Building Relationships as a Strategy to Tackle Rural Oncologist Shortages

Rural oncology practices are facing significant challenges due to the departure of key specialist colleagues, often referred to as "linchpin" physicians. According to a recent study led by Dartmouth College and published in JCO Oncology Practice, the loss of these professionals critically impacts the expertise and trust within care teams, leading to disruptions in patient care. The research highlights that the absence of these specialists results in reduced collaborative capacity, diminished trust, and occasional delays in delivering optimal treatments.

The study involved interviews with 20 rural oncologists across various U.S. sites, exploring their perceptions and strategies in managing specialist shortages. A notable finding was the development of a "linchpin" score, used to identify physicians who are uniquely critical in their local networks. These individuals are crucial for providing multidisciplinary cancer care, and their departure is felt profoundly within their communities.

Shortages of oncologists and subspecialists in rural areas cause hurdles such as increased travel for patients, delays in diagnosis, limited access to clinical trials, and heightened clinician burnout. While existing research has primarily used headcount metrics to gauge workforce shortages, this study emphasizes the importance of understanding the relational dynamics among physicians, using social network analysis to better comprehend workforce gaps.

The research uncovered three core themes: the impact of shortages on team expertise and patient volume; innovative strategies employed by oncologists, including referrals to outside systems or generalists, and reallocating responsibilities; and unintended consequences like increased patient travel, delays in treatment, less access to clinical trials, and higher burnout among physicians.

Despite these challenges, the study points to potential interventions such as virtual tumor boards to foster stronger relationships among distant specialists and revised payment policies to improve recruitment and retention in rural settings. Mapping the relational networks can guide resource allocation to mitigate the adverse effects of specialist departures.

This research underscores the critical importance of relationship-building within oncology care, especially in rural communities, and offers pathways to improve stability and patient outcomes amid ongoing workforce shortages.

Source: https://medicalxpress.com/news/2025-07-relationship-key-oncologist-shortages-rural.html