Archive for Health

Estimated 1.9 Million Vapers in U.S. and Growing

Estimated 1.9 Million Vapers in U.S. and Growing

A research team including experts from Johns Hopkins conducted a survey to determine trends in e-cigarette use. Based on more than 400,000 responses from the national telephone survey led by the Centers for Disease Control and Prevention, the researchers estimate that 1.4 percent of the population in the U.S. vapes. Yet these roughly 1.9 million people do not report smoking cigarettes regularly.

E-cigarettes contain the addictive chemical nicotine, and as they are unregulated can contain other harmful chemicals. Although adults report using e-cigarettes to wean themselves off of traditional cigarettes, younger generations are taking up vaping without prior experience smoking.

Their findings in a brief research report, published on Oct. 9 in the Annals of Internal Medicine, suggest that regulating sales and education for vulnerable young people may be needed to prevent more people from getting hooked on nicotine. The researchers found that 60 percent of vapers were younger than 25 years old. Michigan had the highest prevalence of vapers in the population, whereas Alaska had the fewest. People who only smoked e-cigarettes also engaged in more risky behavior, such as binge drinking, risky sex and drug use.

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REPORT: Nearly Half of Resident Physicians Report Burnout

REPORT: Nearly Half of Resident Physicians Report Burnout

ROCHESTER, Minn. – Resident physician burnout in the U.S. is widespread, with the highest rates concentrated in certain specialties, according to research from Mayo Clinic, OHSU and collaborators. The findings appear in the Journal of the American Medical Association. Physician burnout is a dangerous mix of exhaustion and depersonalization that contributes to physicians making mistakes while administering health care.

The study found 45 percent of respondents experienced at least one major symptom of burnout, with those in urology, neurology, emergency medicine and general surgery at the highest risk. Regardless of specialty, high levels of anxiety and low levels of empathy reported during medical school were associated with burnout symptoms during residency.

“Our data show wide variability in the prevalence of burnout by clinical specialty, and that anxiety, social support and empathy during medical school relate to the risk of burnout during residency,” says Liselotte Dyrbye, M.D., a Mayo Clinic researcher and first author of the article.

Residents with burnout had more than a threefold increase in odds of regretting their decision to become a physician. When asked, “If you could revisit your career choice, would you choose to become a physician again?” those in pathology and anesthesiology were also most likely to respond “definitely not” or “probably not.” Similarly, the higher the level of anxiety reported during medical school, the greater the chance of regretting becoming a physician.

Previous research has shown physician burnout has some relation to gender and ethnicity. Residents who identified as female had a higher risk of burnout symptoms, matching studies of later-career physicians.

Although the problems facing female physicians have been reported, the study illustrated the less-studied plight of residents who self-identified as Latino or Hispanic. These individuals were more likely to regret their specialty choice. While the study did not examine the cause directly, the authors speculate that minority physicians often are pressed into participating in various institutional diversity initiatives that overtax their schedules compared to nonminority physicians.

Not all of the study’s findings were negative. The majority of residents are satisfied with their career choice and specialty. In particular, participants who reported high empathy scores during medical school appeared to be more resilient to burnout during residency. This is counter to the common narrative that physicians need “thick skin” or an emotional aloofness to perform.  Similarly, high empathy scores during medical school were associated with a willingness to choose the same specialty again. In addition, participants who reported higher emotional social support during medical school were generally happier with their specialty choice.

Other burnout studies have focused on physicians-in-practice. This was the first national study to longitudinally follow medical trainees from the beginning of medical school into residency to explore predictors of burnout. The study included nearly 3,600 participants who were surveyed in the fourth year of medical school with follow-up in second year of residency. It was derived from a larger study of medical students called the Cognitive Habits and Growth Evaluation Study that has tracked a group of students from their first year of medical school through the last year of residency.

About 50 medical schools were included in the research. Residents were asked to provide information about their specialty, ethnicity, educational debt and other demographic characteristics. They then completed surveys that have previously been developed to measure anxiety, emotional social support, empathy and burnout.

The study was supported by a grant from the National Heart, Lung and Blood Institute, and the Mayo Clinic Department of Medicine Program on Physician Well-Being. Researchers from Mayo Clinic, Syracuse University, University of Minnesota, Yale University, Stanford School of Medicine, and OHSU distributed, collected and analyzed the surveys. Michelle van Ryn, Ph.D., OHSU School of Nursing was the principal investigator.


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Speak Out! Don’t Allow Suicide to Take Another Physician’s Life.

Speak Out! Don’t Allow Suicide to Take Another Physician’s Life.

Did you know cancer was the most common cause of death among residents? Suicide was the second-leading cause of resident death — and the most common cause of death among male residents. A 2015 review of studies estimated 22 to 32 percent of resident physicians in the U.S. suffer from depressive symptoms and multiple studies have shown that residency training places physicians at risk for mental illness and suicidal thoughts.

Monday, Sept. 17, is National Physician Suicide Awareness Day, organized by the Council of Emergency Medicine Residency Directors (CORD), in collaboration with AAEM, ACEP, ACOEP, EMRA, RSA, RSO and SAEM to annually dedicate the 3rd Monday in September to remind physicians and other health care workers that suicide can be prevented and resources are available.

“Medicine is a calling, and the practice of medicine can be a very stressful career,” said Medical Association Executive Director Mark Jackson. “Alabama’s physicians care for thousands of patients each year, but they may not always stop to take care of themselves when they need it most. Physicians have a multitude of options designed just for them when they feel they are reaching a breaking point, and that’s where we can be a lifeline.”

While estimates of the actual number of physician suicides vary, literature has shown that the relative risk for suicide being 2.27 times greater among women and 1.41 times higher among men versus the general population. Each physician suicide is a devastating loss affecting everyone – family, friends, colleagues and up to 1 million patients per year. It is both a very personal loss and a public health crisis.

Help is available for physicians who feel they need assistance. The Alabama Physician Health Program is a confidential, effective, first-line resource for physicians and other medical professionals with depression and other mental health issues. Physicians may contact the APHP at (800) 239-6272 or email


Additional Resources

Let’s Talk About Physician Burnout

Physician Suicide

Medical specialties with the highest burnout rates

Suicide Is Much Too Common among U.S. Physicians

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CDC STUDY: Steep and Sustained Increases in STDs in Recent Years

CDC STUDY: Steep and Sustained Increases in STDs in Recent Years

Nearly 2.3 million cases of chlamydia, gonorrhea, and syphilis were diagnosed in the United States in 2017, according to preliminary data released today by the Centers for Disease Control and Prevention at the National STD Prevention Conference in Washington, D.C. This surpassed the previous record set in 2016 by more than 200,000 cases and marked the fourth consecutive year of sharp increases in these sexually transmitted diseases.

The CDC analysis of STD cases reported for 2013 and preliminary data for 2017 shows steep, sustained increases:

  • Gonorrhea diagnoses increased 67 percent overall (from 333,004 to 555,608 cases according to preliminary 2017 data) and nearly doubled among men (from 169,130 to 322,169). Increases in diagnoses among women — and the speed with which they are increasing — are also concerning, with cases going up for the third year in a row (from 197,499 to 232,587).
  • Primary and secondary syphilis diagnoses increased 76 percent (from 17,375 to 30,644 cases). Gay, bisexual and other men who have sex with men (MSM) made up almost 70 percent of primary and secondary syphilis cases where the gender of the sex partner is known in 2017. Primary and secondary syphilis are the most infectious stages of the disease.
  • Chlamydia remained the most common condition reported to CDC. More than 1.7 million cases were diagnosed in 2017, with 45 percent among 15- to 24-year-old females.

“We are sliding backward,” said Jonathan Mermin, M.D., M.P.H, director of CDC’s National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention. “It is evident the systems that identify, treat and ultimately prevent STDs are strained to near-breaking point.”

Chlamydia, gonorrhea and syphilis are curable with antibiotics, yet most cases go undiagnosed and untreated — which can lead to severe adverse health effects that include infertility, ectopic pregnancy, stillbirth in infants, and increased HIV risk. Prior studies suggest a range of factors may contribute to STD increases, including socioeconomic factors like poverty, stigma, and discrimination; and drug use.

Continued concerns about antibiotic-resistant gonorrhea

The threat of untreatable gonorrhea persists in the United States, and reports of antibiotic-resistant gonorrhea abroad have only reinforced those concerns. Over the years, gonorrhea has become resistant to nearly every class of antibiotics used to treat it, except to ceftriaxone, the only remaining highly effective antibiotic to treat gonorrhea in the United States.

In 2015, CDC began recommending health care providers prescribe a single shot of ceftriaxone accompanied by an oral dose of azithromycin to people diagnosed with gonorrhea. Azithromycin was added to help delay the development of resistance to ceftriaxone.

Emerging resistance to ceftriaxone has not been seen since the dual therapy approach was implemented, and there has not yet been a confirmed treatment failure in the United States when using this recommended therapy.

New CDC findings released today, however, show that emerging resistance to azithromycin is now on the rise in laboratory testing — with the portion of samples that showed emerging resistance to azithromycin increasing from 1 percent in 2013 to more than 4 percent in 2017.

The finding adds concerns that azithromycin-resistant genes in some gonorrhea could crossover into strains of gonorrhea with reduced susceptibility to ceftriaxone — and that a strain of gonorrhea may someday surface that does not respond to ceftriaxone.

“We expect gonorrhea will eventually wear down our last highly effective antibiotic, and additional treatment options are urgently needed,” said Gail Bolan, M.D., director of CDC’s Division of STD Prevention. “We can’t let our defenses down — we must continue reinforcing efforts to rapidly detect and prevent resistance as long as possible.”

A renewed commitment from health care providers — who are encouraged to make STD screening and timely treatment a standard part of medical care, especially for the populations most affected — is an important component to reverse current trends.

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STUDY: Doctor Burnout in Small Practices Is Dramatically Lower Than National Average

STUDY: Doctor Burnout in Small Practices Is Dramatically Lower Than National Average

Physicians who work in small, independent primary care practices — also known as SIPs — report dramatically lower levels of burnout than the national average (13.5 percent versus 54.4 percent), according to a study led by researchers at NYU School of Medicine published online July 9 in the Journal of the American Board of Family Medicine. The findings indicate that the independence and sense of autonomy that providers have in these small practices may provide some protection against symptoms of burnout.

Physician burnout is a major concern for the health care industry. It is associated with low job satisfaction, reduced productivity among physicians, and may negatively impact the quality of care. Multiple national surveys suggest that more than half of all physicians report symptoms of burnout.

Research on physician burnout has focused primarily on hospital settings or large primary care practices. The researchers say that this is the first study that examines the prevalence of burnout among physicians in small independent primary practices — practices with five or fewer physicians.

Researchers examined data collected from 235 physicians practicing in 174 SIPs in New York City. The rate of provider reported burnout was 13.5 percent, compared to the 2014 national rate of 54.4 percent. A 2013 meta-analysis of physician surveys conducted in the United States and Europe found that lower burnout rates were associated with greater perceived autonomy, a quality and safety culture at work, effective coping skills, and less work-life conflict.

“Burnout is about the practice culture and infrastructure in which primary care doctors work. So the obvious question is: what is it about the work environment that results in low burnout rates in small practices?” says Donna Shelley, MD, professor in the Departments of Population Health and Medicine at NYU Langone Health, and the study’s senior author. “It’s important to study the group that’s not showing high burnout to help us create environments that foster lower burnout rates. The good news is that a culture and systems can be changed to support primary care doctors in a way that would reduce the factors that are leading to burnout.”

How the Study Was Conducted

Researchers analyzed data as part of the HealthyHearts NYC (HHNYC) trial, which is funded by the Agency for Healthcare Research and Quality’s (AHRQ) EvidenceNOW national initiative. AHRQ is a division of the U.S. Department of Health and Human Services. The HHNYC trial evaluates how practice coaching or facilitation helps SIPs adopt clinical guidelines for the treatment and prevention of cardiovascular disease.

Each physician answered a multiple choice question with response options indicating various levels of burnout. Options ranged from no symptoms of burnout to feeling completely burned out and questioning whether or not to continue practicing medicine. The question was validated against the Maslach Burnout Inventory, a nationally recognized measure that identifies occupational burnout. Physician respondents were categorized as burned out if they checked one of the last three options in the multiple choice question.

As part of the HHNYC trial, physician respondents were also asked a number of questions about the culture of their practices. The tool used specifically measures “adaptive reserve,” or a culture where individuals have opportunities for growth and the ability to learn from mistakes by talking and listening to each other. Physicians who described this kind of culture in their practice reported lower levels of burnout. According to Dr. Shelley, practices, where employees feel they are included in decisions and have control over their work environment, are referred to as having “high adaptive reserve.”

Dr. Shelley is careful not to minimize the challenges faced by physicians working in solo practices or SIPs. She cites that even though burnout rates are lower, many of these practices are struggling financially, and many of these physicians are on-call all of the time.

“The more we can understand what drives low rates of burnout, the more likely it is that we’ll find solutions to this problem,” says Dr. Shelley. “The hope is that our research can inform ways for larger systems to foster autonomy within practices so that there is space to carve out a work environment that is aligned with doctors’ needs, values, and competencies.”

Dr. Shelley lists a number of the study’s limitations. Since the findings are representative of physicians working in small practices in New York City, the study does not capture burnout rates in other cities across the country. It is also possible that the researchers underestimated the number of hours worked by physicians, since hours worked is associated with burnout. Dr. Shelley also cited the lack of data linking physician burnout to patient outcomes.

In addition to Dr. Shelley, study co-authors include Nan Jiang, PhDCarolyn Berry, PhD; and Gbenga Ogedegbe, MD, MPH, of NYU School of Medicine; Chuck Cleland, PhD, of NYU Rory Meyers College of Nursing; and Batel Blechter of Johns Hopkins University.

The research was supported by the Agency for Healthcare Research and Quality (AHRQ).

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CVS Health to Begin MinuteClinic Video Visits through App

CVS Health to Begin MinuteClinic Video Visits through App

CVS Health is rolling out a new virtual health care offering for patients with minor illnesses and injuries, skin conditions and other wellness needs through the company’s MinuteClinic section of the CVS app. MinuteClinic Video Visits, a telehealth offering via Teledoc, will provide patients with access to health care services 24 hours a day, seven days a week from their mobile device.

A video visit can be used to care for patients ages 2 years and up who are seeking treatment for a minor illness, minor injury, or a skin condition. Each patient will complete a health questionnaire, then be matched to a board-certified health care provider licensed in their state, who will review the completed questionnaire with the patient’s medical history, and proceed with the video-enabled visit.

During a MinuteClinic Video Visit, the provider will assess the patient’s condition and determine the appropriate course of treatment following evidence-based clinical care guidelines. For patients who require a prescription as part of their treatment plan, the provider will submit the prescription to the patient’s preferred pharmacy. If it is determined the patient should be seen in person for follow-up care or testing, the provider will recommend that the patient visit a health care provider in their community, such as their primary care provider or a nearby MinuteClinic.

A MinuteClinic Video Visit costs $59, which is currently payable by credit card or debit card. Insurance coverage will be added to the experience in the coming months. The service is currently available in nine states – Arizona, California, Florida, Idaho, Maine, Maryland, Mississippi, New Hampshire and Virginia – and Washington D.C. and is expected to be available nationwide, where allowed, by the end of 2018.

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WIC Income Guidelines Increase. Are Your Patients Eligible?

WIC Income Guidelines Increase. Are Your Patients Eligible?

Alabama families may qualify for the Special Supplemental Nutrition Program for Women, Infants and Children, better known as WIC. If you are a woman who is pregnant, who had a baby within the past six months, who is breastfeeding, or who is the parent or guardian of a child up to age 5, you are encouraged to apply for WIC at your local county health department or WIC agency.

Participants in the program receive free nutrition education and breastfeeding peer counseling support. In addition, participants have the option to receive up to three months of food benefits at a time for each qualified family member. Food benefits are redeemable at WIC-authorized stores throughout Alabama.

Under the 2018 federal poverty guidelines, more families may be eligible for the program. WIC is open to participants with incomes up to 185 percent of the federal poverty level. Check the table below to see whether your family qualifies:

WIC participants must have both a limited income and a nutritional need. Families who receive Medicaid, SNAP or Family Assistance already meet the income qualifications for WIC. Even families who do not qualify for these programs may be eligible for WIC because of its higher income limits.

Amanda Martin, WIC Director, Alabama Department of Public Health, said, “WIC encourages families to be healthy by providing nutritious foods. Nutritious foods help children grow to be healthy adults and pregnant women to have healthy babies.”

For more information, please go to or call the statewide toll-free line at 1-888-942-4673.

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The Heat Is On! Take Precautions to Stay Safe Outdoors.

The Heat Is On! Take Precautions to Stay Safe Outdoors.
  • Extreme heat can occur quickly and without warning.
  • Older adults, children, and sick or overweight individuals are at greater risk from extreme heat.
  • Humidity increases the feeling of heat as measured by a heat index.

 What can you do if you are under an extreme heat warning?

  • Find air conditioning.
  • Avoid strenuous activities.
  • Watch for heat illness.
  • Wear light clothing.
  • Check on family members and neighbors.
  • Drink plenty of fluids.
  • Watch for heat cramps, heat exhaustion, and heat stroke.
  • Never leave people or pets in a closed car.

What can you do to prepare for extreme heat situations?

  • Find places in your community where you can go to get cool.
  • Keep your home cool by doing the following:
    • Cover windows with drapes or shades.
    • Weather-strip doors and windows.
    • Use window reflectors, such as aluminum foil-covered cardboard, to reflect heat back outside.
    • Add insulation to keep the heat out.
    • Use attic fans to clear hot air.
    • Install window air conditioners and insulate around them.
  • Learn to recognize the signs of heat-related illness.

How can you be safe on very hot days?

  • Never leave a child, adult or animal alone inside a vehicle on a warm day.
  • Find places with air conditioning. Libraries, shopping malls and community centers can provide a cool place to take a break from the heat.
  • If you’re outside, find shade. Wear a hat wide enough to protect your face.
  • Wear loose, lightweight, light-colored clothing.
  • Drink plenty of fluids to stay hydrated. If you or someone you care for is on a special diet, ask a doctor how best to accommodate it.
  • Do not use electric fans when the temperature outside is more than 95 degrees, as this could increase the risk of heat-related illness. Fans create air flow and a false sense of comfort but do not reduce body temperature.
  • Avoid high-energy activities.
  • Check yourself, family members and neighbors for signs of heat-related illness.

Do you know the signs of heat-related illness and how to respond?

    • Signs: Muscle pains or spasms in the stomach, arms, or legs
    • Actions: Go to a cooler location. Remove excess clothing. Take sips of cool sports drinks with salt and sugar. Get medical help if cramps last more than an hour.
    • Signs: Heavy sweating, paleness, muscle cramps, tiredness, weakness, dizziness, headache, nausea or vomiting, or fainting
    • Actions: Go to an air-conditioned place and lie down. Loosen or remove clothing. Take a cool bath. Take sips of cool sports drinks with salt and sugar. Get medical help if symptoms get worse or last more than an hour.
    • Signs: Extremely high body temperature (above 103 degrees) taken orally; red, hot, and dry skin with no sweat; rapid, strong pulse; dizziness; confusion; or unconsciousness
    • Actions: Call 911 or get the person to a hospital immediately. Cool down with whatever methods are available until medical help arrives.

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Quitline: Free Help for Patients to Quit Smoking

Quitline: Free Help for Patients to Quit Smoking

The Alabama Tobacco Quitline is a free telephone (800-784-8669) and online counseling service for your patients who are ready to quit tobacco. The Quitline is open from 6 a.m. to midnight seven days a week. All Quitline services are free to Alabama residents including telephone and online coaching, printed support materials, and up to eight weeks of nicotine replacement therapy (NRT) patches, if enrolled in coaching and medically eligible.

Health care providers are encouraged to refer patients directly to the Quitline by faxing a referral form to 1-800-692-9023 or completing an electronic referral form. Both forms are available at The Quitline will contact the referred patient within 24 hours of receiving a referral to enroll the patient in the Quitline counseling program. Once the patient has enrolled in the program and begun counseling, a two-week supply of NRT is mailed directly to the patient. The Quitline can provide up to eight weeks of NRT as long as the patient is enrolled in the counseling program and medically eligible.

The Quitline is funded through the Alabama Department of Public Health and the Centers for Disease Control and Prevention. The program is available to help callers quit any type of tobacco use.

For Medicaid Patients…

Medicaid patients are required to get their medications through Medicaid services. Medicaid pays for any of the seven approved cessation medications if the following documentation is submitted: both the Medicaid Pharmacy Smoking Cessation Prior Authorization Request form and Quitline referral form should be faxed to Health Information Design, 1-800-748-0116, and the Quitline referral form should be faxed to the Quitline at 1-800-692-9023. Free counseling services are available to Medicaid patients through the Quitline.

Approved cessation medications include nicotine patches, gum, lozenges, inhalers, nasal spray, varenicline and Bupropion SR, according to Treating Tobacco Use and Dependence, U.S. Clinical Practice Guidelines, 2008.

The Quitline fax referral forms, both English and Spanish versions, and the Medicaid Pharmacy Smoking Cessation Prior Authorization Request Form can be found at

For more information about the Alabama Tobacco Quitline, or to order Quitline materials for your office, call Julie Hare at (334) 206-3830 or email Visit and, click on Healthcare Providers.


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Let’s Talk About Physician Burnout

Let’s Talk About Physician Burnout

According to Medscape’s 2018 Annual Physician Lifestyle Report, Burnout and Depression Section, 42 percent of physicians surveyed have reported burnout symptoms in the last year. Fifteen percent of physicians admitted to experiencing either clinical or colloquial forms of depression. The National Institute of Mental Health reports 6.7 percent of all American adults suffered at least one major depressive episode in the past year.

To say that burnout and depression have reached epidemic proportions among the medical community is an understatement.

The Medscape report also revealed a higher percentage of female physicians — 48 percent — suffered from symptoms of burnout than their male counterparts — 38 percent. Age may also be a factor. According to the report, about 35 percent of young physicians feel some sort of burnout whereas about half of physicians ages 45 to 54 feel the pinch.

The report also showed that while physicians in all specialties are susceptible to feelings of burnout, some medical specialties tend to show higher rates of burnout:

  • Critical Care — 48%
  • Neurology — 48%
  • Family Medicine — 47%
  • Obstetrics/Gynecology — 46%
  • Internal Medicine — 46%

What is burnout?

The dictionary defines burnout as exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration. But for a physician, burnout is much more…with much more at stake.

Physicians are trained to endure long hours and stressful situations. However, practicing medicine in today’s highly charged political climate filled with intrusive government regulations tends to take a toll with not only the lives of the patient, but quite possibly the physicians, hanging in the balance. There are symptoms of burnout which can easily be missed or overlooked. These include excessive fatigue, insomnia, depression and anxiety. Unfortunately, prolonged exposure to these symptoms may lead one to self-medicate with alcohol or prescription medications…or worse.

Part of the problem is that few in the medical community want to talk about burnout. However, talking about burnout is not only the beginning of a solution but can also save lives.

Fighting burnout begins with a conversation.

Physicians dealing with mental, emotional and physical exhaustion become less able to provide quality care to their patients and find themselves leaving the medical profession altogether…or worse. It’s the “or worse” scenario that worries Dr. Debbie Booher Kolb of Madison.

As president of the Madison County Medical Society, Dr. Kolb wanted to make a difference in the lives of her colleagues. Together with a wellness committee she chairs, they began to formulate a plan to help physicians in their area who felt overwhelmed in their medical practice and to help everyone achieve a better work-life balance. They had no idea the vast support they would have for the Physicians Resource Network Wellness Program.

“My father is a retired radiologist,” Dr. Kolb explained. “I remember being in school and hearing about a friend of my fathers who changed careers. I was mystified by that. I didn’t know that was even an option. I’d never heard of a physician changing careers. It’s not even on your radar once you’re in the medical profession. If you do change careers, it’s to go into pharmaceuticals, medical directorships, or to be a life coach. For physicians, it’s truly a business decision once you leave the profession. It’s sad really to think you could burn out so badly that you leave the profession you loved so much completely behind you.”

But, it’s happening more and more to physicians. With the added pressures of government regulations, such as MACRA, electronic health records, ICD-10, and Medicaid funding, the practice of medicine has become even more complicated today than it was just a decade ago. Unfortunately, these pressures have caused physicians to burnout and not only voluntarily leave the profession of medicine, but also to lose their medical license for inappropriate behavior, or died by suicide.

Dr. Kolb’s mission is to help her colleagues prevent burnout by learning how to cope with its symptoms and finding a better work-life balance. Her mission began in 2014 at the annual meeting of the American Academy of Family Physicians where she first met Dr. Dike Drummond, better known as The Happy MD, and discovered his book, Stop Physician Burnout. Dr. Drummond’s website is

“This book transcends medicine, and his website is great, too. I was so impressed with his actionable advice. What he taught was good nuts-and-bolts information that made me want to bring him to Huntsville so my colleagues could hear him locally. We’ve had three physician suicides in two
and a half years in Madison County alone. It became more and more apparent that we needed to do something. This is heartbreaking and preventable. All of this coalesced to really be something that we could all get behind.”

And everyone did. Laura Moss, executive director of the Madison County Medical Association, said it wasn’t difficult to get everyone on board with the idea to make the physician wellness initiative a continually evolving priority for Madison County.

“Physician burnout is a trending topic because it’s a huge problem among those in health care. Our hope is that the more we talk about it, and the more solutions such as coaching, counseling and workshops we offer, the more intentional our physicians will become about the decisions they make regarding their own health,” Moss said. “We also hope the more it’s out in the open, the less physicians will feel alone and turn to addiction or worse — suicide. This is not something many physicians were taught about in medical school, and we want to be here to offer ways to help prevent or overcome burnout in a healthy way. MCMS is excited to be focused on taking care of the caregivers and to be giving back to our members in a meaningful way.”

As Dr. Kolb and her colleagues admit, everything begins with a discussion. Little did they know how many lives they were about to touch when they rolled out the first component of the burnout program. The first step was an evening event with Dr. Drummond, which sold out 200 seats and had a waiting list for attendees. Burnout Proof LIVE was a huge success, and it’s just the beginning.

“Burnout transcends specialties, and that’s why our physicians have been so appreciative of this program. After the event with Dr. Drummond, we had people commenting and sharing their stories on social media. That’s what we’re trying to do — effect a paradigm shift in the culture of medicine. We really want to let our colleagues know this is more common than they may realize because physicians just don’t talk about it. We want to start talking about it,” Dr. Kolb said.

How can physicians get help for burnout?

The program in Madison County is an excellent start for awareness and healing, according to Rob Hunt, D.Min., director of the Alabama Physician Health Program, but there’s still more work to be done.

“More programs like the one in Madison County that get people in the medical community talking about burnout is a good start. Unfortunately, there are still so many doctors who don’t understand the warning signs, especially medical students. Female residents are among the biggest burnout populations. I think the key is education. The more they can learn about what burnout is and how to avoid it early in their careers, the better it will be on our physicians and our medical system,” Dr. Hunt said.

APHP is a member benefit for physicians of the Medical Association. It is a confidential clinical resource for physicians, physician assistants, residents and medical students created in 1990 by state law to provide a program for early detection and treatment of medical professionals with problems related to possible impairment due to alcohol, drugs, psychiatric disorders or behavior. About 90 percent of physicians who enter the APHP successfully complete the program and return to their medical practices and see patients.

“Most don’t truly understand exactly what APHP can do until they become part of the program as participants. We are here to help them, and we advocate for them to help them keep their medical licenses. We try to keep or get them healthy and keep them in their medical practice and in the State of Alabama. Our opinion is that a doctor who has gone through APHP as a participant and is being monitored is a safer physician, a better physician, than those who have problems and haven’t gone through our program,” Dr. Hunt explained.

According to Dr. Hunt, most physicians may not even realize they are burning out until the situation becomes substance abuse, disruptive behavior, or other issues that stem from being burned out. It’s these overt signs that APHP can help physicians treat.

“Physicians work as much as 80 or more hours a week easily, and they’ve done that for years and years,” Dr. Hunt said. “Some take medications to cope with that stress. They may not know it, but it gets out of control, and they become addicted. What we see are more middle-aged physicians. Older physicians have learned to cope with that stress. We’ve seen many doctors retire because of EMR, ICD-10 and other government regulations. They just refused to put up with it, so they took that step and closed their practices. It was too much stress. It’s still happening with more and more government regulations that physicians have to navigate. It takes them away from the one thing they trained their entire lives for — medicine.”

Still, if more physicians can learn about what burnout is and how to avoid it early in their careers, the better it will be for our physicians and our medical system.

Could YOU have burnout?

There are specific signs of professional burnout. Ask yourself these questions:

  • Am I overly cynical or critical at work?
  • Do I have to drag myself to work or have trouble getting started once I arrive at work?
  • Am I irritable or impatient with co-workers or patients?
  • Do I lack the energy to be productive at work?
  • Does work consistently satisfy me?
  • Am I disillusioned by the practice of medicine?
  • Have my sleep habits or appetite changed?
  • Do I have headaches, backaches or other physical complaints that don’t subside with rest?
  • Do I use food, drugs or alcohol to feel better or to simply not feel at all?

If you feel you are suffering from symptoms of burnout and would like to get help, please contact the Alabama Physicians Health Program at 1-800-239-6272. APHP is a member benefit of the Medical Association. If you live in Madison County and would like more information about the Physician Wellness program, call (256) 881-7321.

Article written by Lori M. Quiller, APR, Director of Communications, and Mikala McCurry, Communications Assistant.

Posted in: Health

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