An Environmental Scan of Advanced Practice Radiation Therapy in the United States: A PESTEL Analysis

Abstract

In 2021, the Advanced Practice Radiation Therapy Working Group (APRTWG) was established in the United States (U.S.) as a grassroots alliance of multidisciplinary Radiation Oncology professionals - radiation therapists (RTTs), physicians, dosimetrists, and administrators - located across the country, interested in studying and establishing the Advanced Practice Radiation Therapist (APRT) level of practice in the U.S. The APRT model has shown success in the United Kingdom (U.K.), Canada, Australia, Singapore, and other countries, documenting the value of the APRT to the quality and advancement of clinical care. In the U.S., the APRTWG seeks to coordinate activities, align resources, and drive the national agenda forward to collectively develop and define novel models of care utilizing APRT in line with the evolving needs of patients and the radiation therapy profession. This environmental scan aims to examine the context of Radiation Oncology medical practice in the U.S. to inform pathways ahead for a proposed APRT model through a Political, Economic, Social, Technological, Environmental, and Legal (PESTEL) analysis. The international APRT role is evidence-based. Results from this PESTEL analysis indicate that RTTs working within an expanded practice scope can contribute to service delivery. This environmental scan highlights political, social, fiscal, and legal hurdles and opportunities for an APRT level of practice to overcome them.