Practical tips for reducing factors that can lead to burnout
It’s no secret that doctors face higher levels of stress than the average person.
One study found that 28 percent of doctors experience “above threshold” levels of stress, compared to 18 percent of the general population who report this level of stress on the job, according to Verywell Health, a doctor-reviewed website affiliated with The Cleveland Clinic.
Due to a combination of factors including longer hours, increasing administrative demands, and the high stakes and emotional toll of practicing medicine, doctors are facing more stress than ever and struggling to manage it. But if left unchecked, stress can lead to dire consequences for doctors, practices, and patients. Find out what you can do to manage stress for yourself and in your practice.
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The tipping point of stress vs. performance
First, let’s clear up a misconception: stress is not always a bad thing. Most people, in the absence of a deadline or any other stress or pressure to perform, will get bored and check out, according to Dike Drummond, M.D., founder of TheHappyMD.com and author of Stop Physician Burnout. Stress is motivating—to a point. But once you’ve passed the “optimal performance” peak and stress continues, performance drops off rather dramatically, he explains in this blog post. He illustrates this concept with a bell-shaped stress versus performance graph.
Too many doctors experience prolonged high levels of stress that put them at risk for burnout and even suicide.
The problem is that many doctors are regularly on the high side of this curve, says Dr. Drummond. “On anything but the most mellow of days, a solid 30 percent to 40 percent of physicians are in the yellow and red zone for at least a couple of hours in their practice. This is not good stress. You are flirting with overwhelm.”
And prolonged stress has real consequences. “Experience of high levels of stress for protracted periods may have wide-ranging effects on doctors,” stated a 2016 study titled “Burnout and Doctors: Prevalence, Prevention and Intervention,” published in the journal Healthcare. These include compassion fatigue, emotional exhaustion, depersonalisation (negative, cynical, and impersonal feelings towards patients), and reduced personal accomplishments, the study authors wrote. “Another consequence of chronic exposure to stressors is burnout.”
As we know, doctor burnout is rampant in health care. Medscape’s 2018 Physician Lifestyle Report found that 42 percent of U.S. physicians said they feel burned out. According to Dr. Drummond, “The downward spiral of physician burnout begins when you spend too many days in the yellow and red stress zones. Unless you are very skilled at recharging in your time off,” you become drained and “you are walking the edge of the cliff.”
Too many doctors are falling off the cliff; doctor suicide rates are among the highest of any profession.
Minimize the stressors you can control
While reducing stress in today’s health care environment may feel out of your control, there are actually several concrete steps doctors can take that make a noticeable difference. Verywell Health suggests minimizing daily stressors in your life, whether that means hiring a cleaning service to tackle your messy home or avoiding a draining friend. “Getting rid of [these stressors] wherever you can leave you with more time and energy to devote to things you enjoy and can leave you with more energy to handle the stress you face at work.”
Minimize daily stressors in your life and work, for instance, by hiring extra help or using scheduling tricks. This will go a long way toward reducing your overall stress.
This same philosophy holds true in your practice. “Make small changes at work to deal with the things you know stress you out,” advises Dr. Drummond. For instance, he says a common mistake doctors make is allowing non-urgent matters like refill requests, phone messages, and referral paperwork to interrupt their days and add stress. “We mistake every action as an urgent one and chase them just like the dog and the tennis ball.”
His solution to this is what he calls “batch processing.” Instead of addressing each task one by one throughout the day, batch them together and do them all at once twice a day. “In a standard office day where you have an AM and PM schedule, some good times to do batch processing are 11:30am and 4:30pm. That way the morning’s work is done before lunch and the afternoon’s work before you go home,” wrote Dr. Drummond. While he acknowledges that EHRs make this challenging because alerts will pop up on your tablet, laptop, or desktop screen, he urges doctors to batch these, too, in a “virtual basket.”
Another idea is to streamline tasks like patient education. Instead of sketching a diagram or giving verbal explanations to each patient, use a tool like Rendia’s Exam Mode or Outcome Simulator to show patients visually what they can expect. This does not take the place of a doctor-patient interaction—rather, this technology enhances your time with patients, allows them to share the information with family and caregivers, and makes them feel taken care of.
Take care of yourself the way you advise patients to
Our final tip is ironically both the simplest and the hardest for doctors to implement consistently: taking care of themselves and their own needs. “Practice extreme self-care,” advised Verywell Health. “You need to become ruthless in meeting your own physical needs: getting enough sleep, enough exercise, enough healthy food, and enough activities that can help you to manage stress.”
Practicing self-care and managing stress can be as simple as doing a short mindfulness technique or sipping hot cocoa by the fire.
Stress-relieving activities don’t have to be complicated or time-consuming. In a Q-and-A with five doctors about how they manage stress, their answers included sipping hot cocoa by the fire, bicycling, woodworking, oil painting, and hot yoga. It’s well documented that meditation and mindfulness have a positive impact on doctors. The Healthcare study concluded, “Mindfulness-based strategies may be promising.” Medical News Today offers six mindfulness techniques for physicians, including taking a simple three-second pause and a breath before you enter the room to see your next patient.
Not only will self-care and stress-reducing techniques help you as a doctor, but they will also help you take better care of your patients, according to Verywell Health. “Focusing on self-care and stress management can help you to relate to the challenges your patients face and learn to overcome them so you can better help your patients to do the same.”
Looking for a way to reduce your day-to-day stress and boost your productivity? Rendia provides patient engagement tools that can help you streamline and balance your workflow.