A new look at creative solutions to achieve better work-life balance and patient outcomes
Burnout continues to be a widespread problem among doctors. Medscape’s 2018 Physician Lifestyle Report polled over 15,000 U.S. physicians from 29 specialties and found that 42 percent said they feel burned out. Another 15 percent reported feeling depressed, and 14 percent of all doctors surveyed said they feel both burned out and depressed.
These statistics should set off alarm bells, especially given the high rates of doctor suicide. Burnout also has a negative impact on patients. Yet common stress-reducing advice—like getting more sleep and reducing work hours—simply isn’t feasible for many doctors in today’s health care climate. So what, if anything, can be done to stem the burnout epidemic in medicine?
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Who’s most at risk?
The Medscape survey defines burnout as feelings of physical, emotional, or mental exhaustion; frustration or cynicism about work; and doubts about the value of one’s work. The highest rates of burnout were reported by critical care physicians, neurologists, and family medicine doctors, while ophthalmologists, orthopedists, plastic surgeons, and pathologists claimed to be the happiest at work.
Too much bureaucracy and paperwork is the main cause of burnout.
The main factor contributing to burnout, listed by 56 percent of respondents, was too much bureaucracy and paperwork. Spending too much time at work was the second highest factor, followed by lack of respect — from colleagues, administrators, or staff.
In this year’s Medscape report, as in prior year’s reports, a higher number of female doctors reported burnout compared to their male colleagues (48 percent vs. 38 percent). This is not surprising, given that doctors who are also mothers tend to bear the brunt of work-life balance challenges, not to mention higher levels of workplace discrimination, as we’ve previously reported.
For more on this topic, see The Challenges of Balancing Parenthood and Medicine
How burnout hurts patients
At best, burnout can result in lower patient satisfaction; at worst, it can lead to death. “One in three depressed doctors said they were more easily exasperated by patients; 32 percent said they were less engaged with their patients; and 29 percent acknowledged being less friendly,” Leslie Kane, Senior Director, Medscape Business of Medicine, told Reuters Health.
Doctor burnout can decrease patient engagement and satisfaction, and increase risk of medical mistakes.
Even more alarming, nearly 15 percent of depressed doctors said their depression might cause them to make errors they wouldn’t ordinarily make, while 5 percent said depression led them to make errors that might have harmed patients. Johns Hopkins Medicine has reported that 250,000 people die each year from medical errors, making it the third leading cause of death in the U.S., while other sources report much higher numbers of medical mistakes.
What can be done to fix the problem?
For some doctors, techniques like mindfulness and practicing gratitude are the answer to burnout. For Jennifer Janus, M.D., a bouquet of roses and a thank-you note from a patient made all the difference when she was struggling with burnout.
“I had recently attended a mindfulness workshop that discussed gratitude as a tool for dealing with frustration, and had been trying to apply this to my practice,” she wrote on Johns Hopkins Medicine’s Closler.org. “My patient’s note represented a turning point for me. Not only was I grateful for the sentiment, but it also made me aware again of all the ways in which practicing medicine is a blessing.”
Practicing gratitude and pursuing locum tenens work have reduced burnout for some doctors.
Other doctors have taken their schedule into their own hands by pursuing temporary locum tenens work. Doctors who work locum tenens jobs report increased flexibility, freedom over their schedules, and exposure to new techniques and perspectives that help them grow as clinicians, balance work and life, and rekindle their love of medicine.
For more on this topic, see Is Locum Tenens Right for You?
How small changes can help beat burnout
But for other doctors, the answer is working smarter, rather than working less. “In a world where the pace just keeps accelerating, you can’t slow down what’s happening to you. But if you can speed up the pace of recovery, you can be more in balance,” said leadership consultant Bonnie St. John, a Harvard graduate, Rhodes Scholar, and Paralympian, who was the first African-American ever to win medals in winter Olympic competition.
Simple “micro-resilience” techniques that increase energy and speed up recovery can help high performers stay sharp.
In her book, Micro-Resilience: Minor Shifts for Major Boosts in Focus, Drive, and Energy, St. John shares small but powerful “micro-resilience” techniques that can help those with demanding jobs perform better. For example, eliminating decision fatigue by reducing the number of decisions you have to make in a day goes a long way to combat burnout. “It’s well documented that if you make a lot of decisions in a row, your decisions start getting worse,” said St. John on a recent podcast. President Barack Obama reportedly wore the same type of suit and ate the same thing for breakfast every day. St. John recommends using checklists for things you do repeatedly.
“Multitasking is another thing that really destroys our brainpower,” she said. To minimize constant interruptions, create specific times and places when you do your most important thought work and communicate those boundaries to other people.
St. John shared an anecdote about an urgent care doctor who implemented her micro-resilience techniques. “He was able to keep up with his charts…and he also started dating because he didn’t have charts to do at night.”
For more on scheduling your day to achieve better results, see Timing Is Everything? How Scheduling Affects Patient Outcomes
Combating burnout doesn’t have to be complicated. The most popular coping mechanism was exercise, cited by 50 percent of the doctors in Medscape’s survey. This was followed by talking with family and friends.
Learn more industry news and tips to increase productivity and patient outcomes in your practice.