Improving Cancer Equity Through Advocacy

Residency is a transformative and demanding period in the life of a physician. Learning and attaining proficiency within the field comes from a variety of sources, including professors, clinical staff, scientific literature, and research. However, most is gleaned from the patients we treat daily who bring their fears, anxieties, insecurities, and concerns to the clinic.

Unfortunately, the ongoing COVID-19 pandemic has only heightened emotions we see in clinic and further exposed disparities in our health care system. As an example, COVID-19 hospitalization rates among non-Hispanic Black people and Hispanic or Latino people were about 4.7 times the rate of non-Hispanic White people.^1,2 Only 4.7% of the US oncology workforce is Hispanic, 3% is Black or African American, and 0.1% is American Indian or Alaska Native, according to a recent report by the American Society of Clinical Oncology (ASCO).³

Organizations such as ASCO and the American Society for Radiation Oncology (ASTRO) continue to advocate for equitable cancer care and workforce diversity. Lori Pierce, MD, FASTRO, FASCO, focused her ASCO presidency around equity with the theme, “Equity: Every patient. Every day. Everywhere.” And every year, ASTRO hosts a Congressional Advocacy Day. Due to the pandemic, the last two meetings were virtual. The most recent Advocacy Day was in late July 2021 and had a record-breaking number of resident physicians in radiation oncology. Thirty residents were among the 100-plus participants from 32 states. In total, more 150 meetings took place with staff members and lawmakers pertaining to the proposed Radiation Oncology Alternative Payment Model (RO-APM), ongoing prior authorization struggles, and increasing federal funding in cancer research.

During my meetings, I reviewed important parts of the RO-APM and how this model would impact my patients and communities in rural Oklahoma. I shared with patients that I was meeting with members of Congress to discuss proposed changes that have a real chance of impacting radiation therapy services in Oklahoma. I told their stories and those of previous patients throughout my meetings, including their enduring struggles due to lack of resources. We also discussed the anxiety experienced from treatment delays due to prior authorization processes in the midst of a pandemic.

As a resident, we are often on the frontlines of medical care. We spend countless hours with our patients in face-to-face interactions or coordinating care. We do more than take their history, perform a physical exam, and review a treatment plan. Most often, we become an integral member of their medical team and oncology journey. Let us amplify their voices and stories by continuing to advocate for more equitable health care, the health of our patients, and our profession overall.

References

1. Webb Hooper M, Nápoles AM, Pérez-Stable EJ. COVID-19 and racial/ethnic disparities. JAMA. 2020;323(24):2466-2467. doi:10.1001/jama.2020.8598
2. Garg S, Kim L, Whitaker M, et al. Hospitalization rates and characteristics of patients hospitalized with laboratory-confirmed coronavirus disease 2019 – COVID-NET, 14 United States, March 1-30, 2020. MMWR Morb Mortal Wkly Rep. 2020;69(15):458-464.
3. 2020 snapshot: state of the oncology workforce in America. JCO Oncol Pract. 2021;17(1):30.