Physician burnout has increased significantly in the past decade, and organizational strategies are vital to improve physician well-being, according to new research from ASCO. This compilation includes reports on the state of professional well-being among oncologists in 2023, burnout trends among oncology fellows in training, strategies to improve professional wellness, a policy brief describing past efforts to improve oncology workforce well-being and opportunities for improvement, and a graphical summary on well-being among U.S. oncologists. Of note, three out of five (59%) oncologists reported symptoms of burnout, defined as a syndrome resulting from chronic workplace stress that has not been successfully managed.
Physician burnout is characterized by long-term stress that includes emotional exhaustion, a lack of empathy or negative attitudes toward patients, and feelings of decreased personal achievement. The potential impact of physician burnout is far-reaching; it can lead to negative consequences for patients, including a greater risk of medical errors, reduced patient satisfaction, and suboptimal care. Burnout may also contribute to workforce supply concerns and disparities in patient access to care, given physician turnover and attrition due to burnout.
The State of Oncologists’ Well-Being: A Difference in a Decade
In 2023, ASCO sent a survey to U.S.-based oncologists about their professional well-being and its impact on their career plans. Responses to the survey were compared with results from a national survey of U.S. oncologists conducted in 2013 to look at 10-year trends.
Authors found that compared with findings in 2013, the prevalence of burnout among oncologists was significantly higher at 59% in 2023 vs 45% in 2013. Other notable findings from the 2023 survey include the following:
Burnout symptoms were more prevalent among respondents with caregiver responsibilities vs those without (65% vs 47%) and among individuals younger than age 50 vs older than age 50 (64% vs 51%).
Almost half (47%) of respondents reported that the top-two stressors affecting their work were staffing levels and tasks related to electronic health records.
Rates of burnout increased as average work hours increased: 82% among respondents working more than 70 hours per week, 63% for those working 60 to 69 hours per week, and 45% for those working 50 to 59 hours per week.
Respondents with burnout were more likely to report they would likely or definitely reduce clinical care hours within the next 12 months than those who did not report feeling burnout: 75% vs 25%.
Reporting burnout was also associated with the likely or definite anticipation of physicians leaving their current practice in the next 2 years vs those who did not report burnout: 76% vs 24%.
Oncology Fellows’ Experiences of Burnout: A More Favorable Outlook
Another study looked at data from surveys of U.S. oncology fellows. This study found that professional well-being has improved among physicians enrolled in U.S. medical oncology fellowship training programs in the past decade. In 2023, fellows reported fewer symptoms of burnout than their counterparts in 2013, at 20% vs 34%. Fellows in 2023 also reported greater satisfaction with work-life integration than in 2013, at 50% vs 34%. Compared with practicing oncologists, fellows also reported less burnout (49% vs 34%). The improved well-being among fellows in the past decade might be the result of intentional changes training programs have implemented to address well-being more directly and comprehensively.
Addressing Burnout: Tackling the Issue Organizationally
A third manuscript examined strategies to improve oncology workforce well-being and recommended best practices to address the issue through an organizational lens. Authors pointed out the need for more research and metrics on well-being to ensure healthy work environments.
Here are some of the recommendations:
- Eliminate low-value work, including processes related to electronic health record systems
- Restructure teams to improve efficiency
- Promote clinician work-life integration
- Ensure psychological safety in the workplace
- Identify individual practice stressors
- Foster community within an organization.
In addition to the manuscripts, ASCO also published a policy brief examining the impact of burnout on workforce well-being as well as on the availability and quality of cancer care. The brief outlined ASCO’s support of initiatives that can assist in mitigating oncologists’ workload, such as increased integration of primary care physicians, nurse practitioners, and physician assistants in cancer care delivery as well as greater integration of telemedicine, which also improves patient access to care and may improve work-life balance among physicians who benefit from the greater flexibility in their schedules provided by telemedicine. The infographic visually outlines the data and trends in well-being among U.S. oncologists covered by the manuscripts in the compilation.
What’s Next?
“These findings show there is a critical need to address burnout in the oncology and greater medical workforce, which could help with retention and decrease early retirement and transition to nonclinical roles, as there will be a rising need for cancer care services for both the aging population and future generations,” said Julie R. Gralow, MD, FACP, FASCO, ASCO’s Chief Medical Officer and Executive Vice President. “Strategies to mitigate and reduce burnout are needed to ensure positive downstream impacts on the overall workforce, clinician wellness, and the delivery of high-quality, equitable cancer care.”
Julie R. Gralow, MD, FACP, FASCO
Future efforts may include broadening clinician education resources related to oncology-specific burnout and establishing quality metrics for physician well-being. Report authors called for more research to be conducted on the root causes of emotional distress and compassion fatigue in oncology and highlighted that these efforts would help address the need to improve oncology workforce well-being.
© American Society of Clinical Oncology. ASCO in Action. January 29, 2025. All rights reserved.
