By Matthew Goldenberg, D.O. Board Certified Psychiatry and Addiction Psychiatry Associate Medical Director, Promises Professionals Treatment Program
Why Physician Burnout?
For most physicians working in clinical practice today, the hours are long and pressure and demands are high. Doctors must constantly balance maintaining strong connections to patients, their colleagues and the modern pace of the medical profession. Consequently, doctors typically work 10 hours more per week than other professionals. In addition to seeing patients, doctors have other work-related commitments that demand extra time beyond clinical hours, such as attending conferences, giving seminar presentations, maintaining certification requirements, publishing articles and book chapters, and serving on various medical boards, committees and peer-reviewed journals. It can be challenging to juggle professional demands with personal needs and family obligations. Physicians often become burned out and have little time or energy for nurturing their own health and relationships.
A Pervasive Issue Among Physicians
First described as a syndrome in the 1970s, the 1981 publication of the Maslach Burnout Inventory (MBI) brought the issue of physician burnout to the forefront. The MBI uses three general scales to measure burnout: emotional exhaustion (feeling overextended and exhausted by work); depersonalization (feeling disengaged and unfeeling in the care and treatment one provides to patients); and personal accomplishment (feeling less competent and successful in one’s work). While the MBI has highlighted the pervasive issue of physician burnout, resolving it has proven to be a challenge. This may be because the character traits valued in physicians — compassion, altruism and perfectionism — also predispose them to burnout. Burnout can lead to anxiety, depression and even suicide. An estimated 300 to 400 physicians in the U.S. commit suicide annually, with female physicians at highest risk.
Recognizing the Symptoms of Physician Burnout
Are you among the nearly 50% of doctors in the U.S. who suffer from burnout? There are several signs to look for:
- It is hard to get yourself motivated to go to work each morning.
- You are losing/have lost the desire to be around family and friends.
- You feel irritable or quick to temper.
- You have trouble sleeping (e.g., difficulty falling asleep, awaking during the night, grinding teeth during sleep).
- You have difficulty handling the details of your job or lack energy to do your job well.
- You find it difficult to empathize with patients and provide personalized care.
Taking a self-test is a discreet way to assess whether you need to seek help or take other measures to regain balance in your life. You can take an online version of the MBI to determine where you are on the burnout continuum. There are also other online surveys such as a burnout test from Psychology Today, designed specifically for physicians and others in service fields. It includes 42 questions, takes roughly 15 minutes to complete, and provides a final score and “snapshot” summary of your personalized results. Depending on your score, it may be time to seek a more intensive diagnostic evaluation and get professional support.
Resources for Physicians Suffering from Burnout
There are a variety of resources available to help physicians. Physician health and wellness programs have been established across the country to help doctors prevent burnout and maintain a healthy work-life balance. Perhaps due to societal expectations to be infallible or even heroic, physicians typically resist asking others for help. Physician health programs are aimed at countering this very problem. They encourage taking institutional measures to improve workflows and achieve more flexible staff scheduling, and they confidentially provide resources and support for improving mental, physical and spiritual health among physicians and other health care providers. Promises Professionals Treatment Program conducts confidential diagnostic evaluations and offers several options for physicians and other medical professionals who seek more intensive treatment and support. Our clinical team helps physicians address any addictions, dependencies and mental or emotional problems that have developed during the struggle to balance career demands with personal commitments. We network with other resource centers to help doctors manage problems with sleep, body image and weight, sex and intimacy, gambling, and post-traumatic stress disorder (PTSD), among others.
Finding Balance Through Lifestyle Changes
We also encourage physicians to make lifestyle changes that allow more time for key relationships, as well as hobbies, physical fitness, good nutrition and relaxation. Some fairly easy lifestyle changes can include getting help from outside service providers that take care of daily household responsibilities for you. These services can help out by:
- Doing chores like housecleaning, laundry, errand-running and home repairs
- Delivering groceries or nutritious meals to save you time on shopping and cooking
- Providing reminders for special dates, greeting cards to send and other correspondence
Reducing schedule overload by “outsourcing” basic daily tasks can reduce stress levels and help you prioritize relationships with loved ones. It also frees up time and energy to focus on healthy nutrition and exercise. By making lifestyle changes and getting discreet professional help for any issues that arise from the demands of the job, you can more effectively manage stress and head off a potential burnout crisis. Sources: The Maslach Burnout Inventory (MBI) and MBI Manual, by Christina Maslach, Susan E. Jackson, Michael P. Leiter, Wilmar B. Schaufeli, and Richard L. Schwab (ResearchGate.com) Maslach Burnout Inventory: General Survey (MindGarden.com) Burnout Test for Service Fields, Psychology Today (Psychologytoday.tests.psychtests.com) Time in the Bank: A Stanford Plan to Save Doctors from Burnout, The Washington Post (WashingtonPost.com) Diagnosis: Burnout. Doctors Battle Burnout to Save Themselves and Their Patients, U.S. News and World Report (USNews.com) Physician Burnout Rates Top 50% in US (TheHappyMD.com) Medscape Lifestyle Report 2016: Bias and Burnout (Medscape.com) Physician Wellness Program from the Orange County Medical Association and the Cooperative of American Physicians (OCMA.org) Physician health and wellness, by Sara Taub, Karine Morin, Michael S. Goldrich, Priscilla Ray, Regina Benjamin. The Council on Ethical and Judicial Affairs of the American Medical Association. Occupational Medicine; 2006. (Oxford Academic)