Editorial
Burnout in the haematological workforce
Burnout has been defined as a syndrome of emotional
exhaustion, depersonalisation, and a sense of low
personal accomplishment, leading to decreased
effectiveness at work. It is an issue which is affecting
health-care systems around the world. Burnout in
physicians, which had already been on the rise before
COVID-19, has been exacerbated by the pandemic and
shows little sign of easing. A recent study, presented by
Fumiko Chino at the 2023 American Society of Clinical
Oncology annual meeting, showed that 22% of academic
oncologists surveyed reported feelings of burnout, with
the highest rates among lesbian, gay, or bisexual faculty
(OR 3·56; 95% CI 1·55–8·18) and female faculty (OR 2·32;
95% CI 1·51–3·56). The study included 724 academic
oncologists and used data from the Association
of American Medical Colleges StandPoint Faculty
Engagement Survey between 2017 and 2020. The
importance of addressing burnout and physician well-
being in the oncology community was also highlighted
by Vice Admiral Vivek H Murthy, the American Surgeon
General, during the opening ceremony of the conference.
These concerns and findings are echoed around the
world: burnout is a global health care problem.
While the health-care community has increasingly
recognised the issue of burnout, there are many
challenges which need to be overcome before things
improve. The rising levels of health-care provider
burnout has been contributed to by underfunding of
health-care systems, increased workload, staff shortages,
difficulties in accessing support and resources, and
increased bureaucracy. A wider disconnect between the
task of caring for patients, including less time devoted
to interactions with patients, can lead to feelings of
powerlessness and lack of autonomy. Although there is
certainly recognition that burnout is negatively affecting
the workforce, little is being done to address larger
systemic issues. The onus currently lies on individuals to
recognise burnout, and to administer self-care and set
boundaries. While these strategies could potentially help
physicians reduce workplace stress, they do not tackle the
underlying problems.
Doctors are not the only members of the health-care
system who are suffering from burnout. Nursing staff,
allied health workers, and health-care administrative
www.thelancet.com/haematology Vol 10 July 2023
or management staff are also feeling increased strain.
With physician and other health-care provider burnout,
patients suffer too. Professional consequences range
from lower patient satisfaction or impaired quality
Samuel Ashfield/Science Photo Library
of care up to medical errors that can potentially end
up in malpractice suits, with substantial costs for
both caregivers and hospitals. Social consequences
of unmanaged burnout include unhealthy coping
mechanisms, which can lead to strain in personal
relationships. For the study by Chino and
colleagues see https://meetings.
In 2019, the American Society of Hematology asco.org/abstracts-
conducted a practice survey of haematologists and presentations/227279
oncologists in the American Medical Association For the Surgeon General
comments see https://www.
Masterfile; burnout was measured using a validated, healio.com/news/hematology-
single-item burnout instrument from the Physician oncology/20230603/surgeon-
general-burnout-has-many-
Work Life Study. 36% of respondents reported burnout, health-care-workers-in-crisis
while 12% had a high level of burnout. The authors For responsibility of burnout see
In Focus Lancet Haematol 2022;
found that compensation plans based solely on clinical 9: e806
productivity are associated with high burnout among For the podcast on burnout
haematologists and oncologists, and that increased use and boundary setting see
https://soundcloud.com/
of advanced practice providers is inversely associated npsmedicinewise/episode-
with high burnout among community haematologists 41-burn-out-and-boundary-
setting?utm_
and oncologists. Another study looking at factors source=clipboard&utm_
contributing to burnout in haematology and oncology campaign=wtshare&utm_
medium=widget&utm_
showed similar results. These findings provide some content=https%253A%252F%
guidance on interventions that could improve rates of 252Fsoundcloud.com%252Fnps
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burnout amongst haematologists in the USA. burn-out-and-boundary-setting
While the current issues may seem insurmountable, For the ASH survey analysis see
https://doi.org/10.1182/
medical societies are recognising the importance of the bloodadvances.2021006140
issue, and are beginning to take steps to address the For the study about factors
systemic problems that lead to burnout. The American contributing to burnout see
https://doi.org/10.1182/
Medical Association is addressing systemic drivers blood-2020-139798
of physician burnout (eg, reducing administrative For the AMA plan on dealing
with burnout see https://www.
burdens), aiming to deliver evidence-based solutions
ama-assn.org/amaone/ama-
to increase professional wellbeing. Similarly, the recovery-plan-america-s-
physicians-reducing-physician-
British Medical Association offers guidance on
burnout
recognising and dealing with burnout. By establishing For the BMA guidance on
workflows that support team-based care, health-care burnout see https://www.bma.
org.uk/news-and-opinion/how-
systems can boost productivity and reduce workforce to-recognise-the-warning-signs-
stress. However, measures such as these, without of-burn-out
proper funding investment from governments into
training and retaining more health-care staff, are
unlikely to result in permanent, positive change.
■ The Lancet Haematology
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