Canadian Radiation Oncology 2020 Work Engagement and Burnout Survey

ABSTRACT

Purpose or Objective The Canadian Medical Association recently acknowledged that physician health remains a significant threat to the viability of Canada’s health care system. A 2014 survey reported a 44% prevalence of burnout among American oncologists. The purpose of this survey was to determine the national prevalence of burnout and document work engagement among Canadian radiation oncologists. Materials and Methods Between November 2019 and March 2020 (pre COVID pandemic), online questionnaire was distributed electronically to 333 Canadian radiation oncologists, across 49 centers, through the National Canadian Association of Radiation Oncology office mailing list. The survey included 62 questions determining job engagement, and validated burnout scale The Maslach Burnout Inventory (MBI) (22 questions). Results 241 of the 333 surveyed Canadian radiation oncologists (72%) completed the questionnaire and were included in this analysis. Responses to the MBI showed that 15% of radiation oncologist met the strict criteria for burnout (i.e. negative scores in all 3 domains exhaustion, depersonalization, and low accomplishment). Another 60% scored negative in at least one of the three burnout domains. Using the more commonly reported definition of burnout (negative scores in either exhaustion and/or depersonalization), 44% of Canadian radiation oncologist were burnt out. Only 25% had positive scores in all 3 domains and were fully engaged in their work. The full burnout syndrome varies with the provinces and was the highest in British Columbia (22% ) and lowest in Quebec (3%). The responses to work engagement questions revealed a significant concerns regarding inefficiency in work flow (50%), heavy workloads (>50%), a poor work life balance (68%), lack of control over the work environment (47%) and lack of recognition from administrators (45%). 48% perceive the atmosphere at their primary work area as “chaotic and hectic”. Within the last 3 years, 41% had considered leaving their institution to work elsewhere and 51% were considering reducing their full-time equivalent (FTE). Reassuringly, 80% reported a sense of overall ability to provide high quality care and a 59% feel they have a supportive network of colleagues, 80% are willing to try something new. The top 4 strategies identified by respondants aimed to improve worklife quality were (1) more support staff at work, (2) more efficient care models, (3) more resources for patients, and (4) lighter workloads for physicians. Conclusion The survey shows that only 25% of the Canadian radiation oncologist is fully engaged in their work, 15 % meet the strict criteria for burnout and 44% meet the more commonly used burnout criteria. With the rising incidence of cancer and complexity of care, there is an urgent need for change, leverage the enthusiasm to “try something new”, and develop appropriate strategies to improve the wellbeing of the oncology work force.