Practice and Systemic Pressures Drive Physician Burnout in Oncology

The demands of modern oncology practice extend well beyond patient care, with physicians navigating complex administrative workflows, electronic medical records (EMRs), payer requirements, and increasingly full schedules. Over time, these pressures can take a toll and ultimately contribute to burnout, underscoring the importance for oncology practices to recognize the factors that can affect physician well-being and identify opportunities to provide support.

In an interview with Targeted Oncology^TM, Marcus Neubauer, MD, medical director of professional wellbeing at The US Oncology Network, discussed key factors driving physician burnout in oncology, how practice leaders can recognize and address burnout, and strategies for a sustainable career in oncology.

Targeted Oncology: What are the biggest drivers of burnout among oncologists today?

Marcus Neubauer, MD: Burnout is a challenge affecting physicians across healthcare, including oncology. While the causes vary by individual and practice setting, several common themes tend to emerge. Specifically, administrative burden, leadership and communication gaps, difficulty disconnecting during time off, and insufficient attention to self-care and well-being.

Administrative burden: One contributor to burnout across healthcare is the cumulative administrative workload that accompanies patient care. In addition to caring for patients, physicians often navigate care coordination, documentation and other operational responsibilities that can compete for their time and attention. Continued efforts to simplify workflows, reduce administrative complexity, and support clinicians with efficient tools can help create a more sustainable practice environment.

Leadership and communication gaps: issues, including lapses in communication, mentoring, and recognizing accomplishments, can contribute to burnout. These things are very important even to physicians, let alone staff, and oftentimes burnout can result when you feel undervalued or underappreciated.

Inability to disconnect when on paid time off [PTO]: When you don't detach, you're not fully rested, and so the vacation doesn't serve the purpose of recharging your batteries. And you come back from vacation no better off than when you left.

Insufficient attention to self-care: Doctors often give their all to patient care and don’t pay attention to their own mental and physical health. A physician who is rundown or burned out does not provide optimal patient care so a physician must take care of him/herself to be the best he/she can be.

What signs of burnout should practice leaders watch for?

To recognize burnout, first, you need to be aware it exists.Once you do, you can look for signs. A good place to start is with the World Health Organization's definition of burnout which describes burnout as, “an occupational phenomenon resulting from chronic workplace stress that has not been successfully managed and characterized by emotional exhaustion, cynicism, and/or workplace inefficiency:¹

Examples of emotional exhaustion. Your colleagues say they're overwhelmed. They may appear unusually tired, drained,or seem to have less energy than usual at work. One important point to make is that burnout is not the same as depression; they're not entirely unrelated, but depression is a clinical condition that affects people entirely. Burnout is a phenomenon that is mostly limited to the workplace.

Cynicism. This is very apparent when it exists, particularly in people who you've known not to be cynical. You start to see things like irritability, complaining, short temper, negativity—which are very challenging in a patient care setting. While irritability or negativity can have many causes, a noticeable change from someone’s usual demeanor may be a warning sign. In a colleague who is typically more optimistic and hopeful, a sustained shift toward cynicism may be a red flag.

Finally, ineffectiveness. A health care professional may feel (and be) less effective in their work, which can affect team dynamics, staff well-being, and the consistency or quality of patient care. There are good data to show that patient care is suboptimal when delivered by a physician who's dealing with burnout,² which is why it is important to address and resolve burnout whenever possible.

What practice-level interventions can make the greatest impact in reducing physician burnout?

To improve burnout, I would start with the drivers. To review, the four main categories of drivers of burnout that we identified in surveying over 100 oncologists are administrative burden, inability to detach on PTO, leadership and communication gaps, and inattention to self-care. If you're going to intervene, you want to address these key categories.

Supporting physician well-being includes making appropriate resources and programs available within the practice.For example, The US Oncology Network offers a program called SupportLinc MD specifically for physicians. Practices may benefit from having confidential resources available for physicians who would like additional support. Physicians who may be dealing with burnout may not see this in themselves or, if they do, may not be willing to seek help. Having a defined support program can ease the way towards meaningful support.

Detaching from work when on PTO is something that I am interested in because this is a very common problem among healthcare professionals and is relatively straightforward to address. The practice must create an infrastructure where a physician can take time off and not be responsible for patient-care duties.

Administrative burden is another area where technology, including artificial intelligence [AI], may help. Emerging tools have the potential to streamline documentation, data entry and other routine workflows, reducing manual steps and improving efficiency. As these capabilities evolve, thoughtfully adopting tools that support physicians may help reduce some of the administrative work associated with practice.

And, finally, leadership must know that burnout is a risk and it is up to leaders to mitigate this risk. For example, making sure that you are checking in with people, communicating well, engaging people, and making sure they don't feel isolated.

What systemic drivers outside of individual practices contribute to physician burnout?

Something that I think can contribute to physician frustration is the challenge of accessing a complete picture of a patient's medical history across different care settings. As a physician, I want to be able to quickly access all relevant records for my patients, regardless of where those records were generated. While interoperability continues to advance, navigating information from multiple sources can still pose a challenge. For physicians caring for patients with complex diseases such as cancer, having a more connected healthcare ecosystem can help reduce administrative challenges and allow more focus on patient care.

I think payer requirements can also contribute to burnout. Prior authorization processes can be burdensome and frustrating, particularly when they add administrative work or delay coverage of clearly recommended treatment.

Lastly, Broader public policy and reimbursement dynamics can also affect physician well-being. Community practices may face different reimbursement structures and financial pressures than hospital-based or academic settings, adding complexity to the delivery of care. These are longstanding, system-level issues that can contribute to administrative burden and burnout. Stakeholders also continue to debate how programs such as 340B affect different sites of care, including independent community practices. These issues are not new, but they are larger, overarching issues that can drive burnout.

Where else do you see the role of technology and AI in reducing burnout?

I think AI will play a growing role across healthcare, and for the most part, I think that's a good thing. I've seen how it has made meaningful improvements in workflows at the practice level. If you are trying to solve interoperability, AI may offer opportunities because all the setups for interoperability haven’t worked well. Healthcare records tend to be housed in closed systems. A patient’s medical records should flow to wherever that patient is seeking care. Over time, AI should improve gaps in interoperability (health information exchange).

How can management service organizations (MSOs) help support providers and alleviate burnout?

In today’s healthcare environment, it is very helpful to be part of a network. Practices and physicians need support. I was a physician in a network or an MSO for over 20 years. What I found to be most helpful as a clinician in The US Oncology Network, was not having to figure everything out myself. In a network, physicians can share best practices and learn from each other. Furthermore, an MSO can provide support in complex areas, like technology, strategy, revenue cycle, research, and other administrative functions. By supporting the business side of medicine, an MSO can help reduce some of the operational burden on physicians, allowing them to devote more attention to patient care while retaining control over clinical decisions. In my opinion, being part of an MSO reduces burnout because you have a partner, support, and security on many levels.

What advice can you offer to oncologists on preventing and recognizing burnout in their own careers?

ASCO showed in a survey of oncologists published in 2025 that the burnout rate [in 2023 was approximately] 60%,³ and, in my experience, I would say that number is probably right. What I would recommend is get engaged and learn about not only patient care, but also key aspects of your practice and your community, so you don't feel isolated. Expect (and give) recognition and appreciation. You should try to balance your time between your work and your life. Don’t diminish your career but set boundaries so you aren’t “always” working.

Being an oncologist is rewarding. But it is also challenging and can lead to burnout. Start by recognizing burnout can exist in your colleagues or yourself, look at the drivers of burnout in your practice, and then set up initiatives to improve well-being.

REFERENCES

1. Burn-out an "occupational phenomenon": International Classification of Diseases. World Health Organization. May 28, 2019. Accessed August 19, 2026. https://tinyurl.com/yhxardhw

2. Tawfik DS, Scheid A, Profit J, et al. Evidence Relating Health Care Provider Burnout and Quality of Care: A Systematic Review and Meta-analysis. Ann Intern Med. 2019;171(8):555-567. doi:10.7326/M19-1152

3. Schenkel C, Levit LA, Kirkwood K, et al. State of Professional Well-Being, Satisfaction, and Career Plans Among US Oncologists in 2023. JCO Oncol Adv. 2025;(2). doi:10.1200/oa.24.00010