title: Cancer surgeons' distress and well-being, I: the tension between a culture of productivity and the need for self-care.
abstract: BACKGROUND
  Burnout is a prevalent and important occupational hazard among surgical oncologists. The well-being or distress experienced can have a significant effect on clinicians and their families, the quality of care provided to patients, and the success of the health care organization.
  
  
  METHODS
  We aimed to measure the prevalence of burnout, psychiatric morbidity, and quality of life using standardized measures; characterize associated features; and ascertain the surgical faculty's views on potential interventions and obstacles to change. Additional questions about service commitment to well-being, use of annual leave, and attitudes about weekend surgical practice were constructed to guide future targeted interventions.
  
  
  RESULTS
  Among the 72 surgeons who responded (response rate of 73%), we found that 42% of surgeons reported burnout and 27% psychiatric levels of distress, while 30% used alcohol and 13% used sleep medications as a possible means to cope. Only one third of surgeons reported high quality of life across physical, emotional, spiritual, and intellectual domains.
  
  
  CONCLUSIONS
  Compared to general surgical practices, cancer surgeons achieved more personal fulfillment and made less use of distancing methods to cope with their patients. Institutional culture contributes to the nonuse of available annual leave, attitudes about weekend operating schedules, and missed opportunities for the leadership to attend to surgeons' well-being.
authors.affiliation: Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, USA. guestr@mskcc.org
authors.forename: Rebecca S
authors.initials: RS
authors.lastname: Guest
authors.forename: Ray
authors.initials: R
authors.lastname: Baser
authors.forename: Yuelin
authors.initials: Y
authors.lastname: Li
authors.forename: Peter T
authors.initials: PT
authors.lastname: Scardino
authors.forename: Arthur E
authors.initials: AE
authors.lastname: Brown
authors.forename: David W
authors.initials: DW
authors.lastname: Kissane
mesh_terms: D001291:Attitude of Health Personnel; D002055:Burnout, Professional; D004526:Efficiency; D013502:General Surgery; D006301:Health Services Needs and Demand; D006801:Humans; D008603:Mental Health; D009369:Neoplasms / Q000523:psychology / Q000601:surgery*; D010549:Personal Satisfaction; D010820:Physicians / Q000523:psychology*; D012648:Self Care; D013315:Stress, Psychological / Q000517:prevention & control*