title: Cancer surgeons' distress and well-being, II: modifiable factors and the potential for organizational interventions.
abstract: OBJECTIVE
  We showed in a companion paper that the prevalence of burnout among surgical oncologists at a comprehensive cancer center was 42% and psychiatric morbidity 27%, and high quality of life (QOL) was absent for 54% of surgeons. Here we examine modifiable workplace factors and other stressors associated with burnout, psychiatric morbidity, and low QOL, together with interest in interventions to reduce distress and improve wellness.
  
  
  METHODS
  Study-specific questions important for morale, QOL, and stressors associated with burnout were included in an anonymous Internet-based survey distributed to the surgical faculty at Memorial Sloan-Kettering Cancer Center.
  
  
  RESULTS
  Among the 72 surgeons who responded (response rate of 73%), surgeons identified high stress from medical lawsuits, pressure to succeed in research, financial worries, negative attitudes to gender, and ability to cope with patients' suffering and death. Workplace features requiring greatest change were the reimbursement system, administrative support, and schedule. Work-life balance and relationship issues with spouse or partner caused high stress. Strongest correlations with distress were a desire to change communication with patients and the tension between the time devoted to work versus time available to be with family. Surgeons' preferences for interventions favored a fitness program, nutrition consultation, and increased socialization with colleagues, with less interest in interventions conventionally used to address psychological distress.
  
  
  CONCLUSIONS
  Several opportunities to intervene at the organizational level permit efforts to reduce burnout and improve QOL.
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 / Q000517:prevention & control*; D003430:Cross-Sectional Studies; D013502:General Surgery; D006293:Health Promotion / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D008019:Life Style; D009369:Neoplasms / Q000523:psychology / Q000601:surgery*; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011788:Quality of Life; D013315:Stress, Psychological / Q000517:prevention & control*