of Medicare beneficiaries, hypofractionation, loss of indications, new indications) as well as RO productivity (growth of work relative value units [wRVUs] produced), and demand per beneficiary. The results demonstrated a relative balance between radiation oncology supply and demand for radiation services; the growth in ROs was balanced by the rapid growth of Medicare beneficiaries over the same period. The primary factors driving the model were found to be growth of Medicare beneficiaries and change in wRVU productivity, with hypofractionation and loss of indication having only a moderate effect; although the most likely scenario was a balance of workforce supply and demand, scenarios did demonstrate the possibility of over- and undersupply. Oversupply may become a concern if RO wRVU productivity reaches the highest region; beyond 2030, this is also possible if growth in RO supply does not parallel Medicare beneficiary growth, which is projected to decline and will require corresponding supply adjustment. Limitations of the analysis included uncertainty regarding the true number of ROs, the lack of inclusion of most technical reimbursement and its effect as well as failing to account for stereotactic body radiation therapy. A modeling tool is available to allow individuals to evaluate different scenarios. Moving forward, continued study will be needed to evaluate trends (particularly wRVU productivity and Medicare beneficiary growth) to allow for continued assessment of workforce supply and demand in radiation oncology.
在过去的十年中，放射肿瘤学领域对潜在的劳动力供需失衡问题表示关注。美国放射肿瘤学会于 2022 年委托进行了一项独立分析，研究了美国放射肿瘤学劳动力的供需情况，并预测了 2025 年和 2030 年的未来趋势。最终报告题为《2025 年和 2030 年美国放射肿瘤学家的供需预测》，现已发布。该分析包括评估放射肿瘤学家（RO）的供应（新毕业生、专业退出）、潜在需求变化（医疗保险受益人的增长、少分割治疗、适应症丧失、新适应症）以及 RO 的生产力（相对工作价值单位 [wRVU] 的增长）和每个受益人的需求。结果表明，放射肿瘤学服务的供需之间相对平衡；RO 的增长与同期医疗保险受益人的快速增长相平衡。推动该模型的主要因素被发现是医疗保险受益人的增长和 wRVU 生产力的变化，少分割治疗和适应症丧失的影响只有适度；尽管最有可能的情况是劳动力供需平衡，但方案确实表明了供需过剩和不足的可能性。如果 RO 的 wRVU 生产力达到最高水平，可能会成为供应过剩的问题；如果 RO 供应的增长与医疗保险受益人的增长不同步，超过 2030 年也可能出现这种情况，预计医疗保险受益人的增长将会下降，这将需要相应的供应调整。分析的局限性包括对 RO 实际数量的不确定性、缺乏对大多数技术报销的纳入及其影响以及未能考虑立体定向体部放射治疗。有一个建模工具可供个人评估不同的情景。展望未来，需要继续研究趋势（特别是 wRVU 生产力和医疗保险受益人的增长），以继续评估放射肿瘤学的劳动力供需情况。
