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APRT is the least of your concerns. AI and automated/assistive contouring tools will greatly reduce the effort dedicated to target/OAR delineation. There is no if in that statement. Some of what is out there is almost ready for primetime. Any affect the APRT may have on FTE calculations will more than likely be moot.The concern is always: If APRT is allowed to contour adaptive structures on the table, what prevents some 60-plus chairman from asking APRT to contour routine target volumes such as lung, prostate or breast, which are not that hard to contour and potentially hire fewer attendings?. The current group of attendings are happy because they can maximize the number of consults/new starts. The whole story of CRNA in anesthesia would permeate into radiation oncology as well.
Save for unscrupulous management, this really shouldn't be anything to fear for those of us already in the game. It will probably make life more efficient. And how many positions will this eliminate? Time will tell but do some simple math. How much of your effort is spent contouring? 15-20% (unless you have a crazy H&N volume). In competitive markets where growing your volume with adequate resourcing is possible, I don't see many people deciding to reduce staffing because they can. Probably more likely to try to divert the existing FTEs to growing the patient volume (ie...make it rain). Now, Im not ignorant. Even if positions are not shed, added efficiency absolutely means that fewer positions will be created in the future and will still be a net loss to the job market over the long run.
Less competitive/rural markets where growth potential is limited/non-existent...potentially a different story. You can't do more with the same workforce. But you can try to do what you are already doing with less. Fortunately most of these places are only 1-2 physician joints and I just don't see autocontouring alone reducing FTE needs enough to drop from 2 to 1. But again, could definitely save you from needing to go from 2 to 3.