ASCO Connection

July 2017

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Physician Wellness Blog on ASCO members and leaders are talking about all aspects of burnout, wellness, work-life balance, and emotional resilience on the Physician Wellness Blog on Recent posts include: X "When You're Overwhelmed, It Helps to Hear 'Me, Too'" by Dr. Nasser H. Hanna X "Reflections from the Snack Table: Where Do You Find Your Emotional Strength?" by Dr. Jane Lowe Meisel X "What Keeps Me Going: Family, Patients, Comedy, Faith" by Dr. Shadia I. Jalal X "The Dwindling Benefits of Vacation and the Maslach Affair" by Dr. Ajeet Gajra X "Forgiveness and Fault: Blaming Ourselves Doesn't Help Our Patients" by Dr. Nasser H. Hanna X "Team Wellness: A Deep Reserve or an Empty Pit?" by Mr. Todd A. Pickard X "When 'Patient Care First' Means Doctor Care First" by Dr. Adetokunbo Oluwasanjo Log in to comment and share your thoughts on the posts, or contact editorial staff at ascoconnection@ to learn more about how to contribute to the blog. at their mentors and senior physicians to see people who likely dealt with symptoms of burnout earlier in their career, or know someone who did. "It comes with the job," Dr. Jalal said. "If you want to be a good oncologist, you're going to have some physician burnout. The best way to be a good oncologist is to acknowledge that this is an issue and find ways to deal with it." Often, it can be beneficial simply to hear that you are not alone. That is why Dr. Jalal recommends that if you think you are experiencing symptoms of burnout, you should find a trusted person, describe how you are feeling, and then ask, "Is this normal?" The question will not only help you assess your feelings and identify some of the potential causes of burnout, but can also open up a conversation about a time an older physician or mentor experienced the same thing. Know- ing that someone you admire also struggled can help alleviate shame or embarrassment about your feelings. "We have to acknowledge that burnout is a real problem," Dr. Jalal said. "It is not a sign of weakness." "THESE LAST FEW DAYS WERE STRESSFUL." One of the most difficult aspects of dealing with burnout is recognizing your thoughts and feelings but not personally identifying with them, said Dr. Back. "Instead of saying, 'I'm getting burned out,' it is healthier to say, 'I'm having a really stressful day today,'" Dr. Back said. "You're acknowledging that you are having these feelings, but these feelings don't define you." This is not about ignoring or repress- ing your feelings. Rather, separat- ing your symptoms and feelings of burnout from your sense of who you are as a person can allow you to bet- ter identify and understand what you're dealing with. This more objec- tive attitude —"I feel bad," not "I am bad"—also helps you remember that emotional states are impermanent; negative feelings and emotions come and go, while you remain. Finally, learning to create a healthy and appropriate level of emotional distance can help physicians build their resil- ience to burnout. Many of the causes of burnout —such as the stress of see- ing a patient face treatment setbacks or die while in your care—are part of the job description for oncologists. Understanding these issues and learn- ing to live with negative emotions, without letting those feelings take over, can ultimately help younger oncolo- gists become better doctors. In other words, preventing and manag- ing professional burnout is not about removing negative feelings from your life, but learning to live and thrive in spite of negative feelings. Talking to someone is part of that process. "You don't work through this process of burnout because you're seeking to change or leave the situation. It is so that you can live with it," Dr. Hanna said. "As physicians, we want to solve problems. We want to identify the symptoms, work out the problem, make a diagnosis, and then provide treat- ment. That's not how oncology works. The healing and living with the suffer- ing is a process." • Reference 1. Shanafelt TD, et al. J Clin Oncol. 2014;32:678-86. Michelle Dalton, ELS, contributed to this article. I 47

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