Workplace Burnout Among Oncologists Has Risen: What Can be Done?

Eric Winer, MD, the director of the Yale Cancer Center, chair of the association board for the ASCO, and an investigator on the survey.

In January 2025, the Journal of Clinical Oncology published a survey that revealed a 14% increase in the rate of oncologists who experienced workplace burnout, from 2013 to 2023 (P <.01).1 While there are certainly a great deal of global issues that could have contributed to this, such as the COVID-19 pandemic or changes in technology, there were also many contributing factors that are much smaller in scale.

CancerNetwork® spoke with Eric Winer, MD, one of the authors of the study, about the current state of oncologist burnout, what can be done to fix it, and how it currently affects the workforce.

Among the causes identified in the paper were the use of electronic health records, staffing levels, payer authorizations, hours worked, and age. Beyond that, there was also a correlation between being a caregiver to someone at home and workplace burnout (P <.05). Winer also emphasized that many oncologists have to do tasks, such as administrative ones, that take away from the patient care aspect, which may lead to increased feelings of burnout or fatigue.

Winer is the director of the Yale Cancer Center, president and physician-in-chief at Smilow Cancer Hospital, deputy dean for Cancer Research, Alfred Gilman Professor of Pharmacology, professor of medicine at Yale School of Medicine, and chair of the association board for the American Society of Clinical Oncology (ASCO).

CancerNetwork: What is workplace burnout?

Winer: Workplace burnout is something that is not unique to the medical profession, and there’s a [lot of] literature on burnout in a variety of different situations. When we talk about burnout related to medicine and related to oncology, we’re talking about a syndrome that involves fatigue, some element of depersonalization, a lack of interest in continuing to pursue work, feeling stressed, feeling emotionally exhausted, and oftentimes feeling a lack of empathy for the people one takes care of, with increasingly negative attitudes about work in general.

People could suspect that oncology would be an area where there would be a lot of burnout. For many oncologists, there’s less burnout, and what keeps many of us from being burnt out is the mission-driven nature of the work. I don’t have to go home and worry about whether I gave enough to the world today. There are professions where people don’t have that luxury, and the work I do feels very meaningful.

Why might oncologist burnout have increased from 2013 to 2024?

There are a number of factors. [First], since I referred to burnout across the board and in society, some of this is a little bit of a societal issue because you hear more and more people talking about burnout. You hear more people talking about wanting to achieve a work-life balance, and maybe that’s a little more difficult in medicine than in [other] places, which can lead to burnout. The COVID-19 pandemic was stressful. While, on the one hand, early in the pandemic, everyone felt extraordinarily mission-driven as if they were in a battleground, and while that tends to bring people together, there’s fatigue associated with that. A lot of [clinicians] felt that they couldn’t practice [medicine] the way they would like to practice; they had to make decisions, particularly early on, about treatments that needed to be delayed or not given.

Although telehealth is a great thing when used properly, telehealth also puts a barrier between the doctor and the patient. I will confess to you that I don’t like telehealth. I’m willing to do it occasionally, but I like sitting face-to-face with a patient, and without that, it’s a different interaction. Finally, in the last 10 to 12 years, we’ve seen this proliferation of tasks that many physicians never thought they would have to do: excessive documentation, [spending] all this time in front of screens instead of in front of patients, and insurance authorizations. There are just a lot of pieces of our jobs that don’t feel like they’re mission driven.

The survey also found that 20% of oncologists planned to reduce their hours. How might that affect the workforce?

We have a workforce problem, which is part of the reason why we need to embrace [nurse practitioners] and [physician assistants], or [advanced practice providers]. We need to incorporate them into the care model. There are more oncologists who are nearing retirement age; I’m told, based on ASCO [research], that 23% of oncologists say they’re nearing retirement age, whereas only 14% are under the age of 40.2 Now, I don’t know that those 2 groups are equal, so there may be people in their late 50s who are going to work for another decade who say they’re nearing retirement age. We are concerned about the fact that, if anything, the oncology workforce needs to expand, because people are living longer with active cancer, and they need care—there’s that much more we can do for people. There’s not necessarily an increase in the number of people going into oncology.

When I was a young breast cancer doctor, we didn’t have a lot of treatments. Everything was much simpler because there were only a few choices, and because we only had a few choices, people didn’t live as long when they had incurable cancer. Now, there are people who live for 5, 10, 15, and 20 years with active cancer. Our practices get filled up, not by new patients, but by all the people who need care and that we’re taking care of.

Some of the leading stressors have to do with administrative tasks. How can oncologists better deal with them?

This is where the health system you work in is critical because there needs to be people in the system who are attending to a lot of these issues [such as staffing levels or payer authorizations] so that it doesn’t all fall to the doctor. I cannot overestimate how important this is. We need to have people in place. We need to restructure our teams to make sure that they’re efficient. It’s possible to get rid of a lot of those stressors by having the right team put into place.

I don’t think that’s something that is necessarily entirely under the control of the oncologist. Very few oncologists these days are in [1 to 4] person practices. Most people are either at an academic center, or they’re in a site affiliated with an academic center, or they’re in very large oncology groups. It’s the system that has to work on behalf of the oncologist.

How have you dealt with/managed the times you’ve felt burnout?

Everybody’s different, but I don’t feel like I’ve ever been particularly burnt out for a long period of time, meaning more than about a day. To this day, patients and clinical care drive everything that I do, and that helps me. Everybody’s got to find their own sweet spot, and I don’t pretend to think that what makes me run well, what makes me tick, is what’s good for someone else. The one thing that doesn’t work is when people aren’t comfortable with who they are and what they’re doing. You have to ultimately be comfortable with the mix of work you do during the week.

The administrative burdens of clinical practice are crushing, and we have to take significant steps to make sure that those burdens do not overwhelm all of us. I’ve been protected from a lot of them for a long time, but I see those burdens as [increasing].

What should other oncologists take away from this conversation?

[Oncology] is great for just so many reasons, and it’s greater than it ever was. The patient care is extraordinary; there are wonderful things you can do for patients. Even when we’re not successful in saving someone’s life, the way we take care of people matters. As a part of the job, that’s also something that can be very fulfilling. The other piece of this is that you get to see science in action. Most of the treatments we have today didn’t exist—even in anyone’s imagination—30 years ago. We’ve seen this steady improvement over time, and I don’t know that there are too many other fields like that. Certainly, HIV, which went from being an almost uniformly fatal condition to one that’s treatable and that people can live completely normal lives with, is a good example. I hope people take from this the fact that [oncology is] a great field.

References

1. Schenkel C, Levit LA, Kirkwood K, et al. State of professional well-being, satisfaction, and career plans among US oncologists in 2023. J Clin Oncol. Published online January 29, 2025. doi:10.1200/OA.24.00010
2. 2023 snapshot: state of the oncology workforce in America. JCO Oncol Pract. 2025;21(3):438. doi:10.1200/OP.24.00262