The numbers are in. Medscape National Physician Burnout, Depression & Suicide Report 2019 indicates that the rate of physician burnout is still at an all-time high. Forty-four percent of physicians reported feeling burnt out.
According to the report, 50 percent of women reported experiencing burnout versus 38 percent of men. Carol Bernstein, MD, a psychiatrist at NYU Langone Medical Center, states that the reasons for the difference could be that women tend to seek help more often than men. Additionally, women are more inclined to acknowledge that they have more work-life balance challenges than men.
Burnout shows up in various ways. Physicians reported that burnout is affecting their relationships, causing them to be short with staff and patients, making them dread going to work, and some even say they are suffering from health problems. What’s worse is that most physicians don’t seek help. The answer for some physicians has been to cut back on their hours or to leave the medical field altogether. Both of these responses affect patient care negatively.
The bottom line is that we have to do something about this crisis because we are not seeing improvements. We are also seeing a high number of physician suicides that is twice that of the general population with one doctor per day committing suicide.
Both organizational and physician intervention is needed. Organizations need to structure more efficient workflows, limit administrative tasks for physicians, help with EMR requirements, offer administrative time to complete charting and provide a safe place to talk about issues as well a culture that supports work-life balance and includes physicians in decision making.
What can physicians do? Physicians have to stop and take the time to ask themselves two questions on a regular basis.
The first question is: “How am I feeling right now?”
Take time to analyze your feelings. Reflect and evaluate how things are going. Compare your current situation to last year or so. Think about what is working and what isn’t. Listen to the voice in your head and pay attention to any changes in your mood, activity level, the way you respond to others and how others are responding to you.
More importantly, recognize if you’re exhibiting signs of burnout.
Are you emotionally exhausted? Does it take you longer to recover in between time away from work?
Are you having a distant feeling toward your patients that is causing you to be cynical or sarcastic? Are you too tired to be compassionate?
Do you feel like you have to work harder to solve problems or to feel like you are accomplishing the same thing?
Are you having a hard time asking for help and feeling like you need to do everything yourself?
Physicians are so busy with the day-to-day tasks of practicing medicine and balancing family responsibilities that it leaves little time to just reflect internally. There is no time to take inventory of their own lives when they are so busy caring for others.
After your period of self-reflection ask yourself, is this what I want right now? How is my current situation working for my family and me at this moment? What would life have to look like for me to feel good about going into work every day and have a sense of being fulfilled?
The second question is: “What am I going to do about it?”
The best way to deal with the signs of burnout or to prevent it is to take action. If there is no wellness program at your institution, advocate for one and start it. A wellness program addresses the mind, body and spirit aspect of wellness in addition to the environmental (worksite) wellness of physicians. Gather the help of your colleagues to attack the problem instead of waiting for change to occur from your organization. Be the change.
If there is a wellness program at your hospital or organization, join the committee or make sure there is a physician present who is also responsible for making the decisions. Physicians have to advocate for each other.
Speak up at your specialty board meetings and advocate for change.
Take care of yourself. No one can take care of you like you can. Take time off. Working harder is not the answer. If you need help, seek it now. Talk with colleagues who may be experiencing the same thing you are. Yes, exercise and eating healthy are important but taking a holistic approach to your wellness is even better. This means looking at the different areas that make up your life and see where you would like to change things to bring you the greatest satisfaction. Dr. Bill Hettler, co-founder of the National Wellness Institute, developed a wellness paradigm that integrates six dimensions of wellness that could be used as a guideline for attaining a whole and complete life.
The six domains of wellness are:
Physical. Maintaining healthy body through regular exercise, proper nutrition, sleeping well.
Emotional. Being in touch with your own emotions and being able to express your thoughts and sensations and to be able to take on those of others.
Spiritual. Having a sense that life is meaningful and has a purpose and that we are guided in our journey.
Intellectual. Being able to engage in continued learning, solving problems and being creative.
Environmental. Having a healthy work and living environment.
Social. How healthy are your relationships?
Self-awareness is an ongoing practice. It’s something that is necessary for physicians to do. These questions should be asked on a regular basis to shape and define your personal development and career. Step by step and brick by brick the foundation can be laid for physician well-being.
Lisa Herbert is a family physician and can be reached at Just the Right Balance.
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