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State of Gynecologic Oncology

Joe Cantlupe, for HealthLeaders Media, May 27, 2010

In the tiny subspecialty of gynecologist oncologists, the Society of Gynecologic Oncologists conducts an extensive survey of its 1,100 practitioners every five years. This isn't your quick how-are-things-going type poll. It could take an hour for participants to complete, the society leaders say.

Why dwell on that? Well, Jimmy Orr, MD, former chairman of the SGO and current head of the survey task force, dwells on that. Of 900 or so letters that were sent out in the survey, more than 600 responded. "Who has 70% response rate?" he asks. "That's really huge. If it's 50% that's good, but 70%—that's a big deal." To Orr, it reflects the concern and dedication of gynecologic oncologists.

A bigger deal, of course, is what they said in the survey, Gynecologic Oncology 2010: State of the Subspecialty. Compared to five years ago, there were major differences in what was said about the evolving physician practice. And the survey revealed an evolving nature of the SGO itself.

The workforce is getting younger and a larger number of women are entering the field. In addition, there's a shift away from private practice and an increase in group or multi-specialty practices, not unlike other physician practices. In 2005, women represented 20% of practitioners, and now it's 33%. In 2005, the mean age of a practitioner was 51; now it's 47.

Orr, who is medical director of the Florida Gynecologic Oncology & Regional Cancer Center, in Fort Myers, FL, finds these changes significant.

Having younger practitioners will "propel the specialty forward," he says. "The same can be said of having more women in the field. Women have an understanding of women, and rounds out the whole picture of care, the treatment, surveillance, and family dynamics."

The survey revealed a definite move away from private practice, with 35% of the gynecologic oncologists calling themselves primarily private practice physicians, compared to about 51% in 2005. Twenty-five percent of the gynecologic oncologists now work for a multi-specialty practice/clinic, while only 13% are part of an individual practice.

And 77% say they are salaried employees, compared to 56% who classified themselves as salaried employees in 2005. More work in university or hospital-based teaching facilities, 62% compared to 55% in 2005.

The "security of salaried positions" is definitely reflected in the survey, Orr says. "It relates to the overall angst of what is happening in medicine. There's such a burden with the mechanics and paperwork of medicine. We are going to find an increasing number of individuals trying to integrate themselves into a larger group. The model of an integrated system is not fragmented, it's more efficient, and certainly cost reducing; what we have to look forward to in the future."

The survey shows a "continued dedication" to providing chemotherapy services to patients regardless of the changes in reimbursement rates, as well as the continuation of enrollment of patients into clinical studies rather than the more revenue neutral or industry-sponsored trials, Orr says.

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