November Medical Director’s Minute

Work-Life Balance and Physician Burn Out

Why did you become a doctor? Was it to help others in a significant way? Was it to make a living in a leadership role? Was it to have interesting, diverse work experiences that could engage you in lifelong learning? Was it to apply skills and knowledge in a well-respected, well compensated, and always-in-demand field?

Some combination of these likely applies to every one of us who pursued the challenging and rewarding life of a physician.

So given the above high-minded motivating ideals, it’s clearly problematic that 1/3 to 1/2 of physicians report burnout, according to Medscape’s annual report on the matter.

What is burnout? Christina Maslach and her University of San Francisco colleagues developed the accepted standard for burnout diagnosis in the 1970s, highlighted by three main symptoms:

1) Exhaustion (decreased physical and emotional energy levels, often headed into a downward spiral)

2) Depersonalization (highlighted by “compassion fatigue”)

3) Decreased belief in the meaning and/or quality of your work

For physicians this can then manifest in many as a loss of enthusiasm for our work, decreased satisfaction and joy, increased detachment, emotional exhaustion, and even cynicism.

And while specialty matters to a degree in this struggle, no specialty is immune from it. On the high end of the spectrum, nearly half of critical care specialists, family physicians, OB/GYNs, neurologists, emergency medicine physicians, and internists report burnout. While on the low end, still one-third of orthopedists, ophthalmologists, pathologists, and dermatologists report it. (The only outlier is plastic surgery, but one out of every four plastic surgeons still report burnout.)

So, what causes this rampant burnout within our noble profession? As one would expect, there are many factors, but leading causes include:

  • Too many bureaucratic tasks
  • Too many hours at work
  • A lack of respect from co-workers and/or administrators
  • Insufficient compensation
  • Inefficient EHR systems

And all the above plus more can contribute for many to poor satisfaction with work-life balance.

Maybe you’d rather spend more time with family or volunteer your time to a cause that is dear to you. Maybe you’d like to take some non-vacation time to provide care on a medical mission or you have a non-medical passion that you want to better engage. And perhaps you don’t feel you have the time because of the demands your job entails that don’t help you care for patients, demands that feel beyond your control.

So, what can be done? It’s probably not surprising to you to find out it’s much easier to assess the numbers and root causes related to physician burnout than it is to understand how to solve the problem, let alone implement the changes needed to do so.

But there are certainly a variety of solutions that have been successfully implemented in our profession. They tend to share these overarching themes:

  • Physician choice (having at least some control over our delivery of care)
  • Camaraderie (feeling a connection to our colleagues)
  • Excellence (feeling you’re a part of something meaningful)

How those areas are addressed can vary, but, regardless of specialty, they need to be actively addressed when concern for physician burnout exists, whether in a small practice, a large system, or something in between. The solutions don’t manifest themselves, but with active engagement by physicians and other members of the healthcare and administrative teams, they are out there.

Docs Who Care is a physician founded and physician-centered company that provides medical care to rural areas in need and a company that has been actively preventing and treating physician burnout for over 20 years by:

  • Eliminating bureaucratic issues that drain our energy and joy
  • Allowing us to know our work is valued in the places we serve
  • Allowing us to control how much or how little we work
  • Respecting our autonomy

-Dr. Andy Bukaty, Docs Who Care Senior Medical Director

References:

Peckham, C. (2018, Jan 17). Medscape National Physician Burnout and Depression Report 2018. Medscape. Retrieved from https://www.medscape.com.

Maslach C, Leiter, MP. The Truth About Burnout: How Organizations Cause Personal Stress and What to Do About It. San Francisco: JosseyBass; 1997.

Drummond, D. (2015). Physician Burnout: Its Origins, Symptoms, and Five Main Causes. Family Practice Management, 22 (5), 42-47.

Berg, S. (2018, Aug 3). Physician burnout: It’s not you, it’s your medical specialty. AMA Wire. Retrieved from https://wire.ama-assn.org.

Hasan, H, Kuzmanovich, D. (2018, May 16) The solution to physician burnout? EHR optimization. Advisory Board. Retrieved from https://www.advisory.com.

Parks, T. (2016, Dec 14). Physician burnout: Detailing the impact, exploring solutions. AMA Wire. Retrieved from https://wire.amaassn.org.