1. The EPEC-O Curriculum is produced by the EPEC TM Project with major funding provided by NCI, with supplemental funding provided by the Lance Armstrong Foundation. Education in Palliative and End-of-life Care - Oncology The Project EPEC-O TM

2. EPECEPECOOEPECEPECOOO EPECEPECOOEPECEPECOOO Module 15 Burnout Cancer Doctors and Burnout Module 15 Burnout Cancer Doctors and Burnout EPEC – Oncology Education in Palliative and End-of-life Care – Oncology

3. Overall message Recognize burnout early to minimize the associated distress

4. Objectives l Define burnout l Recognize associated signs, symptoms l Know risk factors l Contrast burnout and depression l Identify techniques to decrease burnout l Define burnout l Recognize associated signs, symptoms l Know risk factors l Contrast burnout and depression l Identify techniques to decrease burnout

5. Video

6. What is burnout? l Psychological syndrome l Response to chronic interpersonal stressors l Psychological syndrome l Response to chronic interpersonal stressors

7. Key dimensions of burnout... l Exhaustion l Depersonalization l Sense of Ineffectiveness l Exhaustion l Depersonalization l Sense of Ineffectiveness

8. Signs and symptoms of burnout... l Fatigue l Physical / emotional exhaustion l Headaches l GI disturbances l Fatigue l Physical / emotional exhaustion l Headaches l GI disturbances l Weight loss l Insomnia l Depression l Boredom

9. ... Signs and symptoms of burnout l Frustration l Low morale l Job turnover l Impaired job performance l  Quality of care l Frustration l Low morale l Job turnover l Impaired job performance l  Quality of care

10. The nature of oncologists’ burnout l 56% - sense of failure l 34% - depression l 20% - disinterest in practice l 18% - boredom l 56% - sense of failure l 34% - depression l 20% - disinterest in practice l 18% - boredom Whippen DA, Canellos GP. J Clin Oncol, 1991.

11. Burnout and head and neck surgeons l Frustration with: Disease – 27% Government – 67% Economics – 58% l Frustration with: Disease – 27% Government – 67% Economics – 58% Johnson JT, et al. Head Neck, 1993.

12. Burnout vs. Depression Burnout l Work specific l ‘In the battle’ Burnout l Work specific l ‘In the battle’ Depression l Pervasive l ‘Given up’ Depression l Pervasive l ‘Given up’

13. Lifestyle management techniques to reduce burnout... l Recognize and monitor symptoms l Good nutrition l Meditation l Spiritual life l Recognize and monitor symptoms l Good nutrition l Meditation l Spiritual life l Grieve loss l  Overtime l Exercise l Energy work

14. ... Lifestyle management techniques l Sense of humor l Consultation for severe symptoms l Discuss stresses l Seek new solutions l Time l Sense of humor l Consultation for severe symptoms l Discuss stresses l Seek new solutions l Time

15. Preventive approaches to burnout l Address emotions that affect patient care l Changes in managerial practice l Improved communications l Address emotions that affect patient care l Changes in managerial practice l Improved communications

16. Summary... l Burnout is prevalent l Monitor for signs and symptoms l Manage lifestyle l Address managerial issues l Burnout is prevalent l Monitor for signs and symptoms l Manage lifestyle l Address managerial issues

17. EPECEPECOOEPECEPECOOO EPECEPECOOEPECEPECOOO... Summary Recognize burnout early to minimize the associated distress