This is a time of great change for physicians and medical care. Oncologists, for example, have to deal with constantly changing standards of treatment due to the tremendous body of research on causes and treatment of cancer. While many practices generated a fair amount of income from drug sales a couple of years ago, reimbursement changes have made that harder. A report from the Journal of Oncology Practice, affiliated with the American Society of Clinical Oncology, gives a perspective on issues in oncology practices. (Oncology Report) This is the seventh year of the report, which surveyed about 100 practices. The practices averaged 8 physicians and three sites. One trend, not unique to oncologists, was toward more hospital ownership and employment. While 76% reported being in a private practice and 14% hospital owned, that was a significant increase from last year in hospital employment.
The most pressing issues for oncology practices are competition, cost of running the practice, and reimbursement pressure from payers. While they generally do not make the money they used to selling drugs, most practices continue to use the buy and bill method of providing drugs to patients. Most use an EHR, with ones tailored for oncology practices leading the way. While most oncology groups use practice guidelines and clinical pathways, they are often generated by the practice itself and many practices don’t actually measure whether physicians are complying with them. Costs are rising in a number of categories for oncologists and the physicians tend to work fairly long hours and see a large number of patients, considering how complex cancer care is. All-in-all, an interesting look at some of the details of operating an oncology practice.