By Dr. Jeff Patton, Acting CEO & President of Physician Services, OneOncology

“Change is the only constant in life.”   - Greek philosopher, Heraclitus 

While the universal flux theory is 2,700 years old, in oncology, it is as applicable today as it was the “weeping philosopher” first uttered his paradoxical doctrine.  

Oncology has experienced more constant change in the last thirty years than from the late 20th century to the time cancer was first identified in 440 BC.  

The rapid pace of innovation in oncology has been fueled by an immense knowledge explosion about cancers, how they grow and how to treat them in different subpopulations. In fact, from May 2018 to May 2019, the U.S. Food and Drug Administration (FDA) approved almost 60 new oncology drugs. And while the advances we see in oncology today - targeted therapies, precise diagnostics, and a better patient experience - are powering a consistent drop in cancer death rates, they also require oncologists to know more than any one person possibly can.  

How then should medical oncologists and their practices stay up to speed on advancements to ensure patient receive the right treatment at the right time?  

• Oncologists and their practices cannot get overwhelmed by the promise of artificial intelligence or any other aspect of technology and instead focus on two vital deliverables: 1) an agile platform that turns data clinical, operational and financial data inputs into actionable insights; and 2) a platform for real-time peer-to-peer communication offering a virtual second opinion. Technology must work to improve physician workflow and efficiency. By engaging physicians and focusing on meeting their needs, technology and the analytical insights it reveals should help oncologists not exacerbate physician burn out.   
• Former Speaker of the House Tip O’Neill’s adage about all politics being local applies to healthcare too. Every market in the U.S. is different and it requires practices looking to thrive to have the flexibility to form partnerships that make sense locally. “One size fits all” does not work for oncology practices or their patients today. Rather, practices need flexibility to form relationship with hospitals or other provider networks that make sense for their patient populations.  
• While flexibility is important locally, practices cannot survive without the scale to negotiate on drug purchasing, payer contracts or employer relationships. Practices don’t have to sacrifice independence for scale, but they cannot go it alone and expect to be able to offer their patients services along the continuum of care from clinical trials to palliative treatments.  Practices must figure out partnerships that work so care options, most notably access to clinical trials, are expanded for patients.  
•  Fee-for-service care will soon be akin to skiing in jeans – a relic of the 20th Century.  Medicare’s voluntary – and risk free - value-based payment model in oncology will soon give way to a two-sided risk model.  And while entering into two-sided risk now might not be right for every practice immediately, ignoring the tectonic shift in payment comes with peril. Practices need to understand value-based models through implementing them so their patients can benefit from better care coordination, drug utilization and communication between the care team and their patients outside the clinic.  

The practice of oncology has changed immensely since I’ve been treating patients. My overarching advice to practices trying to negotiate the constant change that oncology offers is to not be complacent because your patients are receiving the best care possible today. Understand where oncology is headed and how today’s trends will impact your ability to deliver care tomorrow. Do what makes the most sense for your patients and colleagues by always anticipating change rather than reacting to it.