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Editor's Correspondence
October 26, 2009

Medical Oncologists' Experience in Attending a Funeral and Communicating Condolences—Reply

Arch Intern Med. 2009;169(19):1806-1818. doi:10.1001/archinternmed.2009.374

In reply

We thank Dr Morris for sharing with us his experiences with bereavement follow-up. Dr Morris has found that bereavement follow-up, specifically funeral attendance, has many professional benefits including the avoidance of professional burnout.

Professional burnout is increasingly recognized among physicians and is characterized by the following 3 components: depersonalization (emotional hardening and impersonal response), emotional exhaustion, and lack of personal accomplishment.1 Although funeral attendance was reported by a minority of physicians in our study (2% usually or always and 10% sometimes),2 it may indeed provide an effective strategy to overcome one of the key components of burnout, depersonalization, reported by 22% of oncologists.3 However, the potential benefits of routine funeral attendance must also be weighed against the risks of emotional exhaustion (reported by 53%-69% of oncologists3,4), compassion fatigue, and time constraints. In a study at our center, inadequate time to grieve the death of patients was reported by 55% of oncology staff and was a significant predictor of work-related stress.5 In a study of certified nursing assistants working in a nursing home, higher levels of work-related grief appeared to contribute to burnout, whereas positive reactions to grief protected from burnout.6 To our knowledge, there have been no previous studies that describe the relationship between physician grief or bereavement practices and physician burnout.

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