Laboratory/Clinical Translational Research
The Well-Being and Personal Wellness Promotion Strategies of Medical Oncologists in the North Central Cancer Treatment GroupShanafelt T.D.a, b, c · Novotny P.a, e · Johnson M.E.d · Zhao X.a, e · Steensma D.P.a, b, c · Lacy M.Q.b, c · Rubin J.a · Sloan J.a, e
aDepartment of Oncology, bDivision of Hematology, cDepartment of Internal Medicine, dChaplain Services, eCancer Center Statistics, Mayo Clinic, Rochester, Minn., USA
Do you have an account?
- Rent for 48h to view
- Buy Cloud Access for unlimited viewing via different devices
- Synchronizing in the ReadCube Cloud
- Printing and saving restrictions apply
Rental: USD 8.50
Cloud: USD 20.00
Article / Publication Details
Purpose: The well-being of oncologists is important to the well-being of their patients. While much is known about oncologist distress, little is known about oncologist well-being. We set out to evaluate oncologist well-being and the personal wellness promotion strategies used by oncologists. Patients and Methods: We performed a cross-sectional survey of medical oncologists in the North Central Cancer Treatment Group using a validated instrument to measure quality of life. Study-specific questions explored stressors, wellness promotion strategies and career satisfaction. Results: Of 241 responding oncologists (response rate 61%), 121 (50%) reported high overall well-being. Being age 50 or younger (57 vs. 41%; p = 0.01), male (53 vs. 31%; p = 0.01) and working 60 h or less per week (50 vs. 33%; p = 0.005) were associated with increased overall well-being on bivariate analysis. Ratings of the importance of a number of personal wellness promotion strategies differed for oncologists with high well-being compared with those without high well-being. Developing an approach/philosophy to dealing with death and end-of-life care, using recreation/hobbies/exercise, taking a positive outlook and incorporating a philosophy of balance between personal and professional life were all rated as substantially more important wellness strategies by oncologists with high well-being (p values <0.001). Oncologists with high overall well-being also reported greater career satisfaction. Conclusion: Half of medical oncologists experience high overall well-being. Use of specific personal wellness promotion strategies appears to be associated with oncologist well-being. Further investigations of the prevalence, promotion, causes, inequities and clinical impact of physician well-being are needed.
© 2005 S. Karger AG, Basel
- Shanafelt T, Sloan J, Habermann T: The well-being of physicians. Am J Med 2003;114:513–517.
- Haas JS, Cook EF, Puopolo AL, Burstin HR, Cleary PD, Brennan TA: Is the professional satisfaction of general internists associated with patient satisfaction? J Gen Intern Med 2000;15:122–128.
- Linn LS, Brook RH, Clark VA, Davies AR, Fink A, Kosecoff J: Physician and patient satisfaction as factors related to the organization of internal medicine group practices. Med Care 1985;23:1171–1178.
- Lichtenstein RL: The job satisfaction and retention of physicians in organized settings: A literature review. Med Care Rev 1984;41:139–179.
- Bellini LM, Baime M, Shea JA: Variation of mood and empathy during internship. JAMA 2002;287:3143–3146.
- Firth-Cozens J: Emotional distress in junior house officers. Br Med J (Clin Res Ed) 1987;295:533–536.
- DiMatteo MR, Sherbourne CD, Hays RD, Ordway L, Kravitz RL, McGlynn EA, Kaplan S, Rogers WH: Physicians’ characteristics influence patients’ adherence to medical treatment: Results from the Medical Outcomes Study. Health Psychol 1993;12:93–102.
- Melville A: Job satisfaction in general practice: Implications for prescribing. Soc Sci Med [Med Psychol Med Sociol] 1980;14A:495–499.
- Shanafelt TD, Bradley KA, Wipf JE, Back AL: Burnout and self-reported patient care in an internal medicine residency program. Ann Intern Med 2002;136:358–367.
- Firth-Cozens J, Greenhalgh J: Doctors’ perceptions of the links between stress and lowered clinical care. Soc Sci Med 1997;44:1017–1022.
- Hsu K, Marshall V: Prevalence of depression and distress in a large sample of Canadian residents, interns, and fellows. Am J Psychiatry 1987;144:1561–1566.
- Smith JW, Denny WF, Witzke DB: Emotional impairment in internal medicine house staff. Results of a national survey. JAMA 1986;255:1155–1158.
- Caplan R: Stress, anxiety, and depression in hospital consultants, general practitioners, and senior health service managers. BMJ 1994;309:1261–1263.
- Ramirez A, Graham J, Richards MA, Cull A, Gregory WM: Mental health of hospital consultants: The effects of stress and satisfaction at work. Lancet 1996;347:724–728.
- Reuben DB: Depressive symptoms in medical house officers. Effects of level of training and work rotation. Arch Intern Med 1985;145:286–288.
- Firth-Cozens J: Interventions to improve physicians’ well-being and patient care. Soc Sci Med 2001;52:215–222.
- Ramirez AJ, Graham J, Richards MA, Cull A, Gregory WM, Leaning MS, Snashall DC, Timothy AR: Burnout and psychiatric disorder among cancer clinicians. Br J Cancer 1995;71:1263–1269.
- Kash KM, Holland JC, Breitbart W, Berenson S, Dougherty J, Ouellette-Kobasa S, Lesko L: Stress and burnout in oncology. Oncology (Huntingt). 2000;14:1621–1633; discussion 1633–1634, 1636–1637.
- Whippen DA, Canellos GP: Burnout syndrome in the practice of oncology: Results of a random survey of 1,000 oncologists. J Clin Oncol 1991;9:1916–1920.
- Penson R, Dignan F, Canellos G, Picard C, Lynch TJ Jr: Burnout: Caring for the caregivers. Oncologist 2000;5:425–434.
- Clark DC, Eckenfels EJ, Daugherty SR, Fawcett J: Alcohol-use patterns through medical school. A longitudinal study of one class. JAMA 1987;257:2921–2926.
- Hughes PH, Conard SE, Baldwin DC Jr, Storr CL, Sheehan DV: Resident physician substance use in the United States. JAMA 1991;265:2069–2073.
- McAuliffe WE, Rohman M, Santangelo S, Feldman B, Magnuson E, Sobol A, Weissman J: Psychoactive drug use among practicing physicians and medical students. N Engl J Med 1986;315:805–810.
Myers DG: Medical Marriages: A Look at the Problems and Their Solutions. New York, Plenum Medical Book Co, 1994.
- Myers MF: The well-being of physician relationships. West J Med 2001;174:30–33.
- Warde CM, Moonesinghe K, Allen W, Gelberg L: Marital and parental satisfaction of married physicians with children. J Gen Intern Med 1999;14:157–165.
- Gabbard GO, Menninger RW: The psychology of postponement in the medical marriage. JAMA 1989;261:2378–2381.
- Weiner EL, Swain GR, Wolf B, Gottlieb M: A qualitative study of physicians’ own wellness-promotion practices. West J Med 2001;174:19–23.
- Quill TE, Williamson PR: Healthy approaches to physician stress. Arch Intern Med 1990;150:1857–1861.
- Gerrity M: Interventions to improve physicians’ well-being and patient care: A commentary. Soc Sci Med 2001;52:223–225.
Seligman MEP, Csikszentmihalyi (eds): Happiness, Excellence, and Optimal Human Functioning (Positive Psychology). Am Psychol 2000;55:1–169.
- Yamey G, Wilkes M: Promoting wellbeing among doctors. BMJ 2001;322:252–253.
- Myers DG: The funds, friends, and faith of happy people. Am Psychol 2000;55:56–67.
- Landon BE, Reschovsky J, Blumenthal D: Changes in career satisfaction among primary care and specialist physicians, 1997–2001. JAMA 2003;289:442–449.
Horowitz C, Suchman A, Branch WT Jr, Frankel R: What do doctors find meaningful about their work? Ann Intern Med 2003;138:772.
- Recapturing the spirit of medicine. West J Med 2001;174:4–77.
- Dunstone D, Reames HR Jr: Physician satisfaction revisited. Soc Sci Med 2001;52:825–837.
- Sullivan P, Buske L: Results from CMA’s huge 1998 physician survey point to a dispirited profession. CMAJ 1998;159:525–528.
- Spickard A Jr, Gabbe SG, Christensen JF: Mid-career burnout in generalist and specialist physicians. Jama 2002;288:1447–1450.
- Meier DE, Back AL, Morrison RS: The inner life of physicians and care of the seriously ill. JAMA 2001;286:3007–3014.
- Shanafelt T, Adjei AA, Meyskens FL: When your favorite patient relapses: Physician grief and well-being in the practice of oncology. J Clin Oncol 2003;21:2616–2619.
Steensma DP: The narrow path. J Clin Oncol 2001;9:2102–2105.
- Baile WF, Lenzi R, Parker PA, Buckman R, Cohen L: Oncologists’ attitudes toward and practices in giving bad news: An exploratory study. J Clin Oncol 2002;20:2189–2196.
- Baile WF, Buckman R, Lenzi R, Glober G, Beale EA, Kudelka AP: SPIKES – A six-step protochol for delivering bad news: Application to the patient with cancer. Oncologist 2000;5:302–311.
- Back AL, Arnold RM, Tulsky JA, Baile WF, Fryer-Edwards KA: Teaching communication skills to medical oncology fellows. J Clin Oncol 2003;21:2433–2436.
- Sloan J, Loprinzi C, Kuross S, Miser A, O’Fallon J, Mahoney M, Heid I, Bretscher M, Vaught N: Randomized comparison of four tools measuring overall quality of life in patients with advanced cancer. J Clin Oncol 1998;16:3662–3673.
- Loprinzi C, Kugler J, Sloan J, Mailliard J, Krook J, Wilwerding M, Rowland KM Jr, Camoriano J, Novotny P, Christensen B: Randomized comparison of megestrol acetate versus dexamethasone versus fluoxymesterone for the treatment of cancer anorexia/cachexia. J Clin Oncol 1999;17:3299.
- Jatoi A, Yamashita J, Sloan J, Novotny P, Windschitl H, Loprinzi C: Does megestrol acetate down-regulate interleukin-6 in patients with cancer-associated anorexia and weight loss? A North Central Cancer Treatment Group investigation. Support Care Cancer 2002;10:71–75.
- Gill P, Kaur J, Rummans T, Novotny P, Sloan J: The hospice patient’s primary caregiver. What is their quality of life? J Psychosom Res 2003;55:445–451.
- Loprinzi C, Barton D, Sloan J, Zahasky K, Smith de AR, Pruthi S, Novotny P, Perez E, Christensen B: Pilot evaluation of gabapentin for treating hot flashes. Mayo Clin Proc 2002;77:1159.
- Grunberg SM, Groshen S, Steingass S, Zaretsky S, Meyerowitz B: Comparison of conditional quality of life terminology and visual analogue scale measurements. Qual Life Res 1996;5:65–72.
- Gudex C, Dolan P, Kind P, Williams A: Health state valuations from the general public using the visual analogue scale. Qual Life Res 1996;5:521–531.
- Hyland ME, Sodergren SC: Development of a new type of global quality of life scale, and comparison of performance and preference for 12 global scales. Qual Life Res 1996;5:469–480.
- Sriwatanakul K, Kelvie W, Lasagna L, Calimlim JF, Weis OF, Mehta G: Studies with different types of visual analog scales for measure of pain. Clin Pharmacol Ther 1983;34:234–239.
- Wewers ME, Lowe NK: A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health 1990;13:227–236.
- Frank E, McMurray JE, Linzer M, Elon L: Career satisfaction of US women physicians: Results from the Women Physicians’ Health Study. Society of General Internal Medicine Career Satisfaction Study Group. Arch Intern Med 1999;159:1417–1426.
- Lemkau J, Rafferty J, Gordon R Jr: Burnout and career-choice regret among family practice physicians in early practice. Fam Pract Res J 1994;14:213–222.
- Fallowfield L: Can we improve the professional and personal fulfillment of doctors in cancer medicine? Br J Cancer 1995;71:1132–1133.
- Gross E: Gender differences in physician stress: Why the discrepant findings? Women Health 1997;26:1–14.
McMurray JE, Linzer M, Konrad TR, Douglas J, Shugerman R, Nelson K: The work lives of women physicians results from the physician work life study. The SGIM Career Satisfaction Study Group. J Gen Intern Med 2000;15:372–380.
- Cooper CL, Rout U, Faragher B: Mental health, job satisfaction, and job stress among general practitioners. BMJ 1989;298:366–370.
- Asch D, Jedrziewski M, Christakis N: Response rates to mail surveys published in medical journals. J Clin Epidemiol 1997;50:1129–1136.
- Kellerman S, Herold J: Physician response to surveys. A review of the literature. Am J Prev Med 2001;20:61–71.
- Piedmont R: A longitudinal analysis of burnout in the health care setting: The role of personal dispositions. J Pers Assess 1993;61:457–473.
- McCranie E, Brandsma J: Personality antecedents of burnout among middle-aged physicians. Behav Med 1988;14:30–36.
- Lemkau JP, Purdy RR, Rafferty JP, Rudisill JR: Correlates of burnout among family practice residents. J Med Educ 1988;63:682–691.
Article / Publication Details
Copyright / Drug Dosage / DisclaimerCopyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.