Changes in Employment and Practice Locations Among Radiation Oncologists: 2015-2023

Previous population-based studies of practice patterns among radiation oncologists (ROs) have focused on the overall supply of ROs rather than rates of job entry, turnover, and retirement, and have been limited to survey-based data. In this study, we aimed to examine trends in practice consolidation, characterize the frequency with which ROs have been entering and leaving the workforce, and quantify the proportion of ROs who have changed jobs.

We used the Medicare Doctors and Clinicians National Downloadable File to evaluate the employers and practice locations of ROs who practiced between 2015 and 2023. Employers were identified using tax identification numbers and organization names. In addition, we determined the number of ROs who entered, stayed in, and left practice from year to year, and the number of ROs who changed employers and zip code. Solo and large practices were defined as employing 1 RO and ≥10 ROs, respectively.

The number of large practices increased by 51% and the number of solo practices decreased by 27% between 2015 and 2023, resulting in a 13% decrease in the number of organizations that employed ROs. In addition, ROs retired (2.5% per year) and entered the workforce (4.1% per year) at steady rates, resulting in a 16% increase in the size of the RO workforce. Lastly, ROs changed jobs at a mean annual rate of 4.2%; female ROs, early career physicians, solo-practitioners, and ROs from rural practices were most likely to undergo job changes.

ROs are increasingly working in fewer and larger practices, indicative of a trend in practice size consolidation between 2015 and 2023. Rates of entry into and retirement from the workforce among ROs have been consistent, resulting in a steady and gradual increase in the number of practicing radiation oncologists. Lastly, ROs changed jobs at relatively consistent rates over the study period.