While other physician specialties have seen a decline in burnout, oncologists are reporting slightly higher rates of burnout.
Medscape's "Physician Burnout and Depression Report 2024" surveyed 9,226 physicians across 29 specialties between July 5 and Oct. 9. In the rankings, 53% of oncologists said they experienced burnout. This is a 1% increase over the 2023 report, though oncologists jumped to the second-most burned out specialty, up from the 12th spot in 2023.
Becker's asked five leaders why more oncologists may be experiencing burnout during a time when the numbers are declining for other physician specialties:
Wendy Baer, MD. Director of Psychiatric Oncology at Winship Cancer Institute of Emory University (Atlanta): It's really hard to know exactly how these burnout scores reflect individual experiences versus team experiences. Cancer care is very much a team operation, so in terms of feeling well in their workspace, they probably need good energy from everybody else they work with, even more so maybe than other medical disciplines. They have a very elaborate team of people that are interacting. So if you have systemic pressures on all those people — maybe from a global pandemic, maybe from an economic crisis, maybe from a social justice movement where concerns about being treated fairly in the workplace are more prominent — I think oncologists are going to end up reflecting that because their teams are reflecting of all those issues. And if the physicians feel like they're doing more than their medical expertise, like more administrative work than ever before, I think that's going to be a big part of contributing to burnout. I do love that oncologists continue to say that taking care of patients and families rejuvenates them.
Jennifer Bickel, MD. Chief Wellness Officer at Moffitt Cancer Center (Tampa, Fla.): There's no hard data on this but in my work with oncologists, it's clear that the EHR often falls short of meeting the intense and complex documentation needs of medical oncologists. In addition, cancer care has always been a place of strong patient and family emotions. However, there's been an escalation in harassment and violence against doctors and nurses. This has long lasting impacts on morale and, frankly, on the joy the physician has in practicing medicine. It's incredibly hard work to start with but then when you add excessive administrative tasks and violent patients, it can be overwhelming and unfulfilling.
Ken Chaij, MD. Executive Director of the Oncology Service Line at Kettering (Ohio) Health: Burnout is coming from the workload and what physicians have to do in a given day. I was talking to one oncologist earlier this week and he said a number of years ago he could see a full day of patients and leave at 5 [p.m.] with all his charts done, but with constant changes in our EHR and regulations, he now typically leaves after 7 [p.m.]. There is always a balancing act between personal and professional life, and that can add stress to a person if they feel there is an imbalance. At the same time, we are seeing physicians retiring out and we're getting fewer physicians come in who fit with our group.
And thanks to treatment, people are living longer with the disease. We're starting to see people coming back and having other forms of cancer, and the older they get the higher the chance for that. And we see survivors that need more and more services to manage and provide palliative care. We're also seeing an increase of new patients, so overall there's this volume uptick.
Yuman Fong, MD. Sangiacomo Family Chair in Surgical Oncology at City of Hope (Los Angeles): The many recent successes in medicines for the treatment of cancer mean that there is more to learn, and the demand to stay current is more challenging than ever before. The work of the medical and surgical oncologist also now requires added time for the electronic medical record, negotiation with third-party payers for authorization of treatments, and education to patients on all of the options and related outcomes. These added demands contribute to burnout, and as we look to the future, it highlights the importance of screening as well the role of partnering with community oncologists (where 80% of care is delivered) to ensure timely and seamless access to care.
Mothaffar Rimawi, MD. Executive Medical Director at Dan L Duncan Comprehensive Cancer Center at Baylor St. Luke's Medical Center (Houston): We should not be surprised at the precipitous rise of burnout in oncologists. These medical professionals are faced with the convergence of an increasingly complex treatment landscape and testing platforms, which requires them to spend more time explaining these complex concepts to patients. While physicians are inclined to spend more time with their patients, the pressure of productivity targets and limited time in clinic appointments, combined with the complexity of securing insurance company approvals for expensive treatments may become too much for the practicing oncologist. Oncologists now spend long hours on the phone for a peer-to-peer or to appeal denials for drugs even when approved by the FDA and incorporated in practice guidelines by authoritative organizations.
We need a national initiative that can help alleviate some of those converging pressures in oncology. Burnout not only means people leave the specialty, it means fewer younger physicians go into oncology, and that can seriously impact clinical care, research and training.