Evaluation of Burnout in Physician Members of the American Brachytherapy Society

Abstract

Purpose: National studies suggest over fifty percent of physicians have feelings of burnout (Shanafelt et. al. Mayo Clin Proc 2015). This can result in emotional exhaustion, depersonalization, and reduced personal accomplishment. Left unmanaged this can lead to depression, addiction, and suicidal ideation. Burnout rates are reported for radiation oncology residents, program directors, and academic chairs but not amongst radiation oncologists who practice brachytherapy. The purpose of this study was to determine the rates of burnout amongst physician members of the American Brachytherapy Society (ABS). Materials and Methods: An anonymous online cross-sectional survey was performed of ABS physician members from December 2020 to February 2021. The survey was initially emailed from the ABS to members, followed by two participation reminders. Burnout was assessed by the Maslach Burnout Inventory-Human Service Survey (MBI-HSS), a validated 22-question survey. Thirteen additional demographics questions were included. High emotional exhaustion (EE) was defined a score of at least 27, high depersonalization was defined as a score of at least 10, and low personal accomplishment (PA) was defined by a score of no more than 33 (Rotenstein et. al. JAMA 2018). This study was approved by the Institutional Review Board. Results: Overall, 51 out of 400 members responded to the survey (13% response rate). Respondents were predominantly male (69%), married (78%), had 1-5 full time faculty or partners (59%), worked 51-60 hours per week (61%), deliver 6-10 brachytherapy treatments per week (43%), and have a brachytherapy suite in their department (63%). Six percent of respondents met the strict MBI-HSS criteria for high burnout (as defined by high EE, high DP, and low PA). Fifty-seven percent of respondents reported at least one manifestation of professional burnout (either high EE or DP). Based on individual MBI-HSS subscale scores, 47% of respondents demonstrated high EE, 37% high DP, and 16% low PA. Compared to prior surveys of radiation oncology academic chairs, residency program directors, and residents, survey respondents consistently had higher mean scores for EE and higher scores for DP, but higher scores for PA (Table 1). The most common identified stressors were electronic medical records (EMR) and excessive workload. Forty-seven percent of respondents also reported that COVID-19 increased their feelings of burnout. Respondents from academic facilities were more likely to have increased feelings of burnout due to COVID-19 (odds ratio 6.8, 95% CI 1.8-25.7). Conclusions: Nearly 60% of ABS physician members who responded to this survey reported symptoms of professional burnout with 6% meeting strict criteria for high burnout. This is higher than that reported for radiation oncology residents, program directors, or academic chairs. Managing stressors related to the EMR and workload are potential areas for improvement.