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Rachael Zimlich is a freelance writer in Cleveland, Ohio. She writes regularly for Contemporary Pediatrics, Managed Healthcare Executive, and Medical Economics.
Reflect on these elements of burnout and see if you can relate.
Every physician has an off-day now and then. It’s when those days are more frequent than the good days, or feelings of dissatisfaction become so pervasive that they keep physicians from doing their job that burnout becomes a real problem.
Read on to see if you can relate and where to look for burnout in your practice.
Start with an assessment
Burnout is a problem recognized in many professions, first addressed several decades ago by psychologist Christina Maslach, PhD. Maslach recognized that people working in human services settings experience a level of occupational burnout, one she classified with the Maslach Burnout Inventory (MBI) Maslach Burnout Inventory (MBI).
This assessment is still viewed today as the mainstream measure for burnout, but for physicians there is so much more to consider in order to find a real solution, said H. Clifton Knight, MD, FAAFP, senior vice president of education for the American Academy of Family physicians.
Find the MBI and other assessments to gauge physician burnout here and see how you fare.
Elements of physician burnout
Knight leads the charge on addressing physician well-being and burnout for AAFP and said there are multiple elements to consider specific to physician burnout.
The first is emotional exhaustion-not having the energy to do your work well.
“These are the sort of things that everybody has a day now and then, but it’s when it becomes consistent or pervasive that it becomes an issue,” Knight said.
The second element of burnout is depersonalization. In healthcare, this usually translates to a loss of empathy, or in inability to connect to patients and instill in them a sense of trust and caring.
The third element of physician burnout is the feeling that you aren’t making a difference or being effective in your work, Knight said. The growing list of administrative tasks that takes physicians away from patient care is a major contributor to this last element, Knight said.
Administrative burdens and a broken system
One of the top drivers of burnout is the overwhelming amount of work physicians have to do that is not directly related to patient care
“This is a systemic problem that we’ve allowed all of these administrative aspects to overshadow what patients really need from the relationship with their caregivers,” Knight says.
Systemic changes are needed in this area, but there is also work that can be done at the practice level. From investing in scribes and support services to advocating for regulatory change, the road to reducing burnout and creating a better healthcare system for both physicians and patients is a long one.
“The healthcare business model is just really off target right now. We are so driven by the finances of healthcare that it’s just backwards,” Knight said. “We’ve got to figure out how we can change the system so that expectations are that we support people being at their best when they’re providing care rather than just finding ways to decrease expenses and increase revenues.”
A look at physician culture
Another part of the problem is the physician culture, Knight said. From the rigors of residency through to a career as a physician, medicine is not an easy occupation to navigate.
“It has not really valued self-care, and really promotes self-sacrifice,” Knight said.
In other professions, like aviation, there is a focus on self-care, but that is lacking in healthcare.
“From talking with pilots, there seems to be a cultural expectation that it is their professional responsibility to keep themselves physically and mentally fit to perform at their highest level. It’s an expectation. There are regulations on how much time you have off between flights and the expectation that you will be safe when flying,” Knight said. “There is not a cultural expectation like that among physicians.”
Rather, many clinicians feel alone in their struggle, he said, and are plagued with guilt or shame when feeling symptoms of burnout, Knight said.
“It’s important to maintain your well-being. It does sort of drive people into the shadows when they’re struggling,” Knight said. “Part of overcoming this is finding a peer group that you can feel comfort sharing your frustrations with and feeling a sense of support that they understand what you’re going through.”