Burnout is an occupational-related clinical syndrome that manifests as chronic occupational and interpersonal pressures that persevere over time. The setbacks and stress oncologists face that lead to emotional exhaustion and/or depersonalization symptoms can have serious implications for practice management and further contribute to shortages in the oncology workforce.
Physicians experiencing burnout are more likely to reduce their work hours and/or pursue early retirement. Many oncology professionals experience burnout, as highlighted in a 2014 survey of ASCO’s membership that found that 45% of medical oncologist members reported experiencing emotional exhaustion and/or depersonalization symptoms related to burnout.
Common manifestations of burnout are:
- Depersonalization: An individual detaches from the present moment as the demands of work become overwhelming.
- Exhaustion: An individual nears or has reached the point when intellectual, physical, and emotional energy reserves are depleted.
- Reduced personal accomplishment: An individual who experiences growing doubts about professional worth and begins asking questions such as “Does what I do have any value?” and “Could it be I’m just not able to do a good job?”
The Physician Well-Being Index assesses forms of distress that can lead to burnout, although medical professionals should speak with a healthcare professional to receive a full assessment. Index questions include:
- Have you often been bothered by feeling down, depressed, or hopeless?
- Have you fallen asleep while stopped in traffic or driving?
- Have you felt that all the things you had to do were piling up so high that you could not overcome them?
- Has your physical health interfered with your ability to do your daily work at home and/or away from home?
Administrators can take steps to help physicians reduce the risk of burnout. One strategy is encouraging professionals to acknowledge feelings of burnout or exhaustion as they occur, and facilitating efforts to receive help whenever possible. Allowing physicians, especially younger doctors, to grieve the loss of patients can also help reduce burnout.
Encouraging a work-life balance helps address burnout. Setting aside time for activities outside of work—whether for yoga, cooking, watching a game, going for a run, or working on an academic paper and attending a professional conference—can serve as an antidote to stress and emotional exhaustion. Physicians should be encouraged to practice the pillars of self-care: adequate sleep, good nutrition, and regular exercise. Taking a reenergizing vacation also can bring perspective to a stressful work environment.
Finally, an important step in battling burnout is managing time and respecting limits. When dealing with emotionally exhausted physicians, consider reducing the number of patients they see or the number of new patients taken on, if possible.
Prevention is the Goal
The best way to prevent emotional exhaustion among staff is to build resiliency, which promotes individual strength and control.
Some medical schools and professional organizations now offer courses and programs on emotional resilience, including elective courses on the art of physician happiness
When dealing with a staff member experiencing emotional exhaustion, encourage them to detach symptoms and feelings of burnout from their personality traits (such as perseverance, compassionate, a good sense of humor). This will help physicians better identify and understand the emotional burden they are experiencing, while also reminding them about the fleeting nature of feelings and emotions, which come and go.
Finally, encourage veteran staff members experiencing career satisfaction to help colleagues, especially those at the beginning of their careers, cope with the symptoms of burnout. For younger professionals, it can be beneficial to hear they are not alone. Facilitating discussions about the symptoms of emotional exhaustion cannot only help identify some of the potential causes of burnout, but can also lead to early career physicians learning from older physicians or mentors who experienced the same struggles.