Table 1.

Barriers to Collaboration Between the Radiation Oncology and Hospice and Palliative Care Specialties

Factor	Barriers and Limitations
Education	No formal palliative care training for radiation oncology residents
	Lack of radiotherapy training for palliative care professionals
	Minimal protected time at national meetings for palliative oncology topics
Research	Dependence upon patient-reported outcomes in trials
	Missing data points because of declining health or death of accrued patients
	Paucity of experienced research teams in hospice and palliative care programs
	Lack of federal funds dedicated to end-of-life studies
Financial	Hospice capitated payment model differs from radiotherapy model
	Radiotherapy costs several times the average hospice per diem
	Increasing radiotherapy costs due to technologic advances