1 in 5 oncologists is over 65 in the US. Is there a handoff crisis ahead?
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Early-career oncologists are at a significantly higher risk for emotional exhaustion, meaning forcing them to absorb a mature, high-volume patient panel overnight is unsustainable... We cannot rely solely on physicians to absorb the additional workload after-hours.
—Manali Patel, MD, MPH, associate professor in the division of oncology at Stanford
When late-career oncologists retire, their patient load has to go somewhere. For early- and mid-career oncologists, that can mean inheriting a high-volume panel almost overnight.
Just 14.5% of oncologists are under the age of 40, with the median age of oncologists in the US being 53. [] In the field of oncology especially, this poses a challenge for managing patient care.
Related: 4 workload realities oncologists under 40 are facing right now“ASCO data shows that early-career oncologists under 50 are at a significantly higher risk for emotional exhaustion, meaning forcing them to absorb a mature, high-volume patient panel overnight is unsustainable,” Manali Patel, MD, MPH, Associate Professor in the Division of Oncology at Stanford and a member of ASCO, tells MDLinx.
“When a long-standing oncologist retires, their patients may experience unease during the transition while clinicians who remain in the practice must contend with potentially overcrowded and highly condensed schedules,” she continues. “To effectively manage the surge in patient demand, we cannot rely solely on physicians to absorb the additional workload after-hours. It is essential that healthcare systems, payers, and policymakers collaboratively design multidisciplinary workflows that recognize patient transitions as a distinct, valued component of care delivery.”
Smooth workforce transitions cannot be managed on an ad-hoc basis; they require systemic, proactive planning six to twelve months in advance.
—Manali Patel, MD, MPH, associate professor in the division of oncology at Stanford
The challenge in transferring patient care
One in five oncologists in the US is 65 or older. In 2024, there were only four states in the US where less than a quarter of practicing oncologists were nearing retirement age. These included Alabama, Oregon, South Dakota, and Utah.[]
If you inherited a retiring oncologist's patient panel tomorrow, what would be your biggest concern?
In some states, like Montana, Nevada, Alaska, Hawaii, North Dakota, and Rhode Island, more than 40% of oncologists are nearing retirement age.
“Cancer care is an intricate, years-long journey. The primary challenge in transferring care is the potential loss of implicit clinical knowledge—the subtle, vital nuances of a patient’s history that standard EHR text formatting rarely captures fully, such as how they physically and emotionally managed a highly toxic regimen years prior, their interpersonal relationships with the various members of their support networks, or the other important details such as life milestones or unique hobbies and aspects of their life that bring them joy,” Dr. Patel says.
“These important details are part of the magic of a longstanding patient-physician relationship and the essence of what brings joy to many clinicians," she adds. "Many of these details are not always captured in our standard medical clinical notes.”
Building trust
Dr. Patel says one of the best ways physicians can manage the transfer of care between retiring oncologists and those in the early or mid stages of their career is to take the time to build trust with patients.
“Systems and physicians must plan for dedicated, in-person co-visitation. If an oncologist is retiring within a six-month window, the physician who is assuming the care for that patient should be integrated into a live, face-to-face consultation if possible. These co-visitations should be recognized as valuable and necessary for high-quality patient care transitions. The retiring doctor can explicitly introduce the new physician, share their background, and explain why they were specifically chosen to manage that patient’s unique case," she says.
This visible, collaborative alignment honors the established bond, demonstrates deep preparation, and establishes immediate therapeutic credibility.
—Manali Patel, MD, MPH, associate professor in the division of oncology at Stanford