How The US Oncology Network Is Taking a New Approach to Physician Burnout

Successes in cancer care don’t change some facts: There is more cancer than ever, with the number of cases in the US now past 2 million a year, due to an aging population and rising rates of certain types of cancer among women.¹ What’s more, findings from a study by the American Society of Clinical Oncology (ASCO) released in 2025 fall show a growing shortage in the number of oncologists on hand to treat older patients as well as a mismatch between where oncologists practice and where older Americans live.²

In addition, results from published surveys reveal physician burnout, not just in oncology but across health care.³ ASCO reported that 59% of oncologists reported burnout in 2023, up from 45% a decade prior.² The survey results found that 20% planned to cut their clinic hours in the next year.

When one factors in reports of dissatisfaction among nurses and pharmacists, the unhappiness in the ranks raises questions about what kind of cancer care patients will receive in the years ahead. Thus, grappling with burnout in oncology is more than a priority; it’s an essential element of care delivery, one that The US Oncology Network is taking seriously.

One half a workforce should not feel burned out, and with this in mind, The US Oncology Network has elevated efforts to address burnout across the more than 3300 providers in The Network. As leaders of this effort, we offered responses to questions about this initiative provided by The American Journal of Managed Care (AJMC).

AJMC: Is this a new initiative?

Neubauer: It’s relatively new in its current form. Burnout is very real, and it’s been around for a while. Years ago, we looked at burnout, but we really didn’t go far enough. We’re trying to be more proactive in addressing this problem. It’s a very real problem for practices in The US Oncology Network and, frankly, throughout health care.

Cothren: I would echo this. My team supports community practice customers, and as we’re out in the field, time and time again, burnout comes up as practices struggle with issues like employee turnover.

AJMC: Was this renewed effort precipitated by a particular event, or did the data reach a critical point that showed the time was right for a new initiative?

Cothren: This past fall, McKesson hosted our annual oncology conference and practices requested that we address burnout. Dr Neubauer had recently done a podcast, so he and I joined together to present a session. That’s how he and I started working together on this. Even before that, I had started doing presentations [on the topic] at the request of some individual practices.

AJMC: How problematic is burnout in oncology? And is turnover the best way to measure burnout?

Cothren: When we look at statistics, burnout is not specific to health care, but it’s certainly a big problem in health care. Oncology is among the specialties with higher percentages of burnout [in health care]. Back in 2023, ASCO found that almost 60% of oncologists were experiencing burnout.² Several years ago, a meta-analysis found 40% of nurses [experienced burnout], which is probably much higher now since COVID-19.⁴

The Hematology/Oncology Pharmacist Association presented at their conference in 2021 that 62% of oncology pharmacists had reported themselves as being burned out. So, the numbers are pretty high.⁵

Neubauer: Turnover is probably the most objective measure; a consequence of burnout is that people quit. But there are many other consequences that result from burnout. Burnout can impact patient care. You are not at your best when you’re burned out, and that will spill over into your care of patients. This has been proven to be a persistent problem.⁶ Culture, attitude, and the way the office functions are all affected by individuals who are burned out. This is very penetrating when it exists, and a lot of people can be affected. In both our surveys and in published literature, this is a very common finding. You have physicians and health care workers reporting burnout rates of 40%, 50%, 60%, which are really high; you should not have half of your workforce be burned out. That’s not sustainable.

We started by identifying the drivers. Then, we focused on what we can do to make a difference.

AJMC: When you looked at the data that you collected, what really jumped out at you?

Neubauer: We surveyed physicians in 4 practices in The US Oncology Network, just to get our own data; again, there have been a lot of surveys regarding burnout, but there are not really data specific to community practices. As you can imagine, the drivers of burnout often overlap, whether it’s community oncology, academia, or large health systems. However, we wanted to examine community oncology more closely. When we surveyed these 4 practices, questions pertained to issues like the [electronic health record (EHR)], culture, value, and self-care. When we looked at the scores that resulted from the survey, one segment that stood out was leadership and communication gaps. Other areas that stood out in the survey results were the inability to detach while on vacation, EHR burdens, and finding time for self-care. The EHR is a big driver of burnout across health care, but AI [artificial intelligence] tools are starting to change this by offering more efficient ways to create progress notes, helping to simplify complexity and improve patient care.

Cothren: That’s a great point: that we really haven’t defined burnout. I refer back to the World Health Organization definition formed back in 2019. It is an occupational-related syndrome, something that comes out of what we’re doing at work, and then it’s characterized by 3 buckets: physical and emotional exhaustion, cynicism and depersonalization, and then the loss of a sense of personal accomplishment that ends up leading to that decreased effectiveness at work.

AJMC: Just to clarify, when you say AI tools, are you referring to ambient scribes?

Neubauer: That’s the primary one, yes. AI scribes streamline documentation, cutting time spent in electronic health records (EHRs). This is making a bigger difference than any other EHR improvements I have seen over the last 10 years, because physicians spend a large amount of time during the day generating patient notes. Too many physicians can’t get this all done during the day, so they are going home and completing this work at night. And if, day after day, you’re working during the day and also at night after you put your kids to bed or your spouse or significant other goes to sleep, you are in an unsustainable loop. If you can use ambient noting and get your notes done in real time when you see patients and you have no more work left when you go home, this is a counter to burnout. These kinds of innovations don’t just ease administrative burdens, they empower providers to deliver better care.

AJMC: A physician who is a member of Congress, Rep Greg Murphy (R, North Carolina) posted on social media that a medication he needed following his surgery was delayed by months because of issues with his insurance company. The congressman was highlighting that he believes prior authorization and reimbursement issues are contributing to many physicians leaving practice and contributing to shortages. Are reimbursement challenges a component contributing to burnout?

Cothren: Even when it’s not the physician handling it directly, the burden is very real for others in the clinic. Teams can spend hours, sometimes days, working through prior authorizations and coverage considerations to support the care plan they believe is best for the patient. That level of administrative effort adds up and is a real contributor to burnout in healthcare.

Neubauer: I’ll just speak for oncology: Ninety-nine percent of drugs receive authorization, yet 100% have to go through the prior authorization process. Yes, staff has to deal with this prior authorization primarily, but physicians do too. If there’s any delay in getting drugs approved, treatment is delayed, the patient is anxious, and the physician is also anxious on their behalf. So absolutely, this drives burnout.

The other thing I’ll tell you: There is a shortage of oncologists today, and this is only going to get worse over time. For those in healthcare, we want to help them stay in health care, and one way to do that is [to] make it a more pleasant, exciting, empowering place to work. If you’re a private practice and you start losing people, whether it’s physicians or staff, unnecessarily, you’re losing ground.

AJMC: Have you identified a point in the career trajectory of an oncologist or an oncology pharmacist when professionals are at the greatest risk of experiencing severe burnout or quitting?

Neubauer: There’s no set time. There are physicians who come out of fellowship, and they can get disenchanted within two years. So, anyone is at risk of burnout. When you look at millennials or the soon-to-be Generation Z [individuals] who are the new physicians, they don’t want to grind out the next 30 years. They want work-life balance. They want their job to be meaningful but not to be a calling that consumes them. And if you don’t recognize and support that as practice leaders, the younger physicians are not going to hang around; they’ll go somewhere else. They’ll probably stay in medicine because they’ve trained for it, but they’ll leave your practice.

Cothren: When we talk about ways to mitigate burnout, we always talk about resilience and building resilience. You can [find] someone who’s recently out of school who has developed some resilience who maybe has a longer runway, but I agree that it can happen at any point.

AJMC: Have you identified strategies that work, whether it’s job sharing or policies to eliminate intrusions on PTO?

Cothren: Going back to building that resilience, it’s 2-pronged, because it does start with things within yourself. We do talk about self-care, things that you can do: taking care of yourself, making sure you’re getting plenty of sleep [and] exercise, and that you’re eating healthy. You are setting aside time during your day to relax. You are protecting even something as small as your lunch hour. You’re protecting that time to step away, to reenergize yourself. I think it’s very important that leadership normalizes behaviors of wellbeing. Leadership should also encourage behavior that protects time. You are setting the example to delay sending those emails, to avoid the expectation that staff is expected to answer emails at midnight or on weekends. So just emulating that behavior as leaders and then [encouraging] coping skills, turning to other people for support. Having those supportive team meetings during the day is effective as well.

Neubauer: I would just add that the way I look at it, there’s lots you can do, but it’s easier said than done. If this was easy, we would have solved it by now. Health care is very complex. Oncology in particular is very complex. Physicians are trained to try to help patients, and anything that distracts from that isfrustrating. The more that they can’t do that, the more they lose their hope for a fulfilling career. So, you look at things that have significant impact and are low effort and things that have significant impact and high effort. There’s the proverbial low-hanging fruit, and just some of the things that Julie mentioned: such as showing appreciation, communicating well, promoting focus on self care, to name a few.

And then there’s those changes that require much more effort—but are really important—such as, how do you modify the EHR? This takes a lot of work but can result in big differences in the workday.

AJMC: What are the barriers?

Cothren: When we were doing the podcast, you were talking about the difference [between] the younger physicians and the older physicians. We see it in all of the practices we work with, because the older physicians do work longer hours. The younger physicians who come out of residency and fellowship don’t really have those same expectations, correct, Dr Neubauer?

Neubauer: The generational differences are key here. Younger physicians think very differently from older physicians, yet most oncology practices are still run by older physicians. So, a barrier is understanding those differences, because if you don’t, you’re going to lose some of the younger [physicians]. They’re not going to stick around if they aren’t heard or engaged. So that’s one barrier. A lack of communication is a barrier. Some of the payer rules present barriers. And then trying to keep up with the science in oncology is a barrier.

AJMC: How much will AI help?

Cothren: I was at a conference where the keynote speaker predicted that AI would free up about 25% of the physician’s time down the road. His charge was asking physicians, “How are you going to use that time?” Hopefully, it will be turning back toward patient care and focusing on the patient. I think this will go a long way in helping clinicians counter burnout. If they can shift from being in an EHR and tapping on a keyboard all day to focusing on the patient, I predict that will be a big driver as well.

AJMC: How do you scale this? The US Oncology Network is a big organization with a lot of doctors and practice sites. How do you make these changes work in so many different places?

Neubauer: Well, that’s our biggest challenge – and biggest opportunity. As medical director for professional well-being, this is the crux of my role: How do we identify all of the key initiatives to reduce burnout, and how do we scale across a large, diverse organization? At The US Oncology Network, we don’t force one-size-fits-all solutions. We start small, learn fast, and then share what works so practices can adapt proven approaches in ways that make sense locally. That’s how change sticks.

About the Contributors

Marcus Neubauer, MD, retired in July 2025 as chief medical officer of The US Oncology Network and now serves as the medical director for professional well-being. Julie Cothren, DPh, is associate vice president, Clinical Advisors for McKesson, which also supports practices outside of The US Oncology Network. Together, Neubauer and Cothren are guiding The US Oncology Network’s efforts to address burnout across the more than 3300 providers in The Network.

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