Prevalence and Workplace Drivers of Burnout in Cancer Care Physicians in Ontario, Canada

Abstract

PURPOSE: Provider well-being has become the fourth pillar of the quadruple aim for providing quality care. Exacerbated by the global COVID-19 pandemic, provider well-being has become a critical issue for health care systems worldwide. We describe the prevalence and key system-level drivers of burnout in oncologists in Ontario, Canada. METHODS: This is a cross-sectional survey study conducted in November-December 2019 of practicing cancer care physicians (surgical, medical, radiation, gynecologic oncology, and hematology) in Ontario, Canada. Ontario is Canada's largest province (with a population of 14.5 million), and has a single-payer publicly funded cancer system. The primary outcome was burnout experience assessed through the Maslach Burnout Inventory. RESULTS: A total of 418 physicians completed the questionnaire (response rate was 44% among confirmed oncologists). Seventy-three percent (n = 264 of 362) of oncologists had symptoms of burnout (high emotional exhaustion and/or depersonalization scores). Significant drivers of burnout identified in multivariable regression modeling included working in a hectic or chaotic atmosphere (odds ratio [OR] = 15.5; 95% CI, 3.4 to 71.5; P < .001), feeling unappreciated on the job (OR = 7.9; 95% CI, 2.9 to 21.3; P < .001), reporting poor or marginal control over workload (OR = 7.9; 95% CI, 2.9 to 21.3; P < .001), and not being comfortable talking to peers about workplace stress (OR = 3.0; 95% CI, 1.1 to 7.9; P < .001). Older age (≥ 56 years) was associated with lower odds of burnout (OR = 0.16; 95% CI, 0.1 to 0.4; P < .001). CONCLUSION: Nearly three quarters of participants met predefined standardized criteria for burnout. This number is striking, given the known impact of burnout on provider mental health, patient safety, and quality of care, and suggests Oncologists in Ontario may be a vulnerable group that warrants attention. Health care changes being driven by the COVID-19 pandemic provide an opportunity to rebuild new systems that address drivers of burnout. Creating richer peer-to-peer and leadership engagement opportunities among early- to mid-career individuals may be a worthwhile organizational strategy.

Burnout Syndrome (Bs) Among Doctors During the Covid-19 Pandemic in Porto Velho-ro, Brazil

“…In general, those professionals up to 30 years of age were more likely to have Burnout syndrome (p = 0.000000165), with the prevalence decreasing with increasing age. Similarly, in the study by Khan et 2020), observed higher scores on the GAD − 7 scale for anxiety among those younger, between 25 and 44 years old, so those over 45 years old were less likely to experience anxiety symptoms (p = 0.011) [5,[8][9][10][11][12].…”

“…Inventory (CBI) to assess the prevalence among primary care physicians during the pandemic, high levels of BS were found for the 3 domains: 65.9% with personal burnout, 68.7% for Work-related burnout and 54.7% for patient-related burnout. In the study by Civantos et al (2020), who used the Mini-Z for head and neck surgeons, the prevalence was 14.7% [5,[8][9][10].…”

Creating healthy workplaces in healthcare: Are we delaying progress by focusing on what we can do rather than what we should do?

“…We have gathered enough evidence in healthcare to know what is driving poor wellbeing, and how these processes impact on quality of care and patient safety (6). Indeed, there is a plethora of studies on the drivers of burnout (7)(8)(9), the mechanisms of burnout (10-13) and reviews of burnout interventions in healthcare (14)(15)(16)). Thus, it could be argued that we have a good idea of what we need to do to improve the situation.…”

An organizational approach to improve staff resiliency and wellness during the COVID-19 pandemic

“…Prior to the onset of the COVID-19 pandemic, several studies had already reported elevated burnout levels amongst various groups of healthcare workers (e.g. , 4 ; 6 ; 25 ; 27 ; 30 . Globally, research showed that as the COVID-19 pandemic progressed, burnout continued to be a significant problem impacting healthcare workers 11 ; 15 , and in some cases had become present at higher rates than previously reported 17 .…”