2023 Is the Year We Combat Burnout

I find the practice of hematologic oncology to be one of the most gratifying professions. Amazing breakthroughs and discoveries happen regularly, and a significant number of our patients are living longer and with a better quality of life. The tools we have today advanced dramatically over the past three decades, and I’m optimistic that the next decade will bring even greater heights.

Despite these advances, there are many challenges in our profession, and physician burnout is an ever-increasing problem in oncology.

As the term suggests, burnout is an occupational-related syndrome characterized by physical and emotional exhaustion, feeling overwhelmed, having a low sense of professional esteem or accomplishment, and depersonalization in interactions with others. There are multiple factors related to hematologic oncology that increase our susceptibility to the development of burnout.

First and foremost is the daily exposure to life-and-death decisions and the helplessness we experience when treating some of our most advanced and highest-risk patients with cancer. We often develop tight bonds with patients and their families, and many of these relationships end, unfortunately, much too early. We were aware of these challenges when we selected the field of hematologic oncology, but perhaps with today’s advances, we can better serve some of our patients.

Several new challenges in the field are likely to lead to burnout, including the demands of maintaining the electronic medical record, increased administrative burden, and more attention being paid to relative value units as a measure of our productivity. The pandemic brought us the “benefit” of working from home, yet we now spend more time doing job-related work—at home. The boundaries between work and our personal lives are less apparent.

We are spending much more time answering questions and comments from staff and patients within the electronic health record. The inbox has led to new frustrations, including mandates on how quickly we respond to messages and fewer days we are able to log out. These obligations are a major contributor to burnout and job dissatisfaction. How can we reverse the current trend?

I wish I could provide the universal solution, but these are challenging issues. It’s likely solutions are best developed locally. Some strategies include having team-building retreats and off-site meetings where issues can be discussed openly. Some individuals look to spiritual support or find support within their community. There is not a one-size-fits-all solution, and everyone should contribute and be heard. The more everyone participates in the solution, the better the outcome.

We will all experience burnout at some point, and we all need to seek more personalized ways to cope. Exercise is a common way to decompress. I personally decompress in Tahoe by engaging in my favorite activity—downhill skiing. There is no better way to relax than to be with my kids in nature, and with limited cell service! Many hobbies, like reading a novel or watching a movie, can bring similar joy. Whatever activity you choose, make sure you make time for yourself. Most of my faculty have maxed out their accrued vacation time, and I encourage them to take vacation! Recognizing one’s own stress level and asking for help is also important. We should try to check in with one another, and there is always professional help if needed.

One of my favorite activities that we have incorporated at the University of California, San Francisco (UCSF) within the Hematology, Blood and Marrow Transplant, and Cellular Therapy Program is a yearly Remembrance Ceremony. All in the program are invited to attend. During the ceremony, which is performed by one of our spiritual leaders at UCSF, we read the names of the patients who lost their battle with cancer over the past year. After the names are read, everyone has the opportunity to share a story, perhaps a patient experience that touched them, or some way that our collective energy helped a patient or a family. I encourage you all to consider implementing something like this ceremony in your local practice.

Overall, I hope that everyone participates in solutions and develops their own strategies to fight the escalating battle with burnout. Please feel free to send me your comments at editor@bloodcancerstoday.com, and I hope you will share your success stories.

Wishing everyone a productive and less stressful 2023.

Thomas Martin, MD, is the Clinical Research Director of Hematologic Malignancies at the University of California, San Francisco Helen Diller Family Comprehensive Cancer Center.