Cancer care workers in Ontario: prevalence of burnout, job stress and job satisfaction

Background: Cancer Care Ontario's Systemic Therapy Task Force recently revi ewed the medical oncology system in the province. There has been growing co ncern about anecdotal reports of burnout, high levels of stress and staff l eaving or decreasing their work hours. However, no research has systematica lly determined whether there is evidence to support or refute these reports . To this end, a confidential survey was undertaken. Methods: A questionnaire was mailed to all 1016 personnel of the major prov iders of medical oncology services in Ontario. The questionnaire consisted of the Maslach Burnout Inventory, the 12-item General Health Questionnaire, a questionnaire to determine job satisfaction and stress, and questions to obtain demographic characteristics and to measure the staff's consideratio n of alternative work situations. Results: The overall response rate was 70.9% (681 of 961 eligible subjects) : by group it was 63.3% (131/207) for physicians, 80.9% (314/388) for allie d health professionals and 64.5% (236/366) for support staff. The prevalenc e of emotional exhaustion were significantly higher among the physicians (5 3.3%) than among the allied health professionals (37.1%) and the support st aff (30.5%) (p less than or equal to 0.003); the same was true for feelings of depersonalization (22.1% v. 4.3% and 5.5% respectively) (p less than or equal to 0.003). Feelings of low personal accomplishment were significantl y higher among physicians (48.4%) and allied health professionals (54.0%) t han among support staff (31.4%) (p less than or equal to 0.002). About one- third of the respondents in each group reported that they have considered l eaving for a job outside the cancer care system. Significantly more physici ans (42.6%) than allied health professionals (7.6%) or support staff (4.5%) stated that they have considered leaving for a job outside the province. Interpretation: The findings support the concern that medical oncology pers onnel are experiencing burnout and high levels of stress and that large num bers are considering leaving or decreasing their work hours. This is an imp ortant finding for the cancer care system, where highly trained and experie nced health care workers are already in short supply.