Occupational and Personal Consequences of the COVID-19 Pandemic on US Oncologist Burnout and Well-Being: A Study From the ASCO Clinician Well-Being Task Force

Abstract

INTRODUCTION: The COVID-19 pandemic is an unprecedented global crisis profoundly affecting oncology care delivery. PURPOSE: This study will describe the occupational and personal consequences of the COVID-19 pandemic on oncologist well-being and patient care. MATERIALS AND METHODS: Four virtual focus groups were conducted with US ASCO member oncologists (September-November 2020). Inquiry and subsequent discussions centered on self-reported accounts of professional and personal COVID-19 experiences affecting well-being, and oncologist recommendations for well-being interventions that the cancer organization and professional societies (ASCO) might implement were explored. Qualitative interviews were analyzed using Framework Analysis. RESULTS: Twenty-five oncologists were interviewed: median age 44 years (range: 35-69 years), 52% female, 52% racial or ethnic minority, 76% medical oncologists, 64% married, and an average of 51.5 patients seen per week (range: 20-120). Five thematic consequences emerged: (1) impact of pre-COVID-19 burnout, (2) occupational or professional limitations and adaptations, (3) personal implications, (4) concern for the future of cancer care and the workforce, and (5) recommendations for physician well-being interventions. Underlying oncologist burnout exacerbated stressors associated with disruptions in care, education, research, financial practice health, and telemedicine. Many feared delays in cancer screening, diagnosis, and treatment. Oncologists noted personal and familial stressors related to COVID-19 exposure fears and loss of social support. Many participants strongly considered working part-time or taking early retirement. Yet, opportunities arose to facilitate personal growth and rise above pandemic adversity, fostering greater resilience. Recommendations for organizational well-being interventions included psychologic or peer support resources, flexible time-off, and ASCO and state oncology societies involvement to develop care guidelines, well-being resources, and mental health advocacy. CONCLUSION: Our study suggests that the COVID-19 pandemic has adversely affected oncologist burnout, fulfillment, practice health, cancer care, and workforce. It illuminates where professional organizations could play a significant role in oncologist well-being.

The Hardest Weeks of My Life: A Qualitative Study of Experiences, Practice Changes, and Emotional Burden of New York City Oncology Physicians During the COVID-19 Surge in 2020

“…A recent focus group study among ASCO oncologists found that prepandemic burnout compounds the personal and occupational stressors experienced during the pandemic and provided a number of valuable recommendations to reduce burnout including flexible time-off schedules and peer support groups. 9 The ESMO survey similarly found that working hours and availability of colleagues for emotional support were significant predictors of lower distress levels. 10 Given the struggles with isolation from colleagues described in this study, departments should integrate regular team check-ins and identify opportunities to increase collaborative practice across inpatient and outpatient services, such as using telehealth to support joint visits and virtual rounding.…”

“…4 Recent analyses have indicated that health professionals treating COVID-19-infected patients have been more likely to experience depression, anxiety, posttraumatic stress disorder, and other psychiatric conditions. [5][6][7][8] Surveys conducted by ASCO and ESMO have also identified negative mental health outcomes among physicians providing oncology care during the pandemic, [9][10][11] including distress, burnout, and decreased well-being. Furthermore, ESMO found that wellbeing and job performance since COVID-19 were correlated with local COVID-19 crude mortality rates.…”

“…10 However, there has been little in-depth investigation into the experiences of physicians providing cancer-specific care in a location experiencing a COVID-19 surge. Although recent studies have examined the experiences of oncologists providing end-of-life care for patients during COVID-19, 12 and burnout and stress related to disruptions in treatment, clinical research, and professional development, 9 the ways in which oncologists' experienced changes in delivery of routine cancer care, as well as the experiences of oncologic hospitalists devoted to inpatient care, has not previously been explored. In addition, this study focuses on oncologic care during the initial surge of COVID-19 at the pandemic's global epicenter.…”

Oncology Healthcare Professionals’ Mental Health during the COVID-19 Pandemic

“…“I think that all of our colleagues are feeling a lot of burnout right now. Everybody’s seeing a lot of death and heartache and social isolation and anger that they’re not used to encountering in very new and different ways” [ 50 ] p. 431.…”

Maintaining and Advancing Quality Cancer Care During a Global Pandemic

“…Thus, ASCO worked to develop a framework for understanding the role of this pandemic in compounding or exposing ongoing burnout among oncology clinicians. Initially captured as a goal in ASCO's Road to Recovery Report , the subsequently published report on occupational and personal consequences of the COVID-19 pandemic on US oncologist burnout and well-being identified significant distress, practice alterations such as early retirement, and signs of resiliency among clinicians 32 . A follow-up survey is planned for 2022 to assess the ongoing consequences of the public health emergency.…”