Physician Burnout in Hospital & Clinical Careers
February 2, 2017
Job or career burnout can happen anywhere — and to anyone. No matter how much you may have once loved your job — or the idea of it — too much inner or outer office stress can make your time at work miserable. Worse yet, any work-related stress can trickle into your personal life, a problem that can affect your general health and happiness.
Hospital careers, clinical careers, and medical careers are no exception to job burnout, as it often happens in these highly stressful professions — in fact, burnout in one particular medical position, physicians, is rising.
According to the American Medical Association (AMA), work-related burnout is a pervasive problem that’s steadily rising amongst U.S. physicians, across all specialities, and Dike Drummond, MD and CEO of TheHappyMD.com, also states: “There is an epidemic of physician burnout in the United States, and it has a pervasive negative effect on all aspects of medical care.”
In one 2011/2014 study, which was conducted by physician burnout experts from the AMA and the Mayo Clinic, 6,880 physicians of various specialities were evaluated for burnout, including their satisfaction with work-life balance. Their responses were then compared to the general U.S. population’s answers.
During the initial study, “approximately 45 percent of U.S. physicians met criteria for burnout,” but when the follow-up study was conducted three years later in 2014, even more physicians were exhibiting signs of burnout — an average of 54.4 percent.
While there were substantial variations between specialties and career stages for reported burnout rates, these are the following burnout rates, by specialty, for 2011 and 2014, respectively:
- Family medicine: 51.3 percent in 2011 versus 63.0 percent in 2014
- General pediatrics: 35.3 percent versus 46.3 percent
- Urology: 41.2 percent versus 63.6 percent
- Orthopedic surgery: 48.3 percent versus 59.6 percent
- Dermatology: 31.8 percent versus 56.5 percent
- Physical medicine and rehabilitation: 47.4 percent versus 63.3 percent
- Pathology: 37.6 percent versus 52.5 percent
- Radiology: 47.7 percent versus 61.4 percent
- General surgery subspecialties: 42.4 percent versus 52.7 percent
A similar study, the 2015 Medscape Physician Lifestyle Survey, reported that “46 percent of physicians, up from 39.8 percent in [their] 2013 survey” were exhibiting signs of burnout.
What makes these studies so important? They show that burnout is more prevalent among physicians, when compared to the general population, even when specialities, career stages, age, sex, hours worked, and levels of education are factored in and adjusted for.
Unfortunately, they also highlight the fact that physician burnout is directly linked to the following consequences:
- Lower patient satisfaction and care quality.
- Higher medical error rates and malpractice risk.
- Higher physician and staff turnover.
- Physician alcohol and drug abuse and addiction.
- Physician suicide.
Primary Signs of Physician Burnout
Exhaustion (physical and emotional levels are extremely low), depersonalization (cynicism, sarcasm, not emotionally available), and lack of efficacy (doubting the meaning and quality of your work) are the three cardinal symptoms of physician burnout, according to the Maslach Burnout Inventory.
These factors are in direct correlation to how much “juice” is left in an individual’s physical, emotional, and spiritual battery account. These symptoms start to occur when the above “accounts” starts to lean or land directly in a negative balance.
The trick to battling burnout is to recognize it early, be willing to talk about it, and to do something proactive about it. Start by recognizing Mark Linzer’s (MD, Director of the Division of General Internal Medicine at Hennepin County Medical Center in Minneapolis) 7 signs of physician burnout:
- Your High Tolerance to Stress
- You Work in an Exceptionally Chaotic Workplace, Practice, or Hospital
- You Have Poor Leaders
- You’re the Emotional Buffer
- Your Job Constantly Interferes with Family/Personal Events
- You Have No Control Over Your Work Schedule and Free Time
- You Don’t Take Care of Yourself
If you continually neglect yourself — whether that’s exercise, fun, family, medically, etc. — you’re going to burnout. Self care is just as important as caring for others. Care for yourself, and you’ll likely be able to take better care of your patients, too.
Finally, it’s time to do something to address burnout if you find yourself making the following statements: “I just can’t do this anymore” or “I don’t know how much longer I can do this.”
These statements, along with going into “survival mode” — simply putting your head down, churning through work, and focusing on just making it through the day — are a sure sign that you or someone else is burning out.
The Cause of Physician Burnout
Next, take a look at Dike Drummond’s (MD and CEO of TheHappyMD.com) well-known article: “Physician Burnout: Its Origin, Symptoms, and Five Main Causes.” It covers the origin of physician burnout, burnout’s three cardinal symptoms, and finally, the five main causes of physician burnout:
- The practice of clinical medicine.
- Your specific job.
- Having a life.
- The conditioning of your medical education.
- The leadership skills of your immediate supervisors.
Battling Physician Burnout
The best way to prevent burnout is to lower the sources of stress, as well as to work on rebuilding your personal, emotional, and spiritual accounts so that they stay well within positive levels. Other ways to prevent burnout are to eliminate your need to work by saving more and adopting a frugal lifestyle, retiring early, and simply working less.
You can read more about how to do it on this blog post, “Avoiding Burnout,” (and more) from the White Coat Investor. Otherwise, let’s take a look at Dr. Drummond’s 4 Tools for Reducing Burnout by Finding Work-Life Balance:
1. Create a Work-Life Calendar
Build a work-life calendar that includes a schedule for you, your spouse/partner, children, workouts, vacations, date nights, and yes…free time. Stick to this schedule by saying “no” when a conflicting request arises. If someone asks you to do something, check your schedule and politely tell them you are unfortunately already booked.
2. Make Intentional Date Nights with Your Significant Other/Friends/Family
This is a great place for a personal, healthy recharge for you and your significant other. Don’t skip them, and try to go at least twice a month! Don’t have a significant other? Work on building and maintaining your friendship or spend time with your family.
3. Create Weekly and Life Bucket Lists
Make a list of the things you want to before you die — THE bucket list. To help achieve these goals, make weekly bucket lists that will help get you there.
4. Create a Work-Life Boundary
Learn how to “turn off the switch” and simply be at home , that is, not doing work or thinking about work when you are at home. Achieve this by creating and practicing a boundary ritual.
Dr. Drummond gives the example of Mr. Roger’s boundary role ritual: He takes off his coat and puts on a sweater, he changes his shoes, and he sings his song, “It’s a wonderful day in the neighborhood.” After this is complete, he is no longer the Mr. Rogers from work, he’s now the Mr. Rogers from his show. Creating your boundary ritual will take three things:
- An intention to let go of work.
- A releasing breath.
- An action (a change of clothes, walking the dog, taking contacts out and swapping them for glasses, or making dinner).
Recognizing medical and physician burnout isn’t always easy. However, if you exhibit any of these signs, it might be time to do something about it. Make sure to take each of these suggestions one step at a time, but do take action sooner than later.
Try the above strategies or check out these tips from residents who have conquered burnout. Bottom line: you are more than your medical training — you deserve to take care of yourself and be happy. You deserve to find better work-life balance, all while taking care of your patients to the highest standards.
You can’t give what you don’t have — so make sure to spend some time recharging your personal self — physically, emotionally, and spiritually — so that you can find joy and purpose in all of your personal and professional relationships.