BCOPs: Bridging the Gap in Oncology Patient Care

Andrea_Iannucci

Because of the aging population and the rising incidence of cancer it is expected that in the next 5-10 years, there will be a shortage of oncology physicians in the US.   In 2007 the American Society of Clinical Oncology (ASCO) reported that by 2020, the increased demand for oncology services would exceed the increased supply of oncology physicians by about 34%1.  In a 2014 update, ASCO confirmed the earlier information, predicting a shortfall in the number of oncology providers to keep up with the increasing demand for oncology services2.  They estimated that by 2025 there will be a 40% increase in the need for oncology services with only a 25% increase in the number of oncology physicians2.  The net result amounts to an estimated shortage of approximately 2300 FTE’s in oncology physicians2.  ASCO’s assessment of the situation is that oncologists will need to partner with more Non-Physician Practitioners (NPP), such as Nurse Practitioners and Physician Assistants in order to meet the needs of the ever-increasing population of oncology patients.

Wait a minute!  What about oncology pharmacists?  Aren’t we capable of some collaboration with oncologists to help meet the increasing needs of our cancer patient population?

In effort to address that aspect of the situation, Bob Ignoffo, a leader in oncology pharmacy practice and one of my personal mentors, asked just that question.  Dr. Ignoffo assembled an expert panel of seasoned and highly accomplished BCOP’s to determine the feasibility of BCOP’s playing a part in the team of NPP’s that might be able to help offset the shortage of oncology physicians.  The study was reported in the April 1, 2016 edition of the Journal of Oncology Practice3.   The BCOP’s identified several patient care services that could be provided by oncology pharmacists, including:

 

·  Assessing response/toxicity to treatment

·  Adjusting treatment plans based on response/toxicity/organ dysfunction

·  Management and prevention of treatment-related toxicities (e.g. nausea/vomiting, myelosuppression)

·  Managing anticoagulation therapy

·  Managing patients on clinical trials

·  Symptom management

·  Patient education

·  Medication reconciliation

 

In this novel assessment, Dr. Ignoffo and his colleagues calculated the approximate number of BCOP’s practicing in the United States currently and extrapolated the number out to 2020, based on the current trajectory of BCOP’s in the US.  Using this strategy, they estimated that academic or office-based BCOP’s could participate in 2.5-3.5 million 30-minute patient visits by the year 2020 (with 50% availability).3

By my calculations, if you estimate 2080 hours in a full year FTE, that could translate to as many as 600-1200 additional FTE’s in the oncology patient care work force.  Certainly, a BCOP isn’t qualified to take the place of an oncologist.  But, when teamed up with an oncologist or other NPP, BCOP’s are exquisitely qualified to perform the various services listed above and could certainly take on a significant portion of oncology patient care visits to provide additional expert support so desperately needed for the successful management of this complex patient population.

 

Andrea Iannucci, Pharm.D., BCOP

Assistant Chief Pharmacist,

Oncology and Investigational Drugs Services

UC Davis Medical Center

Clinical Professor, UCSF School of Pharmacy, UC Davis School of Medicine

 

References:

  1. Erikson C, Salsberg E, Forte G, Bruinooge S, et al. (2007) Future supply and demand for oncologists: Challenges to assuring access to oncology services. J Oncol Pract, 3:79–86.
  2. Yang W, Williams JH, Hogan PF, Bruinooge SS, et al. (2014) Projected Supply of and Demand for Oncologists and Radiation Oncologists Through 2025: An Aging, Better-Insured Population Will Result in Shortage. J Oncol Pract,10:39-45.
  3. Ignoffo R, Knapp K, Barnett M, Barbour SY, et al. (2016) Board-Certified Oncology Pharmacists: Their Potential Contribution to Reducing a Shortfall in Oncology Patient Visits. J Oncol Pract, April 2016:e359-e368.