title: Managing cumulative expectations in oncology: challenges and potential solutions.
abstract: The dedication of oncologists to their patients is undeniable. Patients given what can be a devastating diagnosis look to their physician for hope, guidance, and answers. The physician, in turn, must assimilate information from a staggering amount of resources and outlets and then form a plan that satisfies current practices and guidelines while still being consistent with the most current regulations set by a multitude of sources for oversight. Do all this for every patient in a time in which the number of new and continuing patients is ever increasing, and it is hardly surprising that the shocking overload can lead to physician burnout and, quite possibly, poorer patient care. Overload, be it information, task, knowledge, or expectation, is real, and to avoid succumbing, cancer care providers need to acknowledge that the problem exists by identifying the sources and admit that the problem of overload is out of control. Only then can providers begin to realize what can and can not be done, so that they can focus attention on what they are doing when they are doing it-an application of mindfulness. To take control of the avalanche of incoming information, providers need to make good use of filters, set time aside to evaluate inbound intelligence, and identify and (importantly) rely on a narrow set of trusted resources. Although strategies on coping with overloads abound, the physician needs to be diligent in applying the available options to keep burnout at bay.
authors.affiliation: From the Division of Medical Oncology, Department of Medicine, Duke Clinical Research Institute, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina; Delaware Christiana Care CCOP, Helen F. Graham Cancer Center, Newark, Delaware.
authors.forename: Amy P
authors.initials: AP
authors.lastname: Abernethy
authors.affiliation: From the Division of Medical Oncology, Department of Medicine, Duke Clinical Research Institute, Duke Cancer Institute, Duke University Medical Center, Durham, North Carolina; Delaware Christiana Care CCOP, Helen F. Graham Cancer Center, Newark, Delaware.
authors.forename: Stephen S
authors.initials: SS
authors.lastname: Grubbs
mesh_terms: D002055:Burnout, Professional; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D010817:Physician-Patient Relations / Q000941:ethics*; D058007:Physicians, Primary Care / Q000941:ethics*