By Sayeh Lavasani, MD, MSc, FRCPC
If you are a physician, you have probably experienced a fair share of stress and burnout throughout your education and training, along with your job as an attending. Medical oncologists are at a higher risk of burning out on the job. A stressful job paired with high-risk patients, who are going through a horrible time in their life dealing with cancer, makes the job much more intense. We always should be alert and responsive to our patients during their treatments, and calm their anxieties, along with their families. This process causes stress to the medical oncologist. For women who are medical oncologists, it can be hard to balance the needs of your patients with the needs of your own family, which contributes to compromising your own well-being. I am reaching that point in my life where my own parents are aging and need attention, as does my own family.
There are other factors that contribute to stress and burnout. Medical oncologists are experiencing longer work hours, increased patient volume and contact, decreased autonomy at work, reduced time spent on research and educational activities, and increased professional expectations. Overall, impaired work-life balance can cause burnout in any profession. It not only affects our and our family’s quality of life, but it can also negatively affect our patients. It decreases patient satisfaction, increases the possibility of medical error, and decreases empathy for our patients.
Coping with stress at work is not an easy task. Based on recent research, having resilience, practicing self-compassion, and finding meaning at work can help with job-related stress. A lot of institutions have implemented wellness committees that meet on a regular basis and have activities that can help oncologists to cope with stress. Yoga and Zumba are among the activities that we have at my institution. Of course, it can be hard to find time and energy after a long day in clinic to engage in these activities.
Electronic health records (EHR) have increased clerical burden on medical oncologists and they have reduced the meaningful time we spend with our patients. Based on a reported study, we are spending 49% of our time completing clerical tasks and interfacing EHRs.1
One strategy that I personally use to cope with stress is to make sure that I take some time out of every day for myself. I spend at least an hour once I get home from work to do something that I personally enjoy. Some suggestions are reading a book, watching your favorite show, spending time with family and friends, cooking, or exercising. Making this into a routine for yourself will greatly help with your mental health and well-being. Taking regular vacations, like 1 week off every 3 or 4 months, can help to decompress and recharge.
Being organized is another way to help with stress. Responding to emails as soon as you get them and completing any task as soon as you can are important. The more organized you are and the better time management skills you gain, the less stressed you will be over time. Using time efficiently will allow you to have more time for yourself, and will let you be at work for a reasonable amount of time. When I first started my current position, I would be at work well into the evenings. But after some time, I learned how to do everything in an efficient manner so I could finish at a reasonable time and lessen my stress and burnout by doing so. The nature of medical oncology requires us to be available to our patients. The 20-minute appointment slots to see a patient, do all the charting, discuss treatment, and put orders in are not sufficient. How can we achieve everything in 20 minutes? It’s impossible. Having clinic staff and a nurse practitioner can definitely help to manage our time, but let’s face it, we spend much more of our time, either the day before prepping our charts or the day of appointment, trying to take care of everything.
I believe that acknowledging burnout is very important. Physicians have always been considered the ones to help and heal their patients without needing any help themselves. We should recognize that in the profession of medical oncology we are under tremendous amount of stress. We can’t deny the elephant in the room and expect miracles to happen to help us thrive. A lot of issues that we see in ourselves and our colleagues, like lack of empathy and dissatisfaction with our job, are due to burnout. Everything starts with us. Even though we are expected to put our patients first, our health is just as important. It’s important to us, our patients, and our family. We can’t do a great job if we are spreading ourselves thin. I wish more things could be done by hospitals, organizations and our employers to recognize and address burnout.
The medical oncology community needs to act on this worrisome issue and to find a solution for it in order to preserve the quality of care that we provide to our patients.
No matter how stressed we are in our jobs, we should remember why we chose this profession in the first place. Medical oncology is an extremely rewarding profession; having an impact on the lives of our patients is priceless. Helping patients in a vulnerable point of their lives to survive and flourish is heartwarming to see.
Dr. Lavasani is a breast medical oncologist and assistant clinical professor in the Department of Medical Oncology and Experimental Therapeutics at City of Hope National Cancer Center in Duarte, California. Follow her on Twitter @sayehml.
- Sinsky C, Colligan L, Li L, et al. Allocation of physician time in ambulatory practice. Ann Intern Med. 2016;165:753-60.