First Large-scale Survey of Advanced Practice Providers in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants

For immediate release
August 22, 2018

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Melissa Lee
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Alexandria, VA Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology published today in the Journal of Oncology Practice. The “Understanding the Role of Advanced Practice Providers in the U.S.” study was conducted as a collaboration of the American Society of Clinical Oncology (ASCO), the American Academy of PAs (AAPA), the Association of Physician Assistants in Oncology (APAO), the Advanced Practitioner Society for Hematology and Oncology (APSHO), and the Oncology Nursing Society (ONS).

“Nurse practitioners and physicians assistants are critical healthcare providers in the delivery of quality cancer care,” said ONS Chief Executive Officer Brenda Nevidjon, MSN, RN, FAAN. “This survey is the first step toward better understanding their roles, needs, and challenges in today’s oncology care environment.”

According to data from ASCO’s annual Practice Census, the number of oncology practices in the United States who have reported employing APPs has grown dramatically—from 52% in 2014 to 81% in 2017. However, despite this rapid growth, very little systematic research has been done on the total number of APPs in oncology and their specific roles and responsibilities on the care team.  

 “As the number of individuals with cancer and cancer survivors in the United States continues to grow, advanced practice providers have become increasingly important to ensuring patient access to high-quality cancer care,” said ASCO President Monica M. Bertagnolli, MD, FASCO. “This new study provides an important benchmark to understanding their critical role on the cancer care delivery team.”

To address the lack of data, ASCO, AAPA, APAO, APSHO, and ONS undertook a collaborative effort to identify the number of APPs currently working in oncology. The analysis identified 5,350 oncology APPs—and it is believed there could be as many as 7,000—practicing in the United States. The organizations also conducted a survey of APPs in oncology, which asked questions about the demographics of the APP workforce in oncology. The results of those efforts were published in “Understanding the Role of Advanced Practice Providers in the U.S.,” which provides the first detailed examination of APPs in oncology.

"APPs play a pivotal role in providing high-quality collaborative care for people with cancer,” said President of the APSHO Board of Directors, Pamela Hallquist Viale, RN, MS, CNS, ANP. “APSHO is thrilled to work with our interdisciplinary colleagues on this important research into the nature of our work.”

APPs Play Varied Role in Cancer Care Delivery Team

“This study is yet another affirmation of the value that APPs bring to the table, specifically in a specialty like oncology where collaboration leads to stronger healthcare teams and better patient care,” said AAPA President and Chair of the Board of Directors, Jonathan E. Sobel, PA-C, DMSc, MBA, DFAAPA, FAPACVS.

The study results suggest that oncology practices with APPs routinely rely on them for direct patient care, with APPs spending an average of 85% of their time providing patient counseling, prescribing and managing treatments, and handling follow-up patient visits. Nearly all (92.5%) of APPs who provide direct patient care reported conducting independent patient visits. APPs who practice in independent models (where APPs typically see patients alone but work with a care team to address the most critical care decisions) report the highest level of professional satisfaction. However, the majority of APPs in oncology (90%) are satisfied or very satisfied with their position and their collaborative practice with oncologists (80% NPs, 76% PAs).

Oncology APPs Earn More Than Peers

The study found that APPs in oncology earn an average of between $113,000 - $115,000 per year, or about $10,000 higher than non-oncology APPs. Practitioners working in Western states, academic practices, and large practices earned higher salaries than their oncology peers. Compensation also increases with annual hours worked. Male APPs earn about 7% more than female APPs, even after adjusting for other factors, including years of experience and hours worked. Approximately two-thirds of APPs say they are either satisfied or very satisfied with their compensation.

“The Association of Physician Assistants in Oncology (APAO) is dedicated to providing team-based care for the oncology patient,” said APAO President, Richard Lindsay PA-C. “We are proud of our close working relationship with ASCO through our medical liaison for nearly 15 years and our partnership in the development of oncology training for the APP through ASCO University.”

Understanding the Role of Advanced Practice Providers in the U.S.” is the latest article in ASCO’s State of Cancer Care in America 2018 series, which explores the current challenges, opportunities, and trends in the delivery of high-quality cancer care.

Read the full study.

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About ASCO: 

Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to making a world of difference in cancer care. As the world’s leading organization of its kind, ASCO represents nearly 45,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at www.ASCO.org, explore patient education resources at www.Cancer.Net, and follow us on Facebook, Twitter, LinkedIn, and YouTube.

About APAO:

Our Mission: to promote the utilization of Physician Assistants in the delivery of exceptional care to people with cancer and related disorders.

About APSHO:

The Advanced Practitioner Society for Hematology and Oncology (APSHO) is a society for advanced practitioners—nurse practitioners, physician assistants, pharmacists, clinical nurse specialists, and other oncology health-care professionals. The mission of APSHO is to actualize oncology patient care that is high quality, cost effective, and delivered through collaborative practice models by optimizing the role of the advanced practitioner as an integral member of the care team.

About ONS:

ONS is a professional association of more than 39,000 members committed to promoting excellence in oncology nursing and the transformation of cancer care. Since 1975, ONS has provided a professional community for oncology nurses, developed evidence-based education programs and treatment information, and advocated for patient care, all in an effort to improve quality of life and outcomes for patients with cancer and their families. Learn more at www.ons.org.