Robert Winn, MD, had only one thing on his mind when Becker’s asked him what area of oncology deserved more attention: the workforce shortage

Dr. Winn is the director and Lipman Chair in Oncology at Richmond, Va.-based VCU Massey Comprehensive Cancer Center. Becker’s caught up with him to learn more about his growing concerns and how Massey aims to address them.

Editor’s note: Responses have been lightly edited for clarity and length.

Question: You have noted that the average U.S. oncologist is 53 years old, meaning many are approaching retirement at the same time the demand for cancer care is growing. Why do you see this as one of the most urgent but under-discussed challenges in cancer care today?

Dr. Robert Winn: For me, particularly in oncology, I worry because of what we’ve been able to do in the last 30 years as a country. We’ve been able to reduce cancer deaths by 34% since 1991. We’ve been able to raise the five-year survival rate of lung cancer, we now know that skin cancer can be treated and treated well. Right on the brink of being able to do that, the number of people going into oncology annually, is getting smaller. There is a disconnect between the success of the field and the people entering it — that is not a sustainable model. We know that efficiency matters, so maybe we can do more with fewer people, but when I think it comes to oncology, I’m not quite sure that that’s the workforce that we need fewer of for the maximum impact.

We may need fewer humans because of tools such as AI, machine learning and radiomics, but you’re always going to need a physician at the end of the day.

Who’s going to give the medicine? Who’s going to actually put their hands on the patients? Who’s going to deliver the message? I don’t think that that’s going to come from a bot. I just don’t. As the field finds more successes, it’s going to take an actual human-driven workforce to make those changes for patients.

The workforce is as equally important as the new molecules that become medicine. You can have a drug, you can have an approach, but at the end of the day, you have to have a person — and people — to deliver it. In oncology, the workforce still matters.

Q: Looking ahead to the next decade, what do you predict will be the most significant workforce shifts in oncology?

RW: I think we’re in an interesting time, because we have been so focused on new molecules that become new medicines that produce cures but I’m not quite sure we’ve thought about the workforce and about how we may have to reimagine the workforce. I’m hoping that we will, as health systems, re-engage in the discussion of what our workforce should look like for the future. I think the time for that discussion is now.

We need to figure out: how do we get people more motivated, more aligned and more excited because now this is a field where we can do something. I would love for us to have a discussion as health systems — meaning the big health systems to academic medical systems and all the way down to your rural community hospital. How do we look at this nationally to make sure that we can all benefit from the science that has actually helped us get this far?

We’ve been so focused helping people live — and live longer — with cancer that we forgot to bring along our communities, to let them know that screening is better than it used to be, that a woman’s chances of advanced-stage breast cancer in 2025 are so much better than the woman with the same stage cancer in 1975, ’85, ’95. The people who really need to know don’t actually get a sense that we’ve moved in a positive direction for the benefit of everyone. We have a disconnect with the American public. Yes, cancer is still bad but we’ve made the big “C” smaller.

Q: What specific initiatives are you pursuing to recruit, retrain and retain oncology talent from physicians to front line staff at Massey?

RW: We now have recognized that to probably get the kind of workforce we need here at Massey, we need to do multiple different things. First is, we’re starting younger. We’re starting to go to middle schools and interest them in science. We’re working with undergraduate programs, helping them to fall in love with science, fall in love with being a clinician, but also peppering in there the advances we’ve made in the oncology field. Lastly, we do have a program here that’s in partnership with Amgen, Gilead, Genentech, the Bristol Myers Squibb Foundation, in which we are training the next generation of clinical trialists. Clinical trials now are not seen so much as research; they are an extension of care. We’ve been teaching a new cohort of people here at Massey and around the country not only how to design and implement trials and processes, but how to also integrate the science of engagement to help remove the obstacles for people who traditionally aren’t on clinical trials and getting them on it.

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