Cancer Surgeons’ Distress and Well-being, I: The Tension Between a Culture of Productivity and the Need for Self-Care



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.


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.


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.


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.

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This publication acknowledges grant NCI P30 CA08748, which provides partial support for the Behavioral Research Methods Core used in conducting this investigation. Marwan Shouery and Ethan Basch developed the Web-based survey distribution as part of the Memorial Sloan-Kettering Core Facility for Online Research Tools (“Webcore’)

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Correspondence to Rebecca S. Guest MD, MPH.

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Guest, R.S., Baser, R., Li, Y. et al. Cancer Surgeons’ Distress and Well-being, I: The Tension Between a Culture of Productivity and the Need for Self-Care. Ann Surg Oncol 18, 1229–1235 (2011).

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  • Emotional Exhaustion
  • Psychiatric Morbidity
  • Personal Distress
  • Workplace Culture
  • Annual Leave