Reply to ‘Physician burnout: let’s avoid unsubstantiated claims’

The Correspondence from Mirkovic and Bianchi in response to our Comment (Murali, K. & Banerjee, S. Let’s address burnout in oncologists and reimagine the way we work. Nat. Rev. Clin. Oncol. https://doi.org/10.1038/s41571-018-0097-9 (2018))¹ highlights, once more, that both burnout itself and research on this topic are associated with controversies and challenges (Physician burnout: let’s avoid unsubstantiated claims. Nat. Rev. Clin. Oncol. https://doi.org/10.1038/s41571-018-0150-8 (2018))². In addition to his current letter, Bianchi and various colleagues have published more than ten commentaries or letters raising criticisms of articles reporting on burnout in the medical profession, including original research papers published in The Lancet³ and Annals of Oncology⁴.

One of the points raised repeatedly by Bianchi relates to the prevalence of burnout reported in studies and, more specifically, the methods used to derive these estimates. To date, many studies reporting on the rates of burnout among physicians have utilized the Maslach Burnout Inventory (MBI) because, after more than 35 years since its initial publication, the MBI remains one of the most widely used measures in burnout research⁵. I agree that much work is needed to better assess physician burnout and I hope that researchers in psychology can develop and agree on more robust definitions and measures of burnout.

I would like to point out to readers, as well as to Mirkovic and Bianchi, that our article in Nature Reviews Clinical Oncology is a commentary piece¹ based on our views as practising oncologists and having researched the literature and engaged in discussion forums at leading international oncology congresses, such as European Society of Medical Oncology (ESMO) and American Society of Clinical Oncology (ASCO) meetings⁶. The article was not intended to be a comprehensive review of the literature but rather to raise questions and potential solutions.

Finally, as mentioned in my reply⁷ to Bianchi and colleagues’ previous correspondence on our research paper published in Annals of Oncology⁴, besides any discussion regarding semantics, burnout is a genuine issue for oncologists and therefore we should together focus on seeking solutions.