Reinventing Oncology: The Urgent Need to Address Access, Burnout, and Adherence in a Shifting Landscape

A quarter of a century into the new millennium, today’s oncology environment looks radically different than it did just a few short decades ago. The incidence of cancer is on the rise, and it is affecting younger people at significantly higher rates than ever before.^1,2 These patients have more options for treatment as therapeutic breakthroughs hit the market at an unprecedented rate. But with fewer and fewer oncologists to oversee their increasingly complex care, patients may not be getting access to everything they need to manage their conditions.³

Pallav Mehta, MD | Image provided by Dr Mehta

As a result, the oncology ecosystem is being stretched to its breaking point. Stress and dissatisfaction among cancer care providers are hitting epidemic levels, with a 31% increase in burnout and a similar reduction in satisfaction with work-life integration over the past 10 years, according to a 2023 survey from the American Society of Clinical Oncology.⁴

Overwhelmed oncologists are reducing their hours or leaving the profession entirely, the poll revealed, putting additional burdens on their remaining colleagues even as patients with cancer who have longer life expectancies—and higher expectations for the quality of their care journey—are flooding into community clinics and academic medical centers alike.⁵

With the latest report from the American Cancer Society (ACS) predicting more than 2 million new cancer cases to be diagnosed in 2025 alone,⁶ there is an immediate imperative to rethink the status quo and employ effective strategies for delivering efficient, person-centered, accessible care in the modern environment.

Focusing on Equity and Access to Reduce Disparities in Care
The demographics of patients with cancer may be changing, but one thing remains doggedly the same: the disparities in outcomes that fall along socioeconomic, racial, and ethnic lines. The 2025 ACS report confirms that people who identify as Black, Hispanic, American Indian/Alaskan Native, and Asian American/Pacific Islander still have significantly higher incidences of certain common cancers, as well as higher mortality rates for some diseases, than White patients.⁶

In a time of politically charged opinions around the fundamentals of health equity, the oncology community must maintain its commitment to reducing disparities in outcomes, from continuing to support diverse and inclusive clinical trials to reinforcing clinical best practices that eliminate bias, secure affordability and access for underserved populations, and ensure the standardized delivery of appropriate, evidence-based care.

Making Room for Relationships That Strengthen Adherence
Part of this process involves creating opportunities for open, empathetic patient-provider relationships that prioritize shared decision-making. This must occur alongside science-backed disease education and mental and emotional self-care skills that are essential for achieving and maintaining adherence to recommended care.

To do so, oncology teams must regain the bandwidth to engage with patients in a meaningful manner, whether in person or through remote care technologies, without being bogged down in administrative burdens that can drain hours of valuable time from each workday.

Several strategies could help. For example, a recent report from the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine suggests that introducing enhanced patient navigation services could help to reduce frustrations for both patients and oncologists during the challenging process of identifying optimal treatments, understanding financial responsibilities, or arranging further specialty consultations.⁷

The report also called out the increasingly important role of virtual communication pathways, such as digital platforms that collect patient-reported information between visits and allow providers to assist with managing symptoms, adjusting medications, or suggesting personalized actions in near-real time.

These types of wraparound services can help oncologists sustain the robust, personalized relationships that are necessary to ensure adherence to increasingly targeted and complex therapies, especially as new strategies lengthen survival rates, thereby necessitating continued patient management for longer periods of time.

Reimagining Processes to Architect the Oncology Experience of the Future
With more patients requiring more attention from fewer oncologists, the question of how to ensure the long-term sustainability of accessible, equitable cancer care is a pressing one.

While clinical burnout is often viewed as a problem that should be addressed at the local level with talent retention strategies or workflow adjustments, it’s not a challenge that any one organization can solve. Instead, the health system as a whole must consider how changing reimbursement structures, increasing administrative burdens, and the shift away from community oncology spurred on by rapid practice consolidation have affected the financial and clinical efficiency of cancer care—and the well-being of its practitioners.⁸

Oncologists navigating this changing landscape will need systemic support if they are to remain in practice, including sustained attention to electronic health record usability concerns as well as additional assistance with streamlining documentation, coding, billing, and prior authorization processes.

Additionally, oncologists at the point of care will need expanded access to tools and resources that can surface suggested evidence-based care pathways, highlight cost-conscious alternatives for patients with socioeconomic barriers, communicate with patients and caregivers between visits, and even flag individuals at risk of nonadherence via advanced predictive analytics.

Not only will these strategies reduce burnout by maximizing productivity and effectiveness while minimizing administrative burdens, but they may also assist with creating a more personalized and streamlined patient experience that fosters the right environment for sustained adherence to care.

This dual benefit will be essential for meeting the growing needs of the next generation of oncology patients, including ensuring access to care; reducing disparities among racial, ethnic, and socioeconomic groups; and addressing the specific needs of younger individuals with cancer.

Author Information
Pallav Mehta, MD, is a medical oncologist/hematologist with expertise and interest in breast cancer and integrative oncology and is board certified in medical oncology, hematology, and integrative medicine with previous board certification in internal medicine. Mehta currently serves as an assistant professor of medicine at Cooper Medical School, Rowan University, and as director of integrative oncology and practice development at MD Anderson Cancer Center at Cooper in Camden, New Jersey. He is chief of the Division of Hematology/Oncology and director of oncology for Redeemer Health in partnership with MD Anderson Cancer Center at Cooper. Mehta is also medical director of Reimagine Care, a tech-enabled, human-led start-up company transforming the cancer care experience for patients and the care team. He continues to maintain his breast cancer clinic on a more limited basis.

References
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3. Cavallo J. Tackling the challenges of oncology workforce shortages, increased patient demand, and rising costs of care. The ASCO Post. January 25, 2024. Accessed April 11, 2025. https://ascopost.com/issues/january-25-2024/tackling-the-challenges-of-oncology-workforce-shortages-increased-patient-demand-and-rising-costs-of-care/
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