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Hospitalists and Nonphysician Providers Can Step Into the Breach

Andrew D. Seidman, MD
Published: Tuesday, Mar 13, 2018

Andrew Seidman, MD

Andrew Seidman, MD
I offer a prespective from the field— the musings of a medical oncologist who has spent a quarter of a century in an academic clinical practice and has witnessed a major evolution, not only in cancer treatment, but also in the models by which we deliver cancer care. Here, I will focus on my view of the increasing role of nurse practitioners (NPs) in the outpatient setting and hospitalists in the inpatient setting. Physician assistants (PAs) also have been integrated into many areas of oncology care, where they make important contributions. I hope that what follows might resonate with you or suggest previously unconsidered opportunities.

Integrating an NP Into a Medical Oncology Practice

The American Society of Clinical Oncology projects a shortage of medical oncologists over the next 5 to 10 years, and the demand for visits is expected to increase far above capacity by 2020— to 300% of the available appointment slots.1 Nonphysician practitioners (NPPs) or advanced practice providers (APPs) have increasingly been integrated into clinical care, requiring a thoughtful reassessment of team-based approaches toward optimizing resource utilization and improving the quality of care. Five years ago, the American Academy of Physician Assistants reported that there were approximately 2140 clinically practicing PAs in adult medical, surgical, and radiation oncology subspecialties.2 Similarly, the American Association of Nurse Practitioners reported that of the more than 205,000 licensed NPs in 2013, approximately 2050 worked in oncology.3 These were a median of 48 years of age and had been in practice for an average of 7.7 years.
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