Oncology professionals are quick to extol the rewards of their chosen profession: the close relationships with patients and colleagues, intellectual stimulation, the sense of vocation, and the excitement of rapid advances in the field. These rewards are balanced by significant challenges, such as long hours, the pressure of frequent life-or-death decisions, and the sadness of losing a patient. Without adequate self-care, oncologists may experience burnout, a condition characterized by emotional exhaustion, depersonalization, and loss of purpose.
As professional burnout becomes better understood, ASCO will develop resources to help members not only survive, but thrive at each demanding stage of their career.
A Clear Need for Interventions
Although ASCO has approached issues of physician wellness and burnout in the past, the need for a comprehensive, fully realized wellness program was solidified in 2014, when Tait D. Shanafelt, MD, and colleagues published a series of articles describing findings from ASCO’s nationwide surveys of oncologists and oncology fellows. These surveys collected data on workload, career satisfaction, work–life balance, and plans to reduce work hours or leave a current position, among other measures.
Although survey respondents reported high levels of career satisfaction, approximately 45% of practicing oncologists had at least one symptom of burnout. A majority of respondents reported dissatisfaction with their current work–life balance. Both burnout and dissatisfaction were independently associated with planning to reduce one’s clinical hours or leave one’s current position.
Fellows reported burnout at a similar rate as practicing physicians, approximately 40%. The study uncovered significant discrepancies between fellows’ expectations of their future practice and the reality reported by practicing physicians, with fellows underestimating the number of hours worked, nights on call, and patients seen. The mismatch between expectation and reality could lead to career dissatisfaction and burnout as fellows transition into full-time positions.
The problem of burnout and caregiver fatigue among physicians and trainees is real and immediate. As the leading membership organization for clinical oncology professionals, ASCO recognizes a responsibility to develop interventions to encourage physician wellness and prevent burnout.
Laying the Foundation for Formal Recommendations
As ASCO gives serious thought to the vital components of a physician wellness program, a group of 2014-2015 Leadership Development Program (LDP) participants was tasked with gathering and analyzing information about physician burnout. Upon interviewing wellness experts from a diversity of backgrounds—in high-pressure medical, military, and business settings—the team noted that assessment tools measuring various aspects of wellness and burnout exist and could be incorporated into larger screening programs. The team noted that whereas there is a general consensus that wellness is important, training and resources are currently lacking.
The LDP team’s initial recommendations will be refined and prioritized based on feedback from peers and members of the Professional Development Committee and will be presented to the ASCO Board of Directors. The final recommendations will likely include the incorporation of provider wellness measures into ASCO’s portfolio of quality programs, a significant expansion of educational resources (both online and at in-person meetings), and the launch of a pilot program to explore the effectiveness of different wellness interventions.
Wellness Resources at the 2015 Annual Meeting
The 2015 Annual Meeting will offer three unique opportunities to broaden attendees’ understanding of wellness and burnout. Sessions will address both academic questions of wellness and provide practical strategies attendees can implement in their own lives—even while onsite at the Annual Meeting—to improve vitality and resilience.
Linda H. Clever, MD, will speak at a Special Session on “Coping with Chaos and Other Challenges in Medicine,” Saturday, May 31, 3:00 PM-4:30 PM, in room S103. The session will focus on fundamental skills and values that health professionals can practice to have a fulfilling career and a healthy life. Dr. Clever, a board-certified physician and occupational health specialist, is the founder and President of RENEW, a nonprofit organization helping health care organizations address workplace challenges so that team members can work and live with enthusiasm, effectiveness, and purpose. She is the author of The Fatigue Prescription: Four Steps to Renewing Your Energy, Health, and Life. (For more information on this session, see "Coping with Chaos: Session Features Expert Revitalization Strategies.")
Three speakers will address physician wellness at the Education Session “Burnout in Oncology Health Care Providers: Identifying Silent Despair and Maintaining Purpose” on Monday, 8:00 AM-9:15 AM, in room S404. Session Chair Anthony L. Back, MD, one of the most-cited authors on physician burnout, will ask participants to consider what burnout is and how it feels. Dr. Shanafelt will expand on his published research in the area and discuss mind–body therapies that health care providers can explore to manage and heal burnout. Cynda H. Rushton, PhD, RN, FAAN, will speak specifically to the issue of burnout in oncology nurses and recommend strategies to improve energy and effectiveness. The session will include dedicated time for a question-and-answer panel with the speakers.