Rural Oncologists' Perceptions of Specialty Scarcity and Repercussions for Care Delivery: A Qualitative Study

Area of Science:

• Oncology
• Health Services Research
• Rural Health

Background:

• Specialist physician shortages are a growing concern in healthcare.
• Rural areas often face greater challenges in accessing specialized medical care.

Purpose of the Study:

• To explore oncologists' experiences with specialist scarcity.
• To identify strategies used to manage care during shortages.
• To understand the impact of shortages on patient care and physicians.

Main Methods:

• Semistructured interviews were conducted with 20 oncologists.
• Participants practiced in health systems serving rural populations.
• Thematic analysis was used to analyze interview data.

Main Results:

• Physician shortages affected care team expertise, collaboration, and patient volume.
• Oncologists employed strategies like external referrals, practicing outside subspecialty, and time reallocation.
• Consequences included increased patient travel, delayed/suboptimal treatment, reduced clinical trial access, and physician burnout.

Conclusions:

• Oncology physician shortages create complex challenges for patient care delivery.
• Adaptive strategies have significant downstream effects on both patients and physicians.
• Understanding these impacts is crucial for resource allocation and mitigating negative consequences.