Burnout Hits Oncologists Hard, but Healthcare Systems Can Help

$6 million. That’s how much a hospital or health system stands to lose each year if it doesn’t figure out how to help physicians who are struggling with burnout, says Kathleen Blake, MD, MPH, vice president of healthcare quality at the American Medical Association. That’s because it will cost approximately $6 million to replace those physicians, she says.

Blake, who discussed physician burnout at the Association of Community Cancer Centers (ACCC) Annual Meeting and Cancer Business Summit in Washington, D.C., in March, says physicians experiencing burnout feel “depersonalized and emotionally exhausted.”

“They’re feeling as though [they’re] not achieving what [they] want professionally, and they have a sense of just not being empowered to do what they went into medicine to do.”

Burnout among oncologists, specifically, is a common problem. A 2014 study in the Journal of Clinical Oncology reported that 45% of U.S. oncologists experience it.  

For doctors, the key thing they want to know when they go home is that they took good care of their patients, says Blake. “Oncologists will lose sleep at night and toss and turn.”

Root causes

Blake says physician burnout isn’t an individual physician problem. Rather, in about 80% of cases, it’s caused by organizational or systems problems.

Blake also points to a 2013 study by the Rand Corporation which found that the inability to deliver high-quality care is a stressor for physicians. The study, which revealed that physicians find EHRs to be “cumbersome” and contribute to their dissatisfaction, also found that these issues drive physician dissatisfaction.

It’s frustrating for physicians to have to contend with the increased demands for a “greater quantity of care,” since it “detracted from the quality of care in some cases,” according to the Rand study. The lack of interoperability and the amount of time physicians spend on data entry were also cited as stressors for physicians.

How to curb burnout

Blake highlights providers such as Minneapolis, MN-based Hennepin Healthcare for its work to support physicians. The health system discovered that the way patients are scheduled during the day can have a real impact on physicians’ stress. For example, for younger physicians with children at home, it’s very challenging to have to treat an extremely complex patient at the end of the day, she says.

To remedy this, Hennepin Healthcare has tried to use end-of-the-day scheduling slots for patients who are less complex, which allows physicians to leave the office on time.

She also points to a healthcare provider in the Pacific Northwest that has found a new way to help curb burnout. This provider partners up physicians who are EHR-savvy with physicians who are not. In this case, the physicians who are more adept at documenting within the EHR serve as coaches to other physicians and help them to integrate the EHR more effectively within their work flow.

Staying up to date on the latest medical research is also a challenge that can contribute to burnout, particularly among very dynamic fields such as oncology, says Linda Bosserman, MD, assistant clinical professor and staff physician at Duarte, CA-based City of Hope, who copresented with Blake at the ACCC annual meeting.

That’s one of the reasons she says oncology needs to embrace a team-based approach to care. For example, she highlights the number of times she has to click a button to authorize treatments such as standard chemotherapy. “My team could click that button,” says Bosserman.

Team members who could take the “click burden” off physicians include medical secretaries, medical assistants, licensed practical nurses, registered nurses, and advanced practice clinicians, depending on state laws, she says.

“The unique things that doctors do [are] ensure the diagnosis is correct and determine that the treatment plans are aligned with the wishes and values of their patients,” says Bosserman. “Everybody else can do the other work to document care and make orders, with the doctor signing the orders.”