Oncologists' Experiences with Patient Death - a Qualitative Interview Study

ImportanceFrequent exposure to patient death may challenge oncologists well-being and compromise care quality. Despite these risks, evidence on how patient death affects oncologists across different healthcare settings remains limited. ObjectiveTo explore how patient death affects oncologists, focusing on personal and professional impact, coping strategies, and perceived support and educational needs. DesignQualitative study based on semi-structured telephone interviews conducted in 2024, analyzed using deductive-inductive content analysis. SettingInterviews with oncologists from various specialties, working in inpatient and outpatient adult cancer care settings across Germany. ParticipantsOncologists working within the German health care system with experience of at least one patient death were eligible to participate. Participants were recruited using purposive maximum-variation sampling. None withdrew after enrollment. The sample included a range of clinical roles and levels of experience. Intervention(s) or Exposure(s)Cross-sectional observational study without intervention. Main Outcome(s) and Measure(s)Participants descriptions of personal and professional effects of patient death, their coping strategies, and their reported support and educational needs. ResultsThe sample included 23 oncologists (13 male) from diverse oncological specialties. Participants reported a wide range of personal and professional responses to patient death, from no impact to significant distress, but also described experiences of personal and professional growth. Emotional responses included sadness and helplessness, but also feelings of relief and satisfaction. Lasting effects, including shifts in clinical approach and life perspective but also adverse outcomes such as difficulty separating work from private life were reported. Common coping strategies included peer support, clinical reflection, professional distancing, and both team-based and individual rituals. Barriers to coping included taboos around death, blame dynamics, time constraints and unclear access to institutional support. While many reported no current unmet needs, the findings nonetheless revealed gaps in medical education and a demand for low-threshold support formats. Conclusions and RelevancePatient death can have lasting personal and professional impact on oncologists. Interventions addressing educational gaps and providing low-threshold support may help strengthen oncologists well-being and sustain care quality. Trial RegistrationNot applicable (qualitative observational study). Key pointsO_ST_ABSQuestionC_ST_ABSHow do oncologists experience and cope with patient death, and what support needs do they perceive? FindingsIn this qualitative interview study, oncologists described a wide range of personal and professional effects of patient death. Coping strategies included informal peer support, clinical reflection, professional distancing, and both team-based and individual rituals. While many participants reported no unmet support needs, the findings nonetheless revealed gaps in medical education and a demand for low-threshold support formats. MeaningPatient death can have lasting personal and professional impacts on oncologists, underscoring the need for accessible and structured support.