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Avoiding Stress and Burnout in Cancer Care

Avoiding Stress and Burnout in Cancer Care

Over the past 8 years, I have led discussions and had private conversations about stress and burnout with oncologists of all stripes. Several common themes have emerged with regard to what it is that stresses and burns out oncologists and what helps them the most. At the top of the burnout list are time issues: not enough time with patients, time with family, or time for relaxation. Oncologists are overcommitted and overscheduled, inundated with paperwork, phone calls, and anxiety over never seeming to know enough.

Physical, mental, and psychological weariness are enormous. Sleep is interrupted by calls, worries, children, and family issues. The afternoon waiting room is filled with apprehensive patients newly diagnosed, or waiting for news of restaging, all of them nice people, many of them friends. Telling one person their cancer has progressed despite all the hard work they and their family have done hits you hard. Telling several in succession can decimate you. You may begin to protect yourself by withdrawing, becoming cynical, jaded. Sartre's existential nausea may creep in. You begin to wonder if you have accomplished anything.

What follows are some of the best words of advice I have heard, all from fellow oncologists:

(1) Realistically evaluate your practice and decide if you would be happier earning less money but having more time and help. As it is said, few people go to the grave thinking, "I wish I had worked more hours," or "I wish I had accumulated more money." Stop taking new patients until you catch up. Hire people to help you—another partner, a nurse practitioner, someone savvy to talk with insurance companies and help with paperwork. Pay them well, so they stay with you.

(2) Hang out with other oncologists and take pride in your profession. Teach it to others. Take on a preceptor in medical school or residency. You will see just how valuable your knowledge is. It is easy to get jaded and think others have so much more going on than you.

(3) Say NO. Take time off. Arrange for adequate coverage and reciprocate. Take the cue from the mandatory residents' 80-hour work week—there is a reason why so many people put so much work into making that a reality.

(4) Read a website about sleep hygiene. Make a pact with yourself and your family to get better sleep.


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