Physicians are dealing with an incredible amount of work stress as they confront growing administrative burden, rising operating costs, new technology adoptions, and the increasing patient demand for frontline care.
The new study by Medscape found the nearly half of all U.S. physicians experience burnout. The specialties with the highest reported rates of burnout are Critical Care (48%), Neurology (48%), Family Practice (47%), OB/GYN (46%), Internal Medicine (46%), and Emergency Medicine (45%). The specialties reporting the least amount of burnout were Plastic Surgery, Dermatology, Pathology and Ophthalmology.
There are no signs the situation will improve. It is estimated there will be a shortage of just over 121,000 physicians by 2030. Between 15,000 and 50,000 of those will be primary care physicians. In a study from the Mayo Clinic, physicians reported the desire to shorter work days, and that means seeing fewer patients.
Besides the obvious effects on the health and happiness of doctors, physician burnout leads to low-quality patient care, medical errors, and costs the healthcare system billions of dollars a year.
So, can doctors do anything to prevent physician burnout? Whether you’re struggling with burnout yourself, or are an administrator looking to prevent physician burnout among providers, there are some things you can do to help.
Learn to spot the warning signs.
Sometimes it’s hard to figure out where the line is between normal, manageable work stress and burnout. That’s where the Maslach Burnout Inventory (MBI) comes in. According to the MBI, there are three classic symptoms of physician burnout:
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Emotional exhaustion - You’re completely worn out after work and can’t seem to recover at all in your time away.
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Depersonalization - You’re having trouble connecting with patients, and find yourself constantly blaming others. Your general attitude has turned negative and cynical.
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Reduced accomplishment - You’ve lost confidence in your skills as a doctor and start to believe your care won’t do any good.
Of course, spotting these warning signs isn’t always straightforward, since everyone deals with stress in different ways. Dr. Romila Mushtaq, a neurologist, didn’t realize she was experiencing burnout until her stress started affecting her physically:
“I didn't know that the symptoms I was suffering had a diagnosis of physician burnout. I just internalized the symptoms of emotional exhaustion and a low sense of personal accomplishment...and I thought my problem was that I was a physician failure...I started to gain weight and get anxious. I only realized that I needed to slow down when I started to suffer from debilitating chest pain and other physical symptoms that took years to get correctly diagnosed as achalasia.”
As you’re watching for these warning signs, keep in mind physician burnout may look a bit different for male physicians than female physicians. A recent research study found that male physicians may show signs of depersonalization first, emotional exhaustion second, and skip the reduced accomplishment stage entirely. Female physicians seemed to follow these three symptoms in order.
So, you’ve noticed the warning signs. Now what? How do you stop physician burnout before it takes over?
Pursue a mindful approach.
Try a course in mindfulness. Recent research on stress and burnout finds mindfulness can be especially helpful in preventing burnout and raising job satisfaction. In one study published in the Annals of Family Medicine, a short weekend-long training on mindfulness significantly reduced primary care doctors’ rates of burnout, stress, and depression — results that lasted through the 9-month follow-up mark.
What exactly is mindfulness, you ask? It’s a way of training your mind focus on your experiences in a non-judgemental way. Think greater self-awareness, a clear mind, and a more compassionate, balanced perspective of yourself and others.
There are lots of great resources to help train you on a mindful approach. Here are a few we found:
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Discover mindfulness resources for providers at Harvard Pilgrim Health Care Center
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Sign up for a 5-day intensive training at UMass Medical Center for Mindfulness
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Check out Berkeley’s Greater Good Science Center and sign up for their mindfulness webinar
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Take a mindfulness quiz
Find a release and make time for it.
Everyone needs to find a way to release stress, especially physicians. Whether it’s a hobby, a sport, a weekly acupuncture session, or a guilty-pleasure tv show, making time for something that helps you manage stress can prevent burnout. Whatever the activity is, schedule it on your calendar like you would any other meeting or appointment. Consistently prioritizing your own health can go a long way in reducing burnout.
Find a support system.
For the emotionally tough patient cases, try debriefing with a trusted colleague, mentor, or someone who can lend you emotional support. Make this a regular practice. If your healthcare institution is a member of the Schwartz center, you can also take part in the Schwartz Center Rounds® program. The program offers healthcare providers a chance to meet up and discuss their emotional experiences and tough situations surrounding patient care.
“Many institutions will have formal critical incident debriefings for the entire team, for particularly awful events. While this doesn’t need to be performed formally for routine events, it’s a good idea to informally debrief with a trusted partner, superior or mentor. Talk through the case, review the medicine and the science, review your actions and outcomes, and your emotional response to the situation. It is helpful to do this with someone you respect, so he or she can give you valuable feedback. This can be over coffee or a beer or three; possibly better that way.” Shadowfax, MD, via Kevin MD
Whatever the method, encouraging frank discussions about work stressors is a crucial way of preventing physician burnout. Besides relieving stress, having open discussions can help you or your colleagues spot warning signs early.
Turn to social media.
Social media is another source for help. It may seem unorthodox, but social media can be a great way to connect with other physicians, especially when you’re working solo or in a smaller practice. Dr. Kathy Nieder, a family physician, describes how her own discovery of Twitter helped recharge her initial enthusiasm for practicing medicine.
LinkedIn, Doximity, and Sermo are also great social networks to connect with fellow physicians and find resources to get you re-engaged.
Prioritize work-life balance.
Work-life balance often falls to the wayside when you’re an overworked physician. And as Dr. Kevin Campbell points out in his post on physician burnout, doctors are often trained to overwork themselves and put their own needs last. But work-life balance is one of the most crucial factors in preventing physician burnout. Without that time to recover, to release stress, to spend time with family or loved ones, stress is likely to rule your life.
How to find a better balance? Learn how to say “no” with these great tips from The Happy MD, and set limits to protect your own health and well-being. You can also check out these helpful articles on Physician Life Balance from the AAFP.
Consider locum tenens work.
If your current position is untenable, it might be time to consider locum tenens work. Locum tenens work has many advantages, especially when you’re struggling with burnout. You can take time off when you need it, avoid the institutional politics, and interact and care for new and diverse patient populations. Besides offering the flexibility and change you need, locum tenens work lets you experiment with a bunch of different positions. It might even offer you a commitment-free way to find a new position that’s a better fit for you.
Physician burnout is a symptom of a larger problem - a healthcare system that increasingly overworks doctors and undervalues the health needs of their own. Take the time to prioritize your own health, and use these tools to prevent burnout. The end results? Satisfied, empathetic physicians with happier, healthier patients.
