Aptitude Health, Atlanta, GA
Chadi Nabhan , Bela Bapat , Yolaine Smith , Andrew Klink , Bruce A. Feinberg
Background: Physician burnout, which is often characterized as exhaustion of physical or emotional strength because of prolonged stress or frustration, has become a worsening phenomenon in medicine. Some have suggested that the rate of burnout among oncologists may be higher than other specialties. Methods: US oncologists/hematologists were queried via a web-based survey from Sep-Nov 2018. Physicians were asked about frequency of burnout symptoms, drivers of burnout, and management of increasing workload. Results: Among the 163 physicians surveyed, 46.0% felt substantial amount of stress at work. Most physicians felt emotionally (85.3%) and physically (86.5%) exhausted. Majority of physicians felt lethargic (66.9%), ineffective (63.8%), and/or detached (62.6%). Additionally, 57.1% of physicians described their practice atmosphere as busy or very busy. In a typical workweek, 92.6% stated they needed additional time, beyond time allocated to clinical care, to complete work responsibilities (23.3% needed 1-3 hours; 15.3% needed ≥10 hours). Most (81.6%) physicians felt lack of work life balance as one of their main stressors. Electronic health record (EHR) responsibilities caused moderate to excessive stress among 66.9% of physicians, 79.1% physicians worked on EHR at home. Other sources of excessive stress were changing reimbursement models (33.1%), interactions with payers (31.3%), increasing patient and caregiver demands (30.7%). Due to increasing demands, 19.6% physicians have considered retiring early, while 14.7% physicians have considered changing their career path. However, 62.6% of physicians stated they had optimal or good control over their workload. To combat burnout, physicians’ practices have used following strategies: employed APPs (46.0%), invested in information technology (33.1%), and/or hired additional administrative staff (31.3%). Conclusions: Most oncologists in the US experience burnout and require additional time beyond that allocated to clinical care to complete their workload. The discordance between oncologists feeling burdened by stress and exhaustion while claiming good control over those same burdens is noteworthy. Additional follow-up will assess whether remedial strategies are effective.
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