The increasing demand for cancer care is causing cancer centers to face a new challenge—workforce shortages. The critical shortage of oncology professionals threatens our ability to provide comprehensive cancer services, including access and quality across the continuum of research and care.
Nearly all of the professional disciplines who play a key role in cancer care are experiencing shortages, including physicians, nurses, social workers, pharmacists, public health workers, researchers, technologists, and cancer registrars. Like the general population, cancer health care professionals are aging and fewer people are choosing careers in oncology. U.S. baby boomers started retiring in 2008 and nearly 76 million will retire over the next 10 years. The Census Bureau describes this occurrence as the largest exodus from the U.S. workforce by a single generation.1
The Institute of Medicine's National Cancer Policy Forum hosted a workshop in October 2008 that resulted in the April 2009 publication of Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century.2 This report has prompted a national discussion about the impending workforce crisis and a number of cancer organizations to examine how to sustain a cancer workforce.
As a member of the C-Change Advisory Committee on Sustaining a Strong National Cancer Workforce, I have been working with other organizational leaders to develop a coordinated national strategy to ensure the capacity and skills of the cancer workforce. Founded in 1998, C-Change is the only organization that assembles key cancer leaders from the three sectors (private, public, and not-for-profit) and from across the cancer continuum (prevention, early detection, treatment, and quality of life).
Its mission is to eliminate cancer as a major public health problem at the earliest possible time by leveraging the expertise and resources of a multi-sector membership. C-Change members identify opportunities for collective action that no other organization is undertaking on its own, and apply its unique strength—the collective expertise and resources from leaders in the cancer community, including government, business/industry, and not-for-profit.
The increased demand for care is associated with an aging population at risk for cancer, increased cancer survival, and changes in types of treatment and administration.3 The efforts to sustain a national cancer workforce must include opportunities for expanding the capacity, skills, and coordination of specialists and generalists; developing new models of care and empowering patients and caregivers to strengthen their ability as consumers.
Themes guiding the work of the Advisory Committee incorporated the following:
- Workforce development is a central concern and priority.
- A collaborative effort is necessary to address this issue.
- A national workforce strategy should span the pipeline of workforce development (recruitment, training, licensing, retention), primary and specialty care, the full continuum of cancer care, innovative models of care, and key drivers of research, policy, and practice,
- A complex, comprehensive strategy and prioritized areas for collective efforts are needed to balance short-term and longer-term efforts
The Advisory Committee formed two workgroups: the Framework Workgroup, focused on developing a comprehensive framework for sustaining the cancer workforce; and the Policy Workgroup, focused on unique opportunities for C-Change to act on policy opportunities stemming from the implementation of health reform. This work resulted in A National Strategy to Strengthen the Cancer Workforce: Position Statement and Call to Action.4
The efforts to address workforce shortages by C-Change and other cancer organizations are key to stabilizing the cancer workforce and for ensuring the best care will be available to cancer patients now and in the future.
3. Jemal A, Murray T, Ward E et al. Cancer Statistics, 2005. CA Cancer J Clin 55:10–30, 2005.