The state of professional wellbeing and satisfaction among US oncologists.

Abstract

1 Background: Although previous studies have demonstrated substantial burnout among US oncologists, most of the published literature assessed the experience of oncologists prior to the COVID-19 pandemic. Methods: In January-February 2023, ASCO emailed a novel 36 item REDCap survey to 5892 U.S.-based physician ASCO members. The survey included 2 questions from the Maslach Burnout Inventory (MBI). The survey was distributed through multiple ASCO channels in February-March 2023. Survey responses were compared to findings from a 2013 survey of 1345 oncologists by Shanafelt et al (JCO, 2014). Per convention, those with high levels of emotional exhaustion (EE) and/or depersonalization (DP) were categorized as having burnout. Results: 410 oncologists responded to the survey. Responses from 328 oncologists in active clinical practice (at least 6 hours/week) are included in this analysis. The median age was 47 [IQR: 15]. Respondents were 52% female, 55% white and 85% married/partnered. 68% had caregiving responsibilities for children or adults. 64% reported that their current work setting was an academic institution. In 2023, 57% of clinicians had high EE on the single MBI-EE item (i.e., “feel burned out from [their] work” weekly or more often) compared to 29% in 2013 (p < .0001). 34% had high DP on the single MBI-DP item (i.e., feel that they “have become more callous towards people since [they] took [their] job” weekly or more often) vs. 13% in 2013 (p < .0001). A larger percentage of clinicians demonstrated one or more symptoms of burnout in 2023 compared to 2013 respondents (59% vs. 34%, p < .0001). The prevalence of burnout was higher among 2023 respondents with caregiving responsibilities compared to those without (65% vs 47%; p = .003). Those under 50 were more likely to have high DP relative to those 50 or older (39% vs 24%; p = .007). A higher percentage of non-white-identifying respondents had high EE compared to those identifying as white only (63% vs 52%, p = .068). Compared to 2013, respondents in 2023 reported higher mean fatigue levels (6.1 [SD = 2.6] vs. 5.8 [SD = 2.4]) and lower mean overall quality of life (7.1 [SD = 2.2] vs. 7.3 [SD = 1.8]) (range 0-10). Fewer 2023 respondents were satisfied with their work-life integration (WLI) relative to 2013 (24% vs. 35%, p = .001). Participants in the 2023 survey selected up to two factors associated with joy in work and factors that may improve work. The top factor contributing to joy in work was “speaking with and advising patients” (63%, 205/633 responses). Top factors improving work were enhanced practice/administrative support (46%, 149/618) and enhanced patient care support/staffing (44%, 142/618). Conclusions: Burnout and satisfaction with work-life integration appears to have worsened among US oncologists over the last decade. Policies and organizational interventions that enhance support for administrative and patient care tasks are necessary to improve well-being among oncologists.