Part 1 - Burnout...now what?
So much has been researched, written, and discussed about physician burnout and we continue to be left wondering - is it making a difference in the lives of individual physicians? Despite all that we know, if you've identified yourself as a physician experiencing burnout, what can be done to get you out of this unsustainable place? Just take a walk through Google and you realize that not a lot truly exists when it comes to individual solutions for burnout. Much has been focused on the prevention side, and of course, this is ideal, but when almost half of physicians and medical trainees report symptoms of burnout, there needs to be equal attention on the management side as well.
We, Colin and Sara, think about burnout, a lot, because as much as we have learned and continue to learn about it, solutions aren't clear when a physician has looked to us for help. In the real world, physicians are often met with barriers to improving their situation that is fueling their symptoms of burnout. Here are two interventions, for example, from the landmark Mayo Clinic study, Executive Leadership and Physician Well-being: Nine Organizational Strategies to Promote Engagement and Reduce Burnout, along with realistic roadblocks:
1. Cultivate community at work: Without question, there are benefits to having someone say, “I’ve been there” when facing a medicolegal complaint or dealing with the overwhelming stress of practising medicine. We fully believe in the power of having supportive peers and a peer network. Some strategies to this end include formal peer support groups within hospital settings, or informal support where you can look to a colleague for help. Another strategy has been to implement coffee shops and other meeting areas within hospitals specifically for physicians to connect. We wholeheartedly agree with these concepts but here’s the problem: many physicians are just getting through their days, running low on energy and time, and don’t know where to fit in one more thing. As much as they want to help another colleague, they're running on empty themselves.
2. Promote flexibility and work-life integration: The option to adjust how you work in terms of time and workload could truly make a difference in this physician burnout landscape. Increasing work flexibility will ultimately become essential to maintain an engaged physician workforce, but here’s the rub - many healthcare settings don’t believe they can afford to reduce physician output in an already crunched system. In our personal experience, a requested change in work effort was met with “we can’t afford to set that precedent among the group”. People in positions of leadership may view offering flexibility as a domino effect - tip one over and they all come crashing down.
Take Jane for example. She has been working in a group practice for 12 years, during which time the workload has continued to increase along with the complexity and computerization demands. On most days, she feels completely exhausted and questions why she ever went into medicine. As a result, Jane feels as though she has no energy to do what she needs to do in the course of a day so she gets further behind in her documentation and paperwork, leading to further dissatisfaction with her job.
Jane is well past the point of prevention and doesn’t feel she has time for any self-care given that the one drop of energy she musters at the end of the day goes to her family. She tries to reach out to a colleague who ends up painting a picture of their own life that looks potentially worse than Jane’s, and who is also looking for their own solutions. Despite not wanting to take a pay cut because of trailing debt, and being the primary income earner in the family, she approaches the managing partner of her group and says she would like to reduce her work effort to 80%. Her request ends up being denied because of the fear/inside knowledge that this option will spread quickly leading to an unmanageable workload and unacceptable patient delays in care.
Jane is fully aware that she is burned out. Unfortunately, she's left thinking, okay, so now what? The system is not kind, and unfortunately, a version of Jane’s situation in not unique - it's felt by many physicians. We need to start looking at physician burnout from the point of view of every ‘Jane’ instead of the standard public health, en mass, approach.
We will continue with Part 2 on May 16th (see 'Messages From Us' below). Thanks for reading.
“In times of stress, the best thing we can do for each other is to listen with our ears and our hearts and to be assured that our questions are just as important as our answers.” ~ Fred Rogers