The following is a guest post by Steve Sanders.
Those who work in service professions in the medical disciplines are susceptible to a psychological condition known as burnout. It’s of particular concern in healthcare because of the potential effect on the health or even the life of patients. By some estimates, burnout effects as many as half of US physicians. A recent study published in The Lancet shows that solving this problem requires changes on both the individual and the organizational front, not to mention health care policy changes.
1. Personal: Prevention
Mark Linzer, MD, is the Director of the Division of General Internal Medicine at Hennepin County Medical Center in Minneapolis and has studied burnout for at least 20 years. Linzer says certain characteristics, qualities or situations increase the risk of burnout: a high tolerance to stress, a chaotic practice, disagreement with the boss’ values or leadership and being an emotional buffer for patients. Others factors include practices interfering with family life, lack of control over a schedule or free time and insufficient self-care. According to Linzer, the first step in prevention is recognizing that these conditions exist.
Burnout is the result of excessive or poorly managed stress. It’s an old truism–how can physicians care for patients when they don’t care for themselves? Self-care strategies include all the basics of adequate sleep, a healthy diet, regular exercise and supportive relationships. Stress is a normal part of life, but self-care strategies make a positive difference. Managing your reactions to stress is also key.
3. An Outside Life
It’s important not to let your profession consume you. Hobbies can provide you with a sense of identity and competence not associated with your medical career. Make it a point to develop relationships with people outside of health care. Get involved in the community in ways that aren’t related to medicine, for example; be a mentor to a teenager, tutor a child, volunteer at the library or perform community clean-up tasks.
4. Build Relationships
Many physicians who have experienced burnout say it was their close relationships that sustained them and helped them heal. Those who have not experienced burnout often credit supportive relationships as the reason. A mentor may be helpful as can peers who know what you’re going through.
5. Start Early
Many experienced physicians note that the intern year is often the place where burnout begins. The intern year, if you go back to Linzer’s findings, contains most or all of the seven high potential burnout situations. Awareness of these conditions can help organizations and individuals develop strategies to recognize symptoms and implement solutions.
6. Provide Support
Counseling, support groups and formal mentoring programs are always to provide support. Technology and staffing practices (especially adequate support staff) can also make a difference.
7. Limit Demands
One idea behind limiting resident work hours is to decrease stress on the physician, it may also help protect patients by limiting mistakes made by physicians caused by sleep deprivation. Organizations should explore all possible options to do so through flexible work schedules and processes or systems to make life easier.
8. Resiliency Training
If burnout begins in the intern year (as seems likely), an organization that begins resiliency training at that point can make a big dent in the problem of burnout. Ideally, starting this training in medical school equip physicians to control their reactions to stress, so they can glide instead of crashing.
9. A Wellness Culture
An organization that implements wellness programs, stress management education and support systems should be the norm. Burnout prevention should be a topic of discussion, said Dr. Lotte Dyrbye at the 2015 AMA Annual Meeting, and physicians should talk about medical errors rather than blame themselves or others.
10. Health Care Policy – Environmental Change
For many physicians, the demands to see more patients in less time create several of the conditions Mark Linzer notes above. There are ways to make it better, but health care system reform is required to make them most effective. Physicians can help by getting involved in health care reform.
Steve Sanders is a self-described recovering alcoholic, writer, and blogger at Haven House Addiction Treatment. He lives in Los Angeles, California and enjoys spending time with his family and on his motorcycle when not writing. He can be reached at firstname.lastname@example.org