A Needs Assessment of Social Support Among Medical Physicists: Stress, Medical Error, and Burnout

Abstract

Previous studies suggest medical physicists (MPs) experience the highest stress of the professional groups in Radiation Oncology. While prior work shows that physicians desire social support in times of stress (Shapiro et al., Arch Surg 2012), less is known about MPs social support needs. After Institutional Review Board approval, and in collaboration with the American Association of Physicists in Medicine (AAPM), a survey adapted from Shapiro et al was administered by AAPM to 8566 members via email. Respondents were considered likely to seek support if they answered (probably/definitely would) and unlikely to seek support if they answered (probably/definitely would not). The results were compared to historical data on physicians using chi squared goodness-of-fit. Logistic regression was used to determine demographic predictors of unwillingness to seek support. One thousand four hundred six members (16%) accessed the survey, and 1297 of those (92%) gave consent for the survey. One thousand one (12%) respondents answered the final demographic questions. Respondents were predominantly MPs in radiation oncology (82%), male (69%), private practice (52%), practicing >20 years (36%) or 11-20 years (24%). Sixty-seven percent of respondents endorsed exposure to one or more of the following stressors: serious adverse event in a patient of their own (8%), personal serious physical illness (14%) frequent or constant burnout (33%), serious family illness (35%), death of a family member (25%), personal mental illness (9%), or desire for self-harm (4%). MPs were most likely to seek social support for personal physical illness (79%) or personal mental illness (71%), which differed from physicians’ willingness to seek support (62% physical illness, 50% mental illness, P < 0.001). They were also likely to seek social support after involvement with an adverse patient outcome (75%) or medical error (74%), compared to the physicians' numbers of 63% and 67%, respectively (P < 0.001). After an adverse patient outcome 52% of MPs would seek help compared to 38% of physicians (P < 0.001). MPs were unlikely to seek social support in the setting of personal fatigue and personal burnout (67% and 56% unwilling, respectively) which was, however, markedly more willing than physicians (91% and 76% unwilling, P < 0.001 for each.) Factors associated with MPs unwillingness to seek support for medical error included >20 years in practice (versus still in training, OR = 0.30, P = 0.015), and male gender (OR = 0.60, P = 0.003). There were no demographic factors associated with unwillingness to seek support for burnout. Medical physicists are reluctant to seek support for fatigue or burnout but are more willing to seek social support after involvement with medical error or adverse patient event. Compared to their physician colleagues, MPs are more willing to seek social support in all surveyed situations. The peer support model that has been instituted for physicians could have similar success among MPs.