Any working individual can experience burnout and healthcare professionals are no exception to this rule. A recent study found that approximately 80% of physicians experience at least one symptom of burnout, including exhaustion, cynicism, and low sense of personal achievement. These symptoms of physician burnout vary on a day to day basis, depending on how demanding your job responsibilities are and whether or not you are taking some time for yourself. So what is the best way of dealing with burnout?

Burnout is not defined simply as exhaustion. Experiencing symptoms of burnout can cause you to lose interest not just in work but in almost all other things that you do as well.  It also affects your patients, staff members, and colleagues. Physicians who are frustrated with the stress of daily practice find it more difficult to establish solid relationships with patients.

The most stressful job occupations are ones that involve a great deal of responsibility and little control over results. Your role as a physician fits within this description.

What is Burnout?

This entry is part 1 of 3 in the series Dealing With Burnout

What is Burnout? – The Challenge of Long Term Stress

As a definition, burnout refers to long-term stress characterized by three common symptom patterns:

  • Emotional exhaustion – feeling emotionally depleted and frustrated;
  • Cynicism – being cynical and sarcastic about oneself, patients, and other individuals;
  • Decreased personal achievement – questioning “what is the use” and experiencing work as unrewarding

Dealing With Long Term Stress in Healthcare

Any working individual can experience burnout and healthcare professionals are no exception to this rule. A recent study found that approximately 80% of physicians experience at least one symptom of burnout, including exhaustion (38%), cynicism (29%), and low sense of personal achievement (12%). These symptoms of physician burnout vary on a day to day basis, depending on how demanding your job responsibilities are and whether or not you are “recharging your batteries”.

From studying in medical school and training during residency to establishing doctor-patient relationships and dealing with piles of work – patient charts and appointments – stress is likely to catch up with you. The average physician works over 50 hours a week and long workdays can cause you to feel exhausted and emotionally drained. Moreover, they can lead to symptoms of burnout, deteriorated health, high risk of medical errors, and the inability to provide quality patient care.

However, burnout is not just troublesome for you as a physician, but it also affects your patients, staff members, and colleagues. Physicians who are frustrated with the stress of daily practice find it more difficult to establish solid relationships with patients.

Main Causes of Burnout in Healthcare Industry

The six main causes of burnout among healthcare professionals come with the stress related to:

  • developing a medical education;
  • practicing clinical medicine;
  • working a demanding job;
  • lacking control over schedules and time;
  • working for an unskilled or absent supervisor;
  • juggling both personal and professional life;

The Effects of Burnout on Medical Professionals

In an editorial published in the Journal of General Internal Medicine, 30-65% of burnout rates are seen across several specialties. The two specialties with the highest percentage of burnout are those that deal with severely ill patients: emergency medicine and primary care.

Burnt-out physicians are more likely to leave medicine than other healthcare professionals. Moreover, 45% of these physicians are female, which may be the reason why women tend to enter generalist occupations such as family medicine or obstetrics/gynecology.

The least burnt-out healthcare professionals are pediatricians, dermatologists, pathologists, and psychiatrists. Dermatologists and ophthalmologists have the highest scores for content at work, while emergency medicine physicians, family physicians, and radiologists have the lowest scores for content at work.

Perhaps the greatest concern is the fact that burnout among primary care physicians has increased within the last few years not only in the United States but in Europe too. According to a study conducted back in 2013, job-related stress accompanied with poor treatment for mental health conditions, may account for above average suicide rates among physicians in the United States. Per year, around 300-400 physicians in the United States die by suicide.

Burnout: The Symptoms

So, what is burnout? Burnout is not defined simply as exhaustion. Experiencing symptoms of burnout can cause you to lose interest not just in work but in almost all other things that you do as well. To get a more broad sense of what burnout can look and feel like, here is a list of different perspectives:

  • Being irritable and losing one’s temper;
  • Having difficulty concentrating;
  • Having difficulty maintaining healthy habits;
  • Showing lack of initiation;
  • Showing lack of interest towards work-related goals, household chores, and other tasks;
  • Withdrawing from friends, family, and society;
  • Having a negative attitude;
  • Being frequently bored;
  • Feeling uninspired and unmotivated;
  • Losing one’s personal values and beliefs;
  • Experiencing extreme exhaustion;
  • Experiencing psychosomatic symptoms such as headaches;
  • Having insomnia;
  • Being in denial;

Getting Help

Due to the fact that you may not always be able to identify symptoms of burnout yourself, it helps to turn to friends and family members for support. Every individual is reluctant to hear the truth because like it or not, the truth sometimes brings “bad news” and no one likes bad news. However, your friends and family can offer their opinions and examples as to why they believe you are burnt out.

You may be experiencing symptoms of burnout due to your heavy load of job responsibilities. If this is the case, perhaps you should consider cutting back on work hours or easing your workload. For instance, hiring medical assistants to take care of patients’ medical records and administrative duties can give you more face time with your patients.

The most stressful job occupations are ones that involve a great deal of responsibility and little control over results. Your role as a physician fits within this description. However, job occupations are not the only source of burnout. Sometimes, they may play a small role in a much bigger problem. What is most important is that you pay close attention to what is overwhelming you. If you can find the cause, you can learn how to address burnout.

Burnout Causes and Consequences

This entry is part 2 of 3 in the series Dealing With Burnout

Burnout on the Rise Among Healthcare Professionals

Long-term stress is an escalating problem among medical professionals. According to recent findings from Mayo Clinic, burnout rates continue to grow and physicians are finding it more difficult to maintain a work-life balance. Burnt out physicians are more likely to leave their practices, thereby decreasing patient access to care.

Moreover, physicians are twice as likely to commit suicide in comparison to other professionals. Suicide rates account for over 26% of deaths among physicians aged 25 to 39 in the U.S. Working to address physician burnout starts by being able to identify the early warning signs of burnout: emotional exhaustion, depersonalization, and diminished confidence. From there, it is about recognizing and preventing the causes and consequences of burnout.

Burnout Causes

Throughout the years, several research has gone into identifying the causes of burnout, in hopes of preventing it from occurring. A great deal of burnout cases have been seen to be triggered by the following causes:

  1. Excessive clerical tasks
    Nowadays, physicians have to conduct more administrative tasks and this is getting in their way of providing quality care to patients. “Physicians want to provide our patients with the best care possible, but today there are confusing, misaligned and burdensome regulatory programs that take away critical time physicians could be spending to provide high-quality care for their patients” said Robert M. Wah, president of the American Medical Association.
  2. Decreased patient time
    Most physicians go into the field of medicine for the love of science and willingness to provide quality care. In a Medscape survey conducted among physicians in 2014, over 70% revealed that EHR reduced their face time with patients. With excessive workloads pertaining to data entry, physicians are finding it more difficult to spend their time effectively working and caring for patients.
  3. Diminished income
    Medical education requires time and effort, but it also costs a lot. Several physicians have debts that they need to pay off; however, with health care reforms taking a turn, incomes are diminishing and workloads are increasing. Such issues are leading to decreased physician satisfaction and high rates of physician burnout. “A physician can ace 99% of the requirements and still get penalized for flunking the remaining 1%” said Robert Wergin, president of the American Academy of Family Physicians.
  4. Extended work hours
    With today’s decreasing reimbursement rates, physicians are still high in demand, although they are being asked to put in a great deal of effort with little time. Findings from Physicians Foundation survey conducted back in 2014 revealed that more than 80% of physicians were overwhelmed by work or had reached their full capacity. Extended work hours resulting in making patient appointments, looking over patient charts, and filling out paperwork has led to physicians finding it difficult to juggle a work-life balance.

Consequences of Burnout

  1. Poor patient care
    Physician burnout has been linked with difficulty concentrating, easy distraction, and poor decision-making. Physicians who are both emotionally and physically drained cannot provide high quality patient care. This, in turn, can result in diminished physician-patient relationships. In a recent Medscape survey conducted among physicians, over 10% identified the severity of their burnout at 6 or 7, on a scale of 1 (“does not interfere with my life”) and 7 (“so severe that I’m thinking of leaving medicine”).
  2. High suicide rates
    Every year in the United States alone, over 400 physicians commit suicide. Surprising results reveal that a high number of physicians who express warning signs of burnout are likely to consider committing suicide. Moreover, depression can greatly impact family life and a physician’s ability to provide quality care.
  3. Early retirement
    As the number of patients with insurance begins to grow, so does the demand for physicians. However, due to burnout, several physicians are retiring early. Some are even switching careers. With physician shortage on the rise, patient access will be limited and workload will grow for those who remain. This, in turn, can result in decreased patient engagement and outcomes.

Excessive clinical tasks, decreased patient time, diminished income, and extended work hours are merely some of the most common causes of burnout. Other causes also include high pressure environment, loss of control over time and schedules, family responsibilities, negative work environment, and more. These causes can all lead to consequences of stress, including poor patient care, high suicide rates, and early retirement. However, physician burnout can also negatively affect patient satisfaction, professionalism, and thus lead to increased medical errors within the clinical setting.

The fact of the matter is that burnout is a long-term reaction to stress and it takes time to properly combat it. The most important thing is to be able to identify the early warning signs of it and take measures to address burnout before it occurs. By focusing on physician self-care, those who practice medicine can create a viable work environment, all the while providing accessible and high quality patient care.

How to Address Burnout

This entry is part 3 of 3 in the series Dealing With Burnout

How to Address Burnout?

As a physician, you have to deal with growing medical knowledge, increased clerical duties, as well as new regulatory requirements. All of these aspects can take a toll on your professional life and your personal life as well. The term “burnout” is used loosely after an exhausting day, but actual burnout is quite a serious matter. It is a real condition that is easy to overlook, but the consequences can be serious. So how can you address burnout? What can you do to stay content and motivated at work?

How to Avoid Burnout?

  • Create a positive workplace by choosing to let go of negativity and setting a purpose to experience happiness within the workplace.
  • Take some time off to go on vacation or take a road trip with your family and restore your sense of balance.
  • Schedule a little time for yourself – relax, read a book, write a novel, take a walk, etc.
  • Search deep down and rediscover your personal needs – Is it having authority? Being accepted by others? Attaining a particular accomplishment? Find out what it is that will make you happy.
  • An important way to address burnout is to reach out and talk to your family, friends, or colleagues when you are feeling overwhelmed or unappreciated.
  • Try to exercise at least three times a week. Consider some relaxation techniques such as swimming, biking, meditation or yoga.
  • Develop healthy patterns by being proactive, eating healthy meals, and getting enough sleep.
  • Find an interest outside of medicine to help release your tension. Consider joining a book club, taking up golfing, playing tennis, etc.
  • Reconnect with a medical school classmate and reminisce about the good times spent together. Try to remember why you got into medicine in the first place.
  • Try taking a different route to work or home. Perhaps a change of scenery can help to improve your enthusiasm.
  • Attend a medical school convention and learn about new procedures, treatments, and opportunities. Staying ahead of the latest medical advancements can help you to remain an authority within your field.
  • Address burnout by volunteering for a wellness committee or joining an online interest group to talk and learn from others who are going through similar experiences.
  • Take short breaks at work to ‘recharge your batteries’.
  • Hire medical assistants when necessary to help ease your workload so that you can focus on more important things that require your complete attention.
  • Improve team functioning by engaging staff members to work together as a team and achieve common goals.
  • Conduct weekly or monthly staff meetings in order to discuss various topics and address issues anywhere from jam-packed schedules to virus outbreaks.
  • Work together with administrators and other physicians to identify internal factors (feelings, age, working experience, personality characteristics) that are triggering high burnout rates among physicians.
  • Talk with other physicians about burnout issues that you are facing (depression, anxiety, etc.) or meet to discuss health-related topics that will help you feel less isolated.
  • Strive and work towards your goals and milestones – promotion, disease prevention, patient advocacy, etc.
  • Strive to balance your personal and professional life by prioritizing your responsibilities. Are you spending all of your time at the hospital? Perhaps a little time spent at home may help you to alleviate your mental and physical exhaustion.
  • Seek help from your family, friends, or a professional if you are experiencing early warning signs of burnout – anxiety, depression, chronic fatigue, physical symptoms, and impaired concentration.

Practice Mindfullness

According to several studies, practicing mindfulness meditation can be a useful way to address burnout. Mindfulness is portrayed as “the psychological process of bringing one’s attention to experiences occurring in the present moment, which can be developed through the practice of meditation and other training”. It is a practice that involves organizing on your thoughts and not judging them as good or bad, but rather focusing on the present with open-heartedness. The ultimate goal is to help you achieve both mental and emotional stability.

Moreover, in order to protect your passion for medicine from negative thoughts, stop doing what you believe is holding you back or what is not satisfying you. By letting your own negativity fade away, you can translate your thoughts and emotions towards positivity. At work, strive to create a space where you and your staff members will feel appreciated, productive, and satisfied. At the end of the day, leave work at work. At home, spend some time with your family and do activities that will bring you joy and purpose.

Reflect, Explore and Reevaluate

Throughout countless research studies conducted over the years, it has been determined that stress is the primary and the most common cause of physician burnout. So attempt to change the aspects that may lead to your burnout by changing the way you work. Sometimes, performing the same routine every single day can be draining and overwhelming. Explore your options – for some individuals, this may mean a change of scenery or medical field, while for others it may be an entirely new career. Listen to your inner voice and do some self-reflecting. Ponder over your expertise, what you have achieved so far, and how you feel about your achievements. As you begin to rediscover who you are and why you got into medicine in the first place, your passion for patient care will resurface.

In every line of work, or even at home for that matter, stress is inevitable. Whether you choose to give into the downward pull of stress and exhaustion is up to you. Remember that in clinical practice, your level of stress is a moving target and the end result can be burnout. By proactively focusing on your mental health state, you have a better chance of sustaining resilience in the face of stress and properly caring for your patients. The key to surviving or preventing burnout is being able to achieve a proper work-life balance. The good news is that this balance is yours and you can alter it at any point. Above all, pace yourself in everyday situations and appreciate your line of work and make no mistake; your patients appreciate you.