How Can Physicians Effectively Address Burnout?

How many of your colleagues are complaining that they are doing more work and getting less for it? How many of them are experiencing ever-increasing levels of frustration brought on by outside influences: governmental regulation, insurance regulation, increased concern about medical malpractice, increasingly negative attitude by society towards physicians, and weakened physician-patient relationships?

Most individuals considering medical school know up front that a medical career inherently makes certain demands – they will be called upon to place their personal lives on hold financially as they study and train in the field of medicine. Competition is expected, as is delayed gratification, personal sacrifice, limited sleep, lack of free time, and intense pressure to be up on the latest medical knowledge. Upon completion of their residency or fellowships, they may be able to reclaim certain aspects – they will begin drawing a paycheck, they will have more control over their daily routine, some will even “man their own ship” in private practice – but not all of them.

Unfortunately, the characteristics that a make a good clinician may also lead the physician further and faster down the road to burnout. The field of medicine and often the physicians themselves set very stringent standards to be followed. These standards can be identified in the form of self-imposed limitations.

Physicians must…

• Work until the work gets done
• Not permit downtime, as downtime is time wasted
• Handle everything that comes their way without complaint or assistance
• Be highly conscientious
• Try to be all things to all people – patients, staff, family, colleagues, etc.

On top of all that, the medical environment brings other components. Physicians are faced with repetitive tasks on a daily basis. While the diagnosis may change, the seeing of patients often becomes routine as physicians move from one room to the next. Physicians are often faced with problems that lack solutions, accompanied by demanding and chronically ill patients. Life and death issues are faced on a daily basis. In short, there is no time to emotionally recharge.

After several years of holding themselves to such high standards, a number of physicians are being forced to reevaluate their career, their life’s decisions. Many feel increasingly dissatisfied with their daily lives, and struggle to find a coping mechanism.

Symptoms of Burnout

There are many symptoms of burnout, some emotional, others physiological. Just as he or she would query a patient about the symptoms of an illness, the physician must stop and query himself or herself to identify common burnout symptoms. Examples of these include:

• Negative perceptions of self
• Negative practice habits
• Lack of empathy with patients
• Unhealthy lifestyle
• Dissatisfaction with career
• Sleep disturbances

Identification of the symptoms, and eventually the cause, is critical for two reasons. First, it is the only way the physician can work to overcome burnout and its significant effects. Second, failure to address burnout can foster an environment where the “it-just-doesn’t-matter“ attitude turns into a malpractice claim.

Preventing Burnout

Given the above situations and environments, is it possible to cope with burnout? Research indicates physicians who take charge of their lives and strive to ensure balance, are far more successful than most.

Prevention and/or mitigation can be divided into several areas.

Physical:

• You should acknowledge that you, too, can get sick, and you should take normal steps to prevent it.
• Have an annual physical to identify health concerns promptly.
• If you can’t get motivated alone, hire a personal trainer so someone is expecting to see you at the gym.
• Ensure you get enough rest.
• Maintain a healthy diet.

Environmental:

• Maintain control of your schedule.
• Schedule non-patient appointments when they are convenient for you, and assign a time limit.
• Evaluate your other commitments; be willing to say no when asked to serve on just one more committee or handle one more obligation.
• Set priorities. Identify your daily tasks and divide them into one of four categories: urgent and important; urgent but not important; important but not urgent; and neither important nor urgent. Try to take a realistic approach and avoid lumping everything into “urgent and important.”
• Meet with your staff on a regular basis. This helps prevent their burnout, and subsequently yours if you are not having to deal with staffing issues on top of everything else.
• Chart throughout the day. Several sources agree charting at the end of the day allows a dreaded task to cut into personal time.

Emotional:

• Volunteer
• Find a hobby or leisure activity that does not pertain to medicine to give yourself an outlet.
• You should get involved in your church or a community project that is important to you.
• Spend time with friends or colleagues where you can be yourself.
• Modify your perspective. Instead of saying, “There is no way I can get all this done today,” say “I will do only that which I can get to today.”
• Learn to handle conflict. Resolving conflict instead of just living with it will improve your emotional outlook in a number of areas.

Financial:

• Avoid overextending yourself financially. Stress over finances makes most individuals feel they have given up control of their lives – they must now work to meet their financial demands, and not just to achieve career goals or personal satisfaction.
• Indebtedness may prevent someone from implementing other key steps to preventing burnout.

Is it hopeless? No. Is it easy? No. But today’s environment is highly stressful, and unfortunately, it is not likely to change for the good any time soon. This means physicians must either learn to cope with the forces battering at them on a daily basis or continue to feel ever increasing despair and frustration from their chosen career.

Article contributed by Sae Evans and Maddox Casey, Members, Warren Averett Healthcare Consulting Group. Warren Averett is an official Gold Partner with the Medical Association.