1012 - Changes in Employment and Practice Locations among Radiation Oncologists: 2015 - 2023

S. Lu¹, K. Sindhu², and J. P. Rowley³; ¹SUNY Downstate College of Medicine, Brooklyn, NY, ²Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, ³Department of Radiation Oncology, Maimonides Cancer Center, Brooklyn, NY

Purpose/Objective(s): An increasing number of radiation oncology residents have entered the workforce in recent years at a time in which the practices that employ them have experienced waves of consolidation. However, there has been no nationally representative quantitative analysis of changes in practice patterns among radiation oncologists (ROs). This study aims to examine trends in practice consolidation in radiation oncology, characterize the extent to which ROs have been entering and leaving the workforce, and identify the proportion of ROs who have changed employers or practice locations since 2015. Materials/

Methods: We utilized the Medicare Provider Data Catalog to evaluate the employers and practice locations of ROs who practiced between 2015 and 2023. Employers were identified as group practices 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 one RO and = 10 ROs, respectively. Further analyses were conducted based on practice size, location, and physician graduation year. The first two years (2015 and 2016) and last two years (2022 and 2023) were removed from our analysis on how many practitioners retired or entered the workforce due to lags in data.
Results: While the number of organizations that employed ROs decreased by 13% (from 1,650 to 1,416) between 2015 and 2023, the number of practicing ROs increased by 16% over the same time period (from 4,399 to 5,087). Over the same period, the number of large practices increased by 51%, while the number of solo practices decreased by 27%. In addition, ROs retired (mean 2.5% per year, SD 0.6%) and new graduates entered the workforce (mean 4.2% per year, SD 0.4%) at consistent yearly rates. Overall, 610 members (11%) of the radiation oncology workforce retired and 999 (18%) new ROs entered the workforce between 2017 and 2021. Among the 3,703 ROs that were in practice in both 2016 and 2022, 938 (25%) changed both employer and practice locations, and an additional 335 (9.0%) remained at the same practice location but experienced a change in employer (likely representing practice consolidation). In year-to-year comparisons from 2015 to 2023, ROs completely changed employers and practice locations at a mean annual rate of 4.2% (SD 0.7%).
Conclusion: 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 employers and practice locations at relatively consistent rates over the time period examined.