Nearly 1 in 4 academic oncologists report burnout
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Key takeaways:
- Self-identified lesbian/gay/bisexual faculty were over three times more likely to experience burnout as their heterosexual counterparts.
- Women had twice the likelihood as men.
CHICAGO — Nearly one-fourth of academic oncologists surveyed reported feelings of burnout, with the highest rates among women and lesbian/gay/bisexual faculty, according to study results presented at ASCO Annual Meeting.
The findings indicate an urgent need for tailored interventions at all levels to address factors driving burnout and its impact on attrition and career trajectory for underrepresented in medicine faculty, researchers concluded.
Rationale and methods
“Burnout is a growing problem in medicine and certainly is something that affects disparate groups in differential ways,” Fumiko Chino, MD, radiation oncologist at Memorial Sloan Kettering Cancer Center and a member of Healio’s Women in Oncology Peer Perspective Board, told Healio. “During the pandemic, we all felt the burnout as medical professionals, especially women in medicine. It’s at the point where we need high-quality data to demonstrate the problem, and then discreet and specific interventions to change it.”
Much of the previously published has been limited in scope, according to Chino.
“We were excited to look at national data for academic oncologists for this study because burnout is truly pervasive; it is not an East or West Coast thing and it is truly a multifactorial problem,” she said.
The study included 724 academic oncologists (58% men; 95% self-identified as heterosexual; 65% white; 53% senior faculty).
Researchers obtained national faculty data from Association of American Medical Colleges StandPoint Faculty Engagement Survey between 2017 and 2020. They considered burnout as any response endorsing at least “one or more symptoms of burnout.”
The investigators assessed self-reported workplace culture for four key factors — collegiality, diversity, faculty wellness and recruitment/retention of underrepresented in medicine faculty — and conducted multivariate analysis to discover factors associated with faculty burnout.
Findings
Overall, 22% of respondents reported burnout.
Results showed the highest rate of burnout among faculty who self-identified as lesbian/gay/bisexual vs. heterosexual (43% vs. 21%; P = .0005), followed by female vs. male faculty (31% vs. 16%; P < .0001).
“We were not surprised by these findings; however, there hasn’t been much national data about the LGBTQ population. So, it was important to demonstrate with numbers and data that this population truly is at a disproportionately higher risk for burnout, potentially due to lack of support and discrimination,” Chino said.
Researchers observed the lowest rates of burnout among Asian faculty (12%), followed by white and Hispanic faculty (26% for both), with the highest rates in Black (33%) and multiracial faculty (50%; P = .003).
Faculty considered underrepresented in medicine, who accounted for 7% of the survey respondents, had numerically higher rates of overall burnout (30% vs. 22%), but the difference fell short of statistical significance.
Results of multivariate analyses showed increased odds for burnout among lesbian/gay/bisexual (OR = 3.56; 95% CI, 1.55-8.18) and female faculty (OR = 2.32; 95% CI, 1.51-3.56).
Most faculty reported their institution cultivates collegiality (80%), diversity (73%) and faculty wellness (53%), and most reported their institution was successful at recruiting (63%) and retaining (58%) underrepresented-in-medicine faculty. Men appeared more likely than women to endorse positive diversity (77% vs. 68%; P = .004).
“These are all important questions to evaluate to see if we can identify what is truly driving burnout in oncology,” Chino said. “Outside of this specific study, we have other studies that will be presented at ASCO looking at attrition and sexual harassment in the workplace. We are trying to evaluate this issue in many different ways, which are all a part of the larger burnout problem.”
Next steps
Researchers plan to take a closer look at the data to compare burnout before vs. after the COVID-19 pandemic, Chino told Healio.
“We estimate that burnout rates significantly changed during the pandemic era,” she said. “We have that data now and are analyzing it to see what shifted pre- and post-pandemic. I suspect that burnout increased for pretty much everyone.”
Chino suggested ways to address burnout, starting with oneself.
“We can all start by looking at burnout on a personal level and identify what we can do for ourselves to find better work/life integration,” she said. “Then, look at what can we do within our team to help support them and ensure that we are all working together, what can we do within our department and institution, and what national policies could potentially help decrease the burden we are all feeling. The nuts and bolts of this is if, for example, you are the only Black woman in your department, you may (appropriately) feel that intersectional increased stressors and isolation of not only being a woman but also a Black woman. So, what can we do to change that?”
Perspective
Back to TopStephen R. Grossman and Steven Siegel, MD, PhD
Physician burnout has come to the fore as a problem affecting not only provider well-being but also the ability of our national health care system to deliver high quality, efficient and compassionate care to the neediest patients. This is especially true in oncology, where the emotional toll of treating the majority of patients who will ultimately die can cause strains that result in emotional withdrawal and difficulty in interpersonal relationships.
Odei and colleagues examined burnout using a recent Association of American Medical Colleges faculty engagement survey that addresses wellness across a sample of physicians nationally. The group focused on the subset of academic oncology physicians with a particular focus on understanding the impact of gender, race/ethnicity and sexual orientation on rates of self-reported burnout.
The results of this study were eye-opening, showing a striking gap in rates of self-reported burnout between women and men of all races/ethnicities and physicians who self-report as lesbian/gay/bisexual vs. those self-reporting as heterosexual. The differences in burnout reported in this survey are not only statistically significant, but wide enough to sound an alarm for health systems and the medical community to quickly investigate whether these results are replicable in other nonacademic settings and initiate interventions.
This abstract is a timely call to action to investigate further the causes of and potential solutions for burnout that may impact all clinicians, including oncology physicians, while being sensitive to the unique contributions of gender and sexual orientation.
Keck Medicine of USC
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Odei B, et al. Abstract 11000. Presented at: ASCO Annual Meeting; June 2-6, 2023; Chicago.
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