Assessing burnout among oncologists in Ontario, Canada.

Abstract

41 Background: Provider experience and physician burnout has been recognized as a critical issue in medicine. Ontario, Canada has a single payer cancer system run by Ontario Health (Cancer Care Ontario) with a mandate covering system level planning and delivery of cancer services, funding, and quality improvement. As part of a larger provincial initiative to address clinician burnout, we examined the prevalence and drivers of burnout in practicing physician oncologists in Ontario. Methods: In November-December 2019, surgical, medical, hematological, and radiation oncologists in Ontario were invited to complete an anonymous online survey to assess burnout and its drivers. Burnout prevalence was assessed through the Maslach Burnout Inventory – Human Services Survey for Medical Personnel (MBI-HSS MP). Data on demographic, workplace, engagement, and practice profiles were collected. Logistic regression modeling was conducted to assess key variables associated with “high” burnout using a common definition of high scores on the MBI subscales of emotional exhaustion (EE) (> 27) and/or depersonalization (DP) (>10). Results: Response rate to the survey was 44% (n=418) with 72% reporting high levels of burnout. Mean scores for EE (30.7, SD 12.1) and DP (9.9, SD 6.7) were consistent with high burnout. Participants endorsed known drivers of burnout including: 1) a poor culture of wellness at work (e.g., not comfortable talking to leadership (72%), 2) inefficiencies of practice (e.g. feeling insufficient documentation time (67%)) and 3) personal resilience (e.g. not feeling they are contributing professionally in ways they value (21%)). Age (<45yrs) (OR: 2.15), poor/marginal control over workload (OR: 4.42), feeling used/unappreciated (OR: 2.63), working atmosphere that feels hectic/chaotic (OR: 2.68), and insufficient time for documentation requirements (OR: 2.52) significantly impacted the odds of high burnout in the regression model (p<0.05). Conclusions: The high rate of burnout among oncology physicians in a single payer public cancer system in Ontario is concerning for the wellbeing of providers, patients and system sustainability. Drivers important for maintaining a culture of wellness and efficiency of practice will require local, regional and provincial health policy to improve. Next steps will include raising awareness with provincial initiatives/policy to address key burnout drivers, and examining the impact of working under pandemic conditions (Covid-19) on oncologist burnout.

Physician Task Load: Strategies to Mitigate Stress Among Doctors

“…In response to the COVID-19 epidemic, new healthcare systems can be built that address the root causes of burnout. Early to mid-career employees may benefit from increased peer-to-peer and leadership engagement opportunities (22). According to a national electronic, prospective, cross-sectional study, emergency physicians have suffered substantial levels of psychological distress as a result of the COVID-19 epidemic.…”

Mindfulness Among Medical Oncology Doctors and Its Relation With Burnout: Turkish Oncology Group (TOG) Study

“…[16][17][18] Medical oncology doctors can be exposed to burnout more intensely because of some of the unique features of their profession. [19][20][21][22][23][24] The most prominent features that increase these risks can be the severity of patients' illness, long-term treatments with highly toxic therapies, and the fact that a significant part of their practice is devoted to the psychological rehabilitation of patients with terminal cancer and their families. Unless burnout is noticed or precautions taken against it, it can have significant consequences, such as early termination of a professional career.…”