Policy changes proposed to meet projected need for palliative care

Policy changes proposed to meet projected need for palliative care

(HealthDay)—Policies to support team-based palliative care are urgently needed to meet the growing demand for specialty palliative care, according to a study published in the June issue of Health Affairs.

Arif H. Kamal, M.D., from the Duke Cancer Institute in Durham, North Carolina, and colleagues examined whether the specialty workforce can meet the growing demand for its services. Using data from 2,109 respondents to a 2018 clinician survey, researchers modeled risk factors associated with palliative care clinicians leaving the field early and projected physician numbers for 2019 to 2059 under four scenarios. Respondents all indicated a primary professional role of palliative care or hospice clinician.

The researchers found that the of physicians is decreasing and that in the absence of a policy change, the number is not expected to return to the current level until 2045 based on the modeling. Factors tied to leaving the field early include burnout, poor work-life balance, and being a nonphysician clinician. Approximately 40 percent of the specialty palliative care physician workforce is aged 56 years or older, which indicates a projected rise in retirements within the next 10 years. All scenarios indicated the patient-to-physician ratio will worsen for at least 25 years because of an inadequate supply and a growing number of Medicare beneficiaries eligible for palliative care. The worsening workforce shortage could be reversed with sustained growth in the number of fellowship positions over 10 years.

"We recommend support for additional research into the workforce capacity and growth of nonphysician palliative care specialist clinicians," the authors write. "Specialty palliative care is most effectively delivered by an interdisciplinary team, and policy solutions must address needs across all disciplines."


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