ASCO Connection

July 2017

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established physician, or you may feel more comfortable opening up to a col- league who has gone through similar issues. In some cases, a mental health professional might be the best person with which to speak first. There's no single correct answer on who you can or should talk to. "I think the cardinal sign of somebody who you could approach is somebody who is a good listener," said Dr. Hanna. "Being a good listener is the founda- tion of demonstrating that you care." The most important thing about the conversation, however, is that it is tak- ing place, said Shadia I. Jalal, MD, of Indiana University. "We as physicians always think of our- selves as the caregivers," Dr. Jalal said, "Most of us maybe feel uncomfortable being on the receiving end. I don't see people wanting to be treated as patients. We want somebody to open up the conversation for us and let us know it is okay to talk." "HOW DO I PERFORM UNDER STRESS?" Anthony Back, MD, of the University of Washington and Fred Hutchinson Can- cer Research Center, explained that one of the difficulties in addressing burnout is the pejorative connotation it carries in the minds of many physicians. If you do not want to even entertain the notion of burnout, you may be unable to determine whether you are reaching a breaking point or whether you are dealing with more straightfor- ward short-term stress or melancholy. "Because the vocabulary [we use] is only 'burnout' or 'no burnout,' we haven't developed a language to talk about it," Dr. Back said. "The reality is everybody has bad days where they are really tired and just want to get home and put their feet up. Everybody has days like that, and it's normal behavior. The change comes when you feel, every day, like you can't keep working like this, you can't keep going at this pace." Your supervisor or program director probably won't be able to answer the question, "Am I burned out?" However, they may be able to help you assess whether you are feeling normal stress or professional burnout. Starting the conversation by asking a more neutral question, such as "Do you think I per- form well under stressful situations?", may be more comfortable and feel more natural in a professional setting. The approach sidesteps the negative conno- tations associated with the word burn- out, and allows for a more constructive reflection on how you are feeling and handling professional challenges. "IS THIS NORMAL?" Perhaps the only benefit to 45% of medical oncologists reporting that they've experienced emotional exhaus- tion and/or depersonalization symp- toms is knowing that burnout is not an individual problem. You are in good company. Younger oncologists need only to look TRAINEE & EARLY-CAREER l Beat Burnout important to address the signs and symptoms of burnout as soon as pos- sible, before they become a crisis and derail you from the professional goals you have worked so hard to achieve. The first step is recognizing and acknowledging your own feelings. The second step is telling the people who need to know in order to support you. Physicians familiar with professional burnout shared their advice on how best to begin a conversation about the topic. Not every strategy will apply uni- versally. However, these questions and descriptions can act as a script if you are struggling to find the right words. "CAN WE SET UP A TIME TO TALK?" Nasser H. Hanna, MD, of Indiana Uni- versity, has a saying: "Burnout, by definition, is not something that you can solve in a 30-minute meeting. If it is, you're not dealing with it or it's not actually burnout." Addressing burnout requires patience and vulnerability, difficult character- istics to demonstrate in a quick, infor- mal conversation or routine meeting. Recognizing that burnout will take time and effort to manage, your con- versations will take place with many different people. To start, you may prefer talking to a mentor or a more "The reality is everybody has bad days where they are really tired and just want to get home and put their feet up. Everybody has days like that, and it's normal behavior. The change comes when you feel, every day, like you can't keep working like this, you can't keep going at this pace." —Dr. Anthony Back 46 I 07.2017

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