Burnout in oncologists – a frequent and underestimated problem

Burnout is experienced by more than 40 percent. oncologists, especially young ones. As this can negatively affect the quality of patient care, it is necessary to develop methods that will help us deal with this problem, urge oncologists.

The problem of burnout was discussed at a special symposium for young oncologists at the 35th congress of the European Society of Clinical Oncology (ESMO), which was held in Milan on October 8-12.

Burnout syndrome manifests itself as emotional exhaustion and depersonalization, i.e. feeling a change in the way you think or a sense of identity change.

This is not only a personal problem for a doctor, as it negatively affects not only his quality of life, but also his work and relationships with patients, said Dr. Laurence Albiges of the Gustave Roussy Institute in France, who presented the latest results of research on burnout professional French oncologists.

The scientists who conducted them sent an anonymous questionnaire to 340 young clinical oncologists, radiologists and hematologists. It included questions to help assess the level of burnout, sources of stress, as well as work relationships and support opportunities, and questions about the general health of the doctor. The questionnaires were completed by 204 young oncologists (60%).

According to the scientists’ calculations, 44% of occupational burnout manifested by an abnormally high level of emotional exhaustion or depersonalization was reported. respondents, in 18 percent. both symptoms occurred, and 20 percent. have taken drugs for anxiety or sleeping pills to deal with burnout. The burnout rate did not differ significantly between the three specialties, but was higher among physicians who did not feel valued and adequately rewarded for their job. He was accompanied by worse assessments of his own health and a desire to quit the medical profession or change specialization.

According to Dr. Michael Karamouzis, chairman of ESMO’s Committee of Young Oncologists, it is necessary to obtain similar data from other European countries. Europe is very diverse from a cultural, social and scientific point of view, and the problem of oncologists’ burnout has never been dealt with globally, but analyzed in individual countries. Obtaining similar statistics in all European countries is a challenge that we must face, as burnout affects the quality of cancer care across Europe, he stressed.

According to oncologists, many factors contribute to the occupational burnout of this group of doctors. One of the main ones is the emotional burden of dealing with frequent and repeated deaths of patients, leading to existential doubts and a sense of incompetence, said Dr Marina Garassino of ESMO’s Committee of Young Oncologists.

Among other factors, the doctors mentioned the fears of young oncologists about their future professional position, the tension with senior doctors regarding the choice of therapy, and overwork. Young doctors often work many hours with patients, and additionally conduct research and continue their education, which leaves them little time for rest and private life.

As emphasized by prof. Fortunato Ciardello from the Second University of Naples, burnout is experienced – sooner or later – by all medical workers who care for cancer patients. We live on the verge of equilibrium. It is difficult to see patients go, even at the age of 70. Perhaps the burnout of young oncologists is due to the contrast between their initial enthusiasm and over-optimism and reality. When they enter the profession, they believe that they are able to heal more patients than possible, and this leads to disappointment, said the oncologist. It is also more difficult for young doctors to cope with the expectations of patients and their families. The disease is hard to bear for any person involved, he stressed.

In his opinion, teaching oncologists the skills to better communicate with patients and colleagues would allow them to avoid many stressful situations and could reduce the risk of burnout.

Communication classes are compulsory in medical studies in Anglo-Saxon countries and Switzerland, but are omitted in many other European countries. Meanwhile, communication skills are a key element and one aspect that programs to help oncologists deal with burnout should focus on, said Dr. Albiges.

It is very important to train young doctors to communicate bad news to patients and their relatives and to deal with their reactions. Intervention programs should also encourage young oncologists to communicate with their teammates, including older ones, and with a hospital psychologist. The creation of groups in which young trainee oncologists can share their concerns should become part of their education. Burnout must stop being a taboo subject, said the specialist.

According to Dr Garassimo, discussing difficult patient cases in a group or asking for help from teammates can reduce the pressure on the individual physician. In turn, Dr. Francesco Atzori from Italy pointed out that medical students who decide to specialize in oncology should be very motivated and dedicated to patients, because it is a particularly difficult field. Before making the final decision, they should also be able to complete a trial internship in the oncology ward, which would last at least six months.

According to Dr. Albiges, trainees considering a specialization in oncology must be aware of how much investment it will require on their part. They must also have the ability to set the limits of personal involvement. The optimistic news is that burnout is manageable. However, interventions such as support groups, help from older colleagues, communication and stress management programs are needed. It is also necessary to develop methods for diagnosing this problem in teammates – concluded the specialist. (PAP)

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