7 Threats to Cancer Care

Gabriel Miller; Peter P. Yu, MD; Jennie R. Crews, MD; Matthew Farber

Disclosures

September 10, 2014

In This Article

Oncologist Burnout

Key Facts:

In a 2012 survey of 1500 hematologist/oncologists, 44.7% of respondents reported feeling burned out.[4]

In a survey of 1490 oncologists published this year in the Journal of Clinical Oncology, 26.5% said they were moderately or highly likely to reduce their clinical hours in the next 12 months, and 34% said they were moderately or highly likely to leave their current position within 24 months.[5]

Dr. Yu: There is no question that oncologists are working longer hours. And many oncologists are now seeing 20 to 25 patients a day and having fewer minutes at each visit because they are required to see more patients. Then they have to stay after hours to do all of the extra work of documentation, filling out forms, reviewing results from lab and x-ray tests, and contacting patients -- all of the things you do when everybody else leaves and goes home. So the day has extended considerably for many doctors, and we are starting to see increasing burnout among physicians.

The people [ASCO] brought in to do the report ["The State of Cancer Care in America: 2014"] looked at us at the end and said, "You know, it's really striking; if you ask the question 'Are you, as a physician, satisfied with your choice of a career?', oncologists score the highest that we see across any specialty. But then if you ask 'Are you suffering burnout?', answering 'yes' is also highest among oncologists." So this shortage of oncologists is really, to a large degree, an issue of professional dissatisfaction with the quality of our lives.

As I go and speak to our ASCO members outside of the United States -- a third of our membership is international -- I'm hearing the same thing: They are very frustrated in the healthcare environment that they are working in and they are working long hours; they are not being reimbursed adequately; they are struggling to get the resources they need to do their job the way they feel it should be done. This is not a US-only problem.

Dr. Crews: There are two forces at play here. One is that with reimbursement declining in oncology, there's a huge push towards productivity. So oncologists are being asked to do more, see more patients; and yet at the same time, we have this pressure of meeting performance metrics -- things like patient satisfaction surveys and quality metrics that we're being asked to hit targets on. That has led to a lot of pressure in a field that's already very demanding emotionally. I think that's part of why we're seeing that response to the burnout, and yet oncologists by and large love what they do; it's just becoming harder to do those things we love.

Mr. Farber: There is definitely an issue of burnout, and to make that point, [the ACCC is] having a session at our next annual meeting on helping to prevent burnout. It is something that we are definitely seeing. Oncology is certainly a very difficult specialty to be in at times, given what often happens to patients at the end of the day, at the end of exploring different treatment options. So it can be a very taxing specialty to be in and it takes a very special person to go into oncology. A lot of people are incredibly passionate, but that burnout piece is something that we are certainly watching for. We are trying to provide tools to help spot that early on, to avoid it and then to help providers through it who are experiencing that phenomenon already.

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