Recognizing the signs
Daisy Smith, MD, FACP
ACP vice president for clinical education, Philadelphia
Smith leads the ACP’s efforts to demystify and build awareness about burnout, including how physicians can identify warning signs in themselves. “We need to fix the water clinicians are swimming in,” says Smith. “We know medical students are more resilient when they start medical school, but their risks increase as they complete their training.”
She says it’s important for doctors to recognize burnout in colleagues, because it can be contagious, spreading through an entire staff. “It is part of your responsibility to not only identify and address it when you see colleagues suffering, but to also help intervene and fix the overall culture.
“The overall causes of burnout are a workload where people keep adding more and more things to front-line clinicians, but nothing gets taken away,” says Smith.
Physicians should look for sudden changes in behavior in their colleagues as a warning sign that all is not well. “If someone who was outgoing and is now withdrawn, that can be an indicator,” says Smith. Missing meetings or conferences, or even not answering pages can also be a sign of potential burnout. Physical pain, difficulty sleeping, changing appetite or a crisis of confidence are other warning signs.
“They may have a lack of confidence in their work that comes from a sense of powerlessness because they can’t change things or make things better,” she says. “They may become more cynical, be quick to anger or have relationship problems or trouble getting along with family or friends.”
The ACP has resources on its website for physicians who feel burned out and has trained a cadre of 160 members around the country to fight burnout. “Our message is, don’t worry, you are not alone in this,” says Smith. “This is a common issue and a problem that everyone needs help with sometimes. We encourage them to reach out to a friend, a colleague or call their employee assistance line—whatever they feel comfortable with.”
In addition, the ACP is looking to patients as allies in fighting burnout. “The same things that bother doctors are bothering patients,” says Smith. “They want more time together. We think if we join forces with patients and patient advocacy groups to reform healthcare delivery, we might be successful.”