Canadian Radiation Oncology 2020, Work Engagement and Burnout Survey

Purpose/Objective(s): In 2018, the Canadian Medical Association acknowledged that physician health remains a significant threat to the viability of Canada's health care system. The prevalence of burnout among American oncologists was 44% in a 2014 survey. The purpose of this survey was to determine the national prevalence of burnout indicators and report work engagement among Canadian radiation oncologists. Materials/Methods: Between November 2019 and March 2020 (pre-COVID pandemic), an online questionnaire was distributed electronically to 333 Canadian radiation oncologists across 49 centers through the Stadt lander Canadian Association of Radiation Oncology mailing list. The survey included 62 questions assessing work engagement, and the validated Maslach Burnout Inventory (MBI) burnout scale (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 oncologists 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 oncologists were burnt out. Only 25% had positive scores in all 3 domains and were fully engaged in their work. The full burnout syndrome varied between provinces and was the highest in British Columbia (22%) and lowest in Quebec (3%). The responses to work engagement questions revealed significant concerns regarding inefficiency in workflow (50%), heavy workloads (> 50%), 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 and 80% are willing to try something new. The top 4 strategies identified by respondents aimed to improve work-life 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: Our survey showed that only 25% of Canadian radiation oncologists are fully engaged in their work, whereas 15% met the strict criteria for burnout and 44% met the commonly used burnout criteria. With the rising incidence of cancer and complexity of care, there is an urgent need for system change, leverage enthusiasm to “try something new”, and develop appropriate strategies to improve the well-being of the Canadian radiation oncologist workforce