To help balance work and life, don't strive for perfection

Several recent surveys have shown that work-life imbalance is an increasingly critical issue for oncologists. From the increased administrative burden and a loss of autonomy to increased caseloads and an impending shortage of specialists, today’s oncologists are at an increased risk of burnout.

“A lot of people are trying to figure out the burnout puzzle,” says Gail Gazelle, MD, FACP, FAAHPM, an Executive Coach for physicians and physician leaders. “I spoke with an oncologist who said his spirit was broken and he had become indifferent, but he felt weak for asking for help. The perception that asking for help equals weakness is something physicians learn early in their training, and it’s counterproductive. We all need help at certain times in our life, and we need to accept that help, just as we expect our patients to accept our help.”

In practices that are understaffed or lack sufficient medical assistants, oncologists may be charged with tracking down a CT scan from one hospital, laboratory studies from another, and emergency department visits from yet another, all while trying to reconcile EHRs that don’t communicate with one another. The time on such administrative tasks can far outweigh the time spend analyzing data with a specialist’s eye. These burdens have an additive effect and often encroach on home life and personal relationships.

“It sounds odd, but one of the keys to mitigating burnout is for doctors to shed their unattainable quest for perfection and focus instead on being at their best,” explains Dr. Gazelle, who is also an Assistant Professor at Harvard Medical School. “Physicians learn from a young age to focus on external metrics of success associated with perfection. Given intense practice demands, we end up with a nagging sense of failure which makes us want to give up or reduce our effort. If we shift the focus to what we are achieving and to being at our best despite the challenges, then we experience more of a deserved sense of pride and well-being."

She adds that practice demands can also lead to cutting corners, which not only impacts patient care but also leaves doctors feeling bad about their work. One of the ways to avoid this is to do the highly mindful act of giving full attention to each and every patient. This improves patient care and fosters a resilience that can thwart the effects of burnout.

“It’s important for doctors to know what pushes their buttons,” she says. “They need to get small doses of the things that sustain them, whether it's exercise, music, reading, or spending time in the garden. Small, regular doses are necessary, even if large doses aren’t possible.”

In Dr. Gazelle’s experience, physicians are eager to give their patients the best care possible and to have a balanced work and personal life—but they simply don’t always know how.

“These are the things we work on when I coach physicians,” she says. “It’s all about self-awareness, self-modulation, picking your battles, training your mind to focus where you want to focus, identifying options for growth and change, and figuring out how to live by your own values, even when faced with daunting external circumstances.”

Fast Facts¹

• 52.4%: Oncologist who disagree or strongly disagree that their work schedule leaves them enough time for a personal life.
• 25.7% vs 41.6%: Female oncologists were less likely to be satisfied with their work-life balance than male oncologists.
• 42.6%: Oncologists who report a moderate to moderate-or-higher likelihood of reducing their clinical work hours.
• 52.0%: Oncologists who reported it was moderately likely, likely, or definite that they would leave their current position within 2 years.

¹ Shanafelt TD, et al. Journal of Clinical Oncology. 2014;32(11):1127-1135.