Oncologists Need to Rely Upon NPs, PAs, and NPPs to Overcome Workforce Problems

There is a workforce problem in health care and cancer care, specifically. This is precisely why Eric P. Winer, MD, believes the system needs to embrace and incorporate nurse practitioners (NPs), physician assistants (PAs), and advanced practice providers (APPs) into the care model.

Regarding this problem in the workforce, Winer mentioned that 23% of oncologists are 64 years or older and nearing retirement age, while only 14% of oncologists are under the age of 40. These numbers came from a snapshot of the oncology workforce published in the Journal of Clinical Oncology. Though these numbers may not directly reflect what changes may happen to the workforce, Winer reiterated that the workforce does still need to expand.

One of the major reasons for this, according to him, is that as treatment has become more advanced and improved survival outcomes, patients have started to live longer and require treatment for longer durations of time.

Compared with when Winer was a younger breast cancer doctor and there were far fewer options for treatment, now the available resources make it so patients with active cancer can live for anywhere from 5 to 20 years.

Winer is the director of Yale Cancer Center, president and physician-in-chief at Smilow Cancer Hospital, deputy dean for Cancer Research and Alfred Gilman Professor of Pharmacology and Professor of Medicine at Yale School of Medicine, chair of the association board for the American Society of Clinical Oncology, and one of the authors on the survey.

Transcript:

We have a workforce problem, which is part of the reason why we need to embrace [NPs] and PAs, or APPs. We need to incorporate them into the care model. There are more oncologists who are nearing retirement age; I’m told, based on ASCO [American Society of Clinical Oncology] work, that 23% of oncologists say they’re nearing retirement age, whereas only 14% are under the age of 40. Now, I don’t know that those 2 groups are equal, so there may be people in their late 50s who are going to work for another decade who say they’re nearing retirement age. We are concerned about the fact that, if anything, the oncology workforce needs to expand, because people are living longer with active cancer, and they need care—there’s that much more we can do for people. There’s not necessarily an increase in the number of people going into oncology.

When I was a young breast cancer doctor, we didn’t have a lot of treatments. No.1, everything was much simpler because there were only a few choices, and No. 2, because we only had a few choices, people didn’t live as long when they had incurable cancer. Now, there are people who live for 5, 10, 15, and 20 years with active cancer. Our practices get filled up, not by new patients, but by all the people who need care and that we’re taking care of.

References

2023 snapshot: state of the oncology workforce in America. JCO Oncol Pract. 2025;21(3):438. doi:10.1200/OP.24.00262