Mixed-Methods Study of the Impact of Chronic Patient Death on Oncologists’ Personal and Professional Lives

Mixed-Methods Study of the Impact of Chronic Patient Death on Oncologists’ Personal and Professional Lives
Although it is known that oncologists experience grief when their patients die, the impact of patient death on the lives of oncologists (as it relates to burnout, compassion fatigue, and emotional response) has not been thoroughly explored in the literature.
This study used mixed methods to better define the extent to which the death of their patients affects adult oncologists both personally and professionally. Researchers used semi-structured interviews (qualitative) with a group of 22 oncologists from 3 centers in Israel to explore a variety of themes around death/dying. In parallel, 79 oncologists were surveyed (quantitative) on the topic. Survey questions were designed based on previous qualitative data and literature review.
Perhaps not surprisingly, the study showed that the death of their patients had both a positive and negative influence on the lives of oncologists. Positive effects included gaining perspective and learning from each patient death and becoming a better oncologist, whereas negative effects included personality changes, weakening of personal relationships, exhaustion and burnout. Quantitative results corroborated themes arising from the interviews. It is important to note that palliative care physicians, whose practice revolves around death/dying, do not experience significant burnout. This may relate to perspective; whereas death may be perceived as a failure for oncologists, palliative care professionals view it as an opportunity for alleviating symptoms and providing support.
This study surveyed adult oncologists, who see different diagnoses and experience the death of their patients more frequently than most pediatric oncologists (mean number of deaths/month = 5). The author published similar work in pediatrics (https://www.ncbi.nlm.nih.gov/pubmed/25214471) which support the same conclusions.
The data from this study support the profound impact that patient death has on oncologists, both professionally and personally and confirms that the experience in adult and pediatric oncology is similar. What is equally important is using this to start a dialogue about a need to change the culture in oncology such that the emotional impact of patient death is regularly discussed and normalized.