Medical Oncology Workload in Europe: One Continent, Several Worlds

Abstract

Aims: The workload pressure on medical oncologists will increase in the near future. There are no comprehensive data available about the current workload of medical oncologists in Europe. Here we report the European results of a global survey of the workload of medical oncologists. Materials and methods: An online survey was distributed through a snowball method via national oncology societies to chemotherapy-prescribing physicians in 21 European countries. We compared the workload of medical oncologists in Eastern European countries (EECs) and Western European countries (WECs). The primary measure of workload was the annual number of new cancer patient consults seen per oncologist. Results: In total, 495 oncologists from 16 European countries completed our survey: 100 from seven EECs and 395 from nine WECs. The median number of annual consults per medical oncologist was 225 in EECs compared with 175 in WECs (P < 0.001). The proportion of medical oncologists seeing more than 300 consults/year was 35% (35/100) in EECs compared with 18% (68/395) in WECs. The median number of patients seen in a full day clinic was 25 in EECs and 15 in WECs (P < 0.001). Eastern European medical oncologists reported spending a median of 25 min per new consultation compared with 45 min in WECs (P < 0.001). The top two reported barriers in both EECs and WECs to patient care were high clinical volumes and insufficient time for reading. Conclusion:The clinical workload of medical oncologists in EECs was substantially higher than in WECs. European health policymakers and educators need to address existing disparities in the workload of medical oncologist, undertake plans for future workforce supply and consider alternative models of care.

Distribution of the workforce involved in cancer care: a systematic review of the literature

“…24 , 25 , 26 For example, a rise in cancer cases with a paucity of providers can produce an increased workload for the single providers and lower job satisfaction. 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 One study has shown that the annual case volume in LMs is 2.4 times higher than in HICs, where 40% and 7% of medical oncologists see >500 annual consults, respectively. 28 This is one determinant of the high attrition rate of health providers in LMs.…”

Please mind the gap—about equity and access to care in oncology

“…Seruga et al. 25 reported disparities in clinical oncologist workload around Europe with a significantly higher workload of medical oncologists in Eastern European countries (EECs) than in Western European countries (WECs). This was reflected by a higher median number of annual consults (225 in EECs versus 175 in WECs, P < 0.001), daily consults (25 in EECs versus 15 in WECs, P < 0.001), and the time spent per patient (25 min per new consultation in EECs versus 45 min in WECs).…”

Digital Patient-Reported Outcome Measures for Monitoring of Patients on Cancer Treatment: Cross-sectional Questionnaire Study

“…Oncology is a predominantly outpatient specialty; hence, the increases in outpatient activity are of particular relevance. There has been an increase in National Health Service (NHS) outpatient appointments in England from 63.2 million to 118.6 million in the 10-year period ending between 2016 and 2017 [1] and projected significant increases in the demand for oncology services in both the United States [2] and Europe [3]. Growing service pressures on oncology outpatient activities are specifically driven by increased cancer incidence [4], improved survival rates [5], and an expanded treatment repertoire [6].…”

“…Current pressures on outpatient services have been stated to negatively affect patient and clinician experience [7]. Furthermore, global workforce shortages are increasing and are predicted to increase further [2,3,8]. Therefore, the outpatient system will struggle to continue to offer the capacity to deal with the increasing demand in its current traditional form.…”