The feedback I’ve received from my lastHospital Impact post has been truly astounding. Clearly, on the topic of physician burnout, we’ve touched a nerve. Here’s just a sampling of the comments:
- "This is a critical, growing problem and one that should be given immediate attention." -- Michael T
- "We need to look at physicians as being an overextended precious resource and focus not on just telling them what they need to do but to take a proactive role in engaging them around the values of best practice care." -- Alan R
- "We are all trying to do more with shrinking resources and it reaches a point of overkill too easily. Nursing and medicine are noble professions, but not if they erode life's passion and job." -- Diann M
So what to do about this growing, global problem?
The solution to physician burnout often lies in stress reduction
Burnout is a healthcare professional's occupational disease. And like any disease, it must be recognized early and treated.
In an article in Occupational Medicine, burnout is defined as exhaustion of physical or emotional strength--as a result of prolonged stress or frustration. "Early identification of this emotional slippage is needed to prevent the depersonalization of the provider-patient relationship," the article urges.
Suggested prevention and treatment methods of this "emotional slippage" include: greater job control by the individual worker, group meetings, better up-and-down communication, more recognition of individual worth, job redesign, full orientation to job requirements, availability of employee assistance programs and flexible work hours (particularly now that so many women have double home-work careers).
As a corporate anthropologist, what I found most interesting are the article’s wellness-related suggestions for burnout prevention: health insurance coverage for mental health and chemical dependency care; family leave policies so that conflicts between home and work can be resolved; informal staff and family events such as picnics, retreats or potluck suppers; and, probably most important, the encouragement of away-from-the-examining-room activities, including walking or jogging on hospital rooftop tracks, swimming, and even music therapy and meditation.
This same sentiment is echoed in a recent article in The Atlantic. When Dr. Mary Brandt, a pediatric surgeon and professor at Baylor College of Medicine in Houston, gives lectures to medical students, she often adds pointers on healthy eating and lifestyle, she says. This sort of advice--about well-being, over the long haul of a medical career--wasn't provided when she was a student or surgical resident. "One of my best friends is an astronaut," she explains. "Nutrition, exercise, self-care and being well is part of her job." Among that group, it's unthinkable that you wouldn't take care of yourself because that would put your team at risk—precious information for today’s overtaxed doctors and nurses.
An alternate view: Combat burnout not by reducing stress but by promoting professional fulfillment
A contrasting article, also from The Atlantic, offers a different solution to the burnout problem. "Unfortunately, individuals and organizations often respond to burnout by recommending coping strategies focusing on the reduction of stress. While reducing stressors in the work environment may offer real benefit, it does not get at the problem's real roots. Instead of merely reducing the bad in medical practice, we need to enhance the good," it advises.
According to the article, this approach is rooted in the work of the late Frederick Herzberg, a psychologist at the University of Utah. Herzberg found that if individuals feel ashamed of their workplace, unfairly treated or undercompensated, their level of satisfaction will suffer. Yes, reducing "dissatisfiers" will reduce workers' level of dissatisfaction, but this does little or nothing to enhance intrinsic fulfillment. To enhance fulfillment and quality of work, it is necessary to focus on the work itself.
In the case of medicine, do physicians recognize what they find most fulfilling? What does their best work look like? Are they making full use of their knowledge, skills and innate abilities? Are they growing and developing as human beings? Do they feel that they are making a real difference in the lives of their patients and communities? If not, burnout is practically inevitable.
Good news: Today’s crop of doctors seems better able to cope
Even though burnout is a very real problem in medicine today, the situation is not all bleak. "The current generation gets it completely," Brandt says in the aforementioned Atlantic article. "Wellness is common vernacular for trainees now. In the past, you'd be considered weak if you discussed your fatigue or needs. Now, it's understood that the best way to take care of your patients is to take care of yourself."
Truer words never spoken.
Andrea J. Simon, Ph.D., is a former marketing, branding and culture change senior vice president at Hurley Medical Center in Flint, Michigan. She also is president and CEO of Simon Associates Management Consultants.