Simply providing oncology services in your hospital will not be enough to attract patients, physicians and payors; oncology programs must be able to demonstrate superior outcomes in the care they provide. Expectations will continue to increase and information about what constitutes quality care will become widely available

The Internet has already revolutionized how patients and families learn about cancer, network with other patients, and learn where to go for care. Treatment guidelines for the public are now widely available, and more are translated into lay language each month. The balance of power is changing, as information becomes a new currency in the therapeutic relationship.

Physicians and hospitals are forging new relationships in the provision of oncology care. Payer- directed care has made an impact almost everywhere, changing irrevocably the way that hospitals and oncologists relate to one another. As reimbursement continues to change, so will these relationships.

The bar is continually being raised for quality, and for patients' expectations of how they should be treated as they enter and navigate the oncology care system. This trend can be expected to continue as patients continue to learn more about cancer and how it should be treated.

Leadership becomes ever more important as times become more difficult. Programs which have identified and groomed skilled leaders, both clinical and administrative and provided them with the tools they need, stand the best chance of success.