Characterizing the specialty palliative care workforce in the United States: Results of a national survey.

Authors

Arif Kamal

Arif Kamal

Duke University Medical Center, Durham, NC

Arif Kamal, Janet Bull, Ursula A. Rogers, Keith Mark Swetz, Dio Kavalieratos, Amy Pickar Abernethy

Organizations

Duke University Medical Center, Durham, NC, Four Seasons Hospice, Flat Rock, NC, Duke Clinical Research Institiute, Durham, NC, Mayo Clinic, Rochester, MN, University of Pittsburgh Medical Center, Pittsburgh, PA

Research Funding

No funding sources reported

Background: Increasingly, oncology teams and specialty palliative care (PC) clinicians are collaborating in the care of patients with serious or advanced cancer. Because of such partnerships, PC services have grown tremendously, with teams now available in most US cancer centers. Despite increased penetrance of services, little is known about the workforce that delivers this care, including their demographics, training, and future plans. Methods: Members of the American Academy of Hospice and Palliative Medicine (e.g. advanced practice provider (APP), registered nurses, chaplains) completed a workforce characteristics survey through electronic invitation in the second half of 2013; respondents were recruited via e-mail, blog and Facebook posts, and Twitter tweets. Descriptive statistics were calculated. Results: 1,241 clinicians responded, representing approximately a third of those who received the survey; 68% were physicians and 14% were APPs. Most (56%) were older than 50 years of age; 65% were female. Of physicians, 58% were board-certified through the experiential track, while 22% had completed fellowship training. Of clinical responsibilities, about half (48%) split time between consultative PC and hospice; 30% performed PC consultations only. Regarding organization size, 35% work with 1-3 other colleagues; 8% work alone. Regarding tenure, 34% have worked in PC for <5 years; 22% for >10 years. 82% reported they would become a PC clinician again, if asked to revisit their career choice. Of motivations for joining clinical PC, leading reasons were “opportunity for personal growth” and “influential experience during practicing another specialty”. About half (47%) intend to leave the field within 10 years. Of reasons to leave, 49% will retire; 24% may leave due to burnout; and 20% reported dissatisfaction with practice. Conclusions: The specialty PC workforce is diverse and faces sustainability challenges due to advancing physician age, impending retirements, evolving burnout, and dissatisfaction with the profession. If patients are going to have adequate access to services, research and approaches are needed to develop solutions that sustain and grow specialty PC.

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Abstract Details

Meeting

2014 Palliative and Supportive Care in Oncology Symposium

Session Type

Poster Session

Session Title

General Poster Session A: End-of-Life Care, <span>Patient-Reported Outcomes</span>, and Survivorship

Track

Survivorship,Patient-Reported Outcomes: Mechanisms of Symptoms and Treatment Toxicities,Early Integration of Palliative Care in Cancer Care,Psycho-oncology,End-of-Life Care

Sub Track

End-of-Life Care

Citation

J Clin Oncol 32, 2014 (suppl 31; abstr 90)

DOI

10.1200/jco.2014.32.31_suppl.90

Abstract #

90

Poster Bd #

A9

Abstract Disclosures

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