Cardinal Health Specialty Solutions, Dublin, OH.
Aptitude Health, Atlanta, GA.
JCO Oncol Pract. 2020 Apr;16(4):e357-e365. doi: 10.1200/JOP.19.00542.
Physician burnout, characterized by exhaustion of physical or emotional strength, cynicism, and lack of achievement, has become a worsening phenomenon in medicine, contributing to higher health care costs and patient/physician dissatisfaction. How burnout has affected hematologists and oncologists is not well studied.
US community oncologists/hematologists were queried via a Web-based survey from September-November 2018. Physicians were asked about frequency of burnout symptoms, drivers of work-related stress, and their perceptions on management of workload.
Among the 163 physicians surveyed, 46% felt a substantial amount of stress at work. Most physicians felt emotionally (85%) and physically (87%) exhausted. A majority of physicians felt lethargic (67%), ineffective (64%), and/or detached (63%). In a typical workweek, 93% needed time beyond time allocated to clinical care to complete work responsibilities. Electronic health record (EHR) responsibilities caused moderate to excessive stress at work for 67% of physicians; 79% of physicians worked on EHRs outside of clinic hours. Other sources of excessive stress were changing reimbursement models (33%), interactions with payers (31%), and increasing patient and caregiver demands (31%). A third of physicians have considered retiring early or changing their career path to cope. To combat burnout, physicians' practices have used advanced practice providers, invested in information technology, and/or hired additional administrative staff. However, the majority of physicians stated they had optimal or good control over their workload.
Most oncologists experience burnout symptoms and require additional time beyond that allocated to clinical care to complete their workload. The discordance between oncologists' admission of stress and exhaustion while claiming good control over those same burdens warrants exploration in future research.
医生职业倦怠是一种日益严重的现象,其特征是身体或情绪疲惫、玩世不恭和缺乏成就感,这已成为医学领域的一个问题,导致医疗保健成本上升和患者/医生满意度下降。职业倦怠如何影响血液科医生和肿瘤学家尚未得到充分研究。
2018 年 9 月至 11 月,通过网络调查对美国社区肿瘤学家/血液科医生进行了调查。医生被问及倦怠症状的频率、工作相关压力的驱动因素以及他们对工作量管理的看法。
在接受调查的 163 名医生中,46%的人感到工作压力很大。大多数医生感到情绪(85%)和身体(87%)疲惫不堪。大多数医生感到懒散(67%)、低效(64%)和/或冷漠(63%)。在典型的工作周内,93%的医生需要超出临床护理分配时间来完成工作责任。电子健康记录(EHR)的责任给 67%的医生带来了中等至过高的工作压力;79%的医生在诊所时间之外处理 EHR。其他过度压力的来源包括不断变化的报销模式(33%)、与支付方的互动(31%)以及患者和护理人员需求的增加(31%)。三分之一的医生考虑提前退休或改变职业道路以应对。为了应对职业倦怠,医生的实践已经使用了高级实践提供者,投资了信息技术,并/或雇佣了额外的行政人员。然而,大多数医生表示他们对自己的工作量有最佳或良好的控制。
大多数肿瘤学家都经历过倦怠症状,需要额外的时间来完成他们的工作量,而这些时间超出了临床护理的分配时间。肿瘤学家承认自己承受着压力和疲惫,但同时声称对这些负担有很好的控制,这一矛盾值得在未来的研究中进一步探讨。