ideasIdea
Advanced-practice radiation therapists doing contouring and on-treatment reviews
Radiation therapists, the staff who deliver daily treatment, can be trained to outline normal organs on scans and to review patients during treatment, work that oncologists now do.
The UK, Canada, and Australia have advanced-practice radiation therapist roles covering organ-at-risk contouring, on-treatment review, palliative planning, and image-guidance decisions, with evidence of equivalence to physician performance and reduced waiting times. Most countries have no such role. Recognising and funding advanced practice would enlarge the effective workforce without new professions.
Hypothesis
Departments with advanced-practice therapists will cut referral-to-treatment time by at least 20% and free at least 15% of oncologist clinical time, with contouring concordance to oncologist reference at or above inter-oncologist variability.
Rationale
Contouring of normal structures and routine on-treatment review are protocol-driven tasks well suited to a trained non-physician workforce, as demonstrated in existing programmes.
What would test it
A multi-centre implementation study with blinded contour-concordance scoring, waiting-time and physician-time measurements, and patient experience surveys.
Maturity
being tested at scale
Who has to act
regulator
Cost to try
Small (under $1M)
Years to first evidence
2
Bottlenecks it attacks
- Not enough oncologists, nurses, pathologists, physicists · The number of people with cancer is rising faster than the workforce trained to treat them.
- Surgery and radiotherapy cure most, get least · Surgery and radiotherapy cure more people than drugs do, but attract a fraction of the research investment.