Survey: US Oncologists Happy With Career, Very Happy

Nick Mulcahy

January 30, 2014

Overall career satisfaction is “high” among oncologists in the United States, according to a new survey published online this week in the Journal of Clinical Oncology.

The large majority of the 1117 oncologists who responded to the survey were satisfied with their career (82.5%) and choice of specialty (80.4%), report the authors, led by Tait Shanafelt, MD, Mayo Clinic, Rochester, Minnesota.

Those scores are unprecedented in the authors' experience.

"Notably, satisfaction with career and specialty choice among oncologists in our study (both > 80%) was the highest of any group of physicians we have studied," they write.

Dr. Shanafelt and his colleagues know the subject of job satisfaction well.

The team, which includes oncologists from a variety of major centers and the American Society of Clinical Oncology, has now conducted and published 5 large surveys of doctors about career satisfaction and burnout. Their 2012 study, which involved 7000 physicians in a variety of specialties, concluded that doctors suffer more burnout than other workers in the United States and was widely covered by major media.

There was one notable qualification about satisfaction in the new findings. Academics, who comprised about one third of the respondents, were happier than oncologists in private practice. Both measures of career satisfaction were lower for those in private practice relative to academic practice (all P < .006).

Nevertheless, the overall high level of satisfaction found in the new study is a well-earned reward for demanding work, the authors suggest.

"Oncologists work long hours, supervise the administration of highly toxic therapy, and are continually exposed to death and suffering," they write.

The new survey corroborates the authors' opinion about oncologists' long hours. The respondents said they worked an average of 57.6 hours per week and saw a mean of 52 outpatients per week.

Those long hours, especially when they are consumed by taking care of patients, may be an Achilles heel in the oncologists' otherwise solid body of satisfaction, the survey results suggest.

The number of hours devoted to direct patient care per week was the "dominant predictor of burnout," reported the authors.

About half (44.7%) of the respondents reported at least one symptom of burnout, a syndrome that includes emotional exhaustion and/or "depersonalization" (treating patients like objects).

The connection between patient care hours and burnout is "concerning…given the projected shortage in the supply of oncologists during the coming decades," the authors write.

The prevalence of burnout among oncologists in the new survey is higher but comparable to what was found in another recent survey.

The Medscape 2013 Physician Lifestyle Report found that 38% of oncologists experienced burnout (defined as having at least 1 symptom of loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment).

This rate of burnout among oncologists was very similar to the overall average rate among all specialities (39.8%) in the Medscape survey.

Oncologists and critical care physicians were the only specialities in the Medscape survey that cited "compassion fatigue" in their top 3 stressors, observed Carol Peckham, who oversaw and published the survey in her former post as director of content at Medscape, and was asked to comment on physician surveys for this story.

The Medscape Physician Lifestyle Report 2014 was published this month. The focus of the survey this year is, "Do physicians lead healthy lives?"

Women Overrepresented

The survey participants were initially sent an email with a link to an online survey. They comprised ASCO members and were evenly matched in terms of men and women (1500 each) and had an even distribution by career stage.

The fact that 50% of the respondents ultimately turned out to be women might have caused the rate of reported burnout among oncologists to be a bit inflated in the new survey, observed Peckham to Medscape Medical News in an interview.

In the US, there are more male oncologists than females (65% vs 35%), she commented. "Women have a much higher burnout rate than men," Peckham said, citing the Medscape lifestyle survey and other research on physicians.

However, Dr. Shanafelt said that in various studies, including his new one, women have higher rates of burnout in univariate analyses. "But when you conduct the multivariate analysis, adjusting for age, it disappears," he said. The reason is that women oncologists are, on average, younger than men in the field, and age is a "dominant" factor in burnout, with young oncologists being more vulnerable for a variety of reasons.

What do the study authors do about job stress?

Study coauthor Quyen Chu, MD, MBA, from the Feist-Weiller Cancer Center at Louisiana State University Health Sciences Center in Shreveport, said in an email to Medscape Medical News that "I think about my family and concentrate on the positives and remind myself that I add value to my society. I also have a close social network with trusted colleagues that I can confide with. I should exercise more, but it's always the same thing...maybe tomorrow I'll get to it."

Interestingly, Dr. Chu's response about family somewhat mirrored the findings of the Medscape lifestyle survey. Roughly 85% of those respondents said that spending time with family was their number 1 pastime.

The authors and commentators have disclosed no relevant financial relationships.

The study was supported by the American Society of Clinical Oncology, the National Institutes of Health, and Mayo [Clinic] Department of Medicine Program on Physician Well-Being.

J Clin Oncol. 2014;32. Abstract

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