Burnout is unusually common among physicians – and the problem appears to be getting worse.
Jon Shapiro, M.D., Medical Director of the Foundation of the Pennsylvania Medical Society’s Physicians’ Health Program, shared strategies for recognizing and addressing physician stress and burnout at a Sept. 27 event in Lancaster.
Here are some top takeaways from Dr. Shapiro’s talk:
A number of factors can contribute to burnout, ranging from the electronic medical record to malpractice fears, maintenance of certification requirements, sleep deprivation and lack of control over the work environment.
Burnout leads to exhaustion, the feeling that job demands are insurmountable, and doubts about self-worth and professional effectiveness. The passion once felt for work is replaced by cynicism and depersonalization.
Critical care and emergency medicine physicians report the highest levels of burnout, followed by family physicians, internists, general surgeons and HIV/infectious disease specialists. Dermatology, psychiatry and pathology have the lowest levels of burnout.
Burnout comes not just from where physicians work but from who they are. Individual drivers of physician burnout include high achievement orientation, difficulty setting boundaries, intellectualization, delayed gratification and perfectionism.
Physicians work in a “zero defect” environment where they are expected to deliver excellent, cost-effective care while delighting every single patient. This unrealistic goal sets them up for failure.
Almost half of all physicians report at least one symptom of burnout. Warning signs include sleep problems, including nightmares; social withdrawal; professional and personal boundary violations; poor judgment; perfectionism and rigidity; and questioning the meaning of life.
The Maslach burnout index scale has 22 questions, but Mayo Clinic researchers say that the answers to just two true-or-false questions can paint an accurate picture: 1. “I feel depleted and burned out from my work.” 2. “I have become more callous toward people, treating patients as objects instead of humans.”
Physician burnout contributes to broken relationships, alcoholism and suicide. Burnout also affects patient care in the form of increased medical errors and malpractice risks, and decreased patient adherence and satisfaction.
To build resilience and fight burnout, start with these five steps. Make healthy lifestyle choices. Concentrate on the core of medicine: the doctor-patient relationship. Get enough sleep. Build physical activity into your daily routine. Eat healthful food, and avoid excessive alcohol and caffeine.