Physician Burnout - How Resiliency Helps
A whopping 78% of physicians have experienced burnout according to the 2018 Physicans Foundation survey.
The AMA StepsForward module “Preventing Physician Burnout” defines burnout as, “a long-term stress reaction characterized by depersonalization, including cynical or negative attitudes towards patients, emotional exhaustion, a feeling of decreased personal achievement and a lack of empathy for patients.”
Yikes. That doesn’t sound like a doctor any of us want treating our loved ones. As a physician you’re a role model, whether you intend it or not. If you aren’t addressing your own health, you’re not being a good role model to your patients, your colleagues or your family.
The good news is that despite 90% of physicians feeling they have no impact on the health care system, research shows that developing personal resiliency skills has a positive impact on burnout – and that’s completely within your control.
The AMA notes that physicians who practice resiliency are better equipped to handle their many challenges and are less likely to experience burnout. It describes resiliency as, “The capacity to recover from difficulties, the ability to spring back into shape or the ability to withstand stress and catastrophe. We can also deliberately enhance our resiliency by learning self-management skills and connecting with the meaning and purpose in our lives.”
In their research, TRACOM Group® identified nine elements of resiliency. Let’s take a quick look at each:
Personal Responsibility is the belief that you control your own destiny with successes or failures determined by your own talents and motivations, rather than luck or fate.
Realistic Optimism is expecting the future to be good whilst realizing that challenges will arise. This crucial aspect of resiliency instils motivation while allowing you to anticipate and plan for challenges.
Personal Beliefs is the sense that life has meaning and purpose. This may take the form of religion, spirituality, or a sense of connection to causes you believe in. Bennet Omalu, a forensic pathologist who discovered chronic traumatic encephalopathy says, “Don’t let your job as a physician consume you and define who you are. You are who you are with or without medicine, and come what may, you are you. You must learn to be yourself and be happy being yourself.” Compare where you are spending your time and money to your core values and beliefs. Is there a mismatch? What is the legacy you want to leave behind?
Self-Assurance is a belief in yourself (without slipping into arrogance). You have confidence in your ability to handle challenges.
Self-Composure is the ability to manage stress and remain calm, dealing with challenges rationally without allowing emotions to rule. Ronald Vender, professor of medicine and chief medical officer at Yale Medicine cautions, “Burnout typically results from unrelenting stress, so I encourage my colleagues to regularly self-evaluate their stress levels and their sense of work-life harmony. If you are finding yourself experiencing more stress, you need to intervene before burnout develops. If burnout has developed, you need to recognize it and begin the process of dealing with it. Spend more time with your loved ones. Make sure you are exercising, and spend some time in nature at least once a week.”
Problem Solving is the ability resolve problems effectively by gathering information and planning carefully, using reason, logic, and creativity. Barbara McAneny, a board-certified medical oncologist/hematologist and president of the AMA notes, “[F]or the last 20 years of seeing patients and being the managing partner, the success of solving problems has kept me from burnout. Feeling like you made a difference in someone’s life is the best antidote to burnout.”
Goal Orientation is setting appropriate professional/personal goals, monitoring progress and adjusting behavior accordingly. “I will ensure that I make it to [gym] class despite my 80+ hour workweek,” said Fatima Cody Stanford, an obesity medicine physician scientist at Massachusetts General Hospital and Harvard Medical School. “While I am certain I still have some burnout, this has helped to mitigate much of the burnout that I inevitably experience in a very rigorous environment. I do realize that we are conditioned to put everyone before ourselves. I have been guilty of this, and I continue to strive to create ‘work-life balance’ in the midst of what often seems to be ‘work-work balance.”
Courageous Communication is the tendency to communicate in a candid, respectful and courageous way. You freely and effectively share ideas, ask difficult questions, and address problems directly. This may include the need to ask for or offer help. “This is a hard job and people will generally be understanding and will pitch in to get you through it,” said Robert Wachter, chair of the Department of Medicine at San Francisco School of Medicine. “When I was going through a difficult time myself, a wise friend gave me the best advice I’ve ever received: ‘There is nothing in your life that is so bad that you can’t make it better.’ That may not be true in the very short term, but physicians have lots of options, including taking time off.”
Social Support is feeling part of a supportive network and having close confidants you can turn to during difficult times. “Long hours in the hospital are more enjoyable when you know and like the people you work with and, in parallel, outside the hospital having family to re-center me—or friends to decompress—served as my medicine to stay healthy,” said Tina Shah, the AMA’s 2018 Dedication to the Profession Award winner. “It’s OK that you are feeling burned out. Chances are, most of your colleagues are too. The first step is to acknowledge it. Seek community and support because it’s not a one-size-fits-all solution.” You can also seek professional help and connect with local resources such as PBCMS’s wellness program that offers confidential counseling.
Each small step toward improving your own resiliency will help reduce your risk of burnout, benefiting you, your patients and your family.
This article was first published in Palm Beach County Medical Society's magazine ON CALL (Q4, 2018).
