VOLUME 29, ISSUE 2
Russell K. McAllister, MD
TSA Editor
Program Director, Anesthesiology Residency Program
Assistant Dean of Quality & Patient Safety
Baylor Scott & White Health
Temple, TX
Physician Burnout: The importance of remembering to care for ourselves
“Physician heal thyself” -Luke 4:23
Throughout our medical training, we have always had a focus on caring for the ailments of others, often at the expense of our own well-being. The stress of medical school, internship, and residency require long hours and the sacrifice of our time for ourselves and our families. Long hours beyond training and into our careers continue to propagate these same issues. At what point do we take time for looking out for our own well-being in order to better serve our patients and prolong our productive years? Many speak of finding the proper work life balance; a goal that can be quite elusive for many, myself included. Avoiding burnout has become a new focus for many in healthcare.
Burnout is a syndrome resulting from work-related stress that is characterized by emotional exhaustion, depersonalization (cynicism/detachment), and reduced personal accomplishment.1 The Accreditation Council for Graduate Medical Education (ACGME) has taken on the issue of physician burnout as a major topic of concern in residency training programs, with education on the risks of burnout soon to be a required component of all graduate medical education programs.
A report from 2006 reveals that, when people enter medical school, they are psychologically healthier than their same-age cohorts. However, after entering training, their depression and burnout rates increase dramatically compared to their peers. In addition, practicing physicians commit suicide at a higher rate than people in any other profession, estimated to be about 400 per year.2
Many barriers exist to achieving physical and mental health and a proper work life balance. Most of us work long hours, deal with challenging patients, work alongside disgruntled co-workers, and tend to put the needs of ourselves behind those of our patients. Fast-paced work environments lead to poor diets and little time for exercise. Taking the time to get regular medical checkups can be challenging in many of our groups. Some struggle to find time for hobbies or friends outside of work. Often, working extended shifts leads to relationship struggles and less time for family commitments. Many loved ones learn to
accept the fact that we will not be able to attend important life events due to work commitments. Additional work-related stressors might include the death of a patient, a bad outcome, a lawsuit (even if unfounded), or dealing with administrative agencies such as the medical board. Physicians often fear getting treatment for depression due to the impact it may have on their medical licensure.
Eventually, if work-life balance issues are not adequately addressed, it can lead to depression, relationship difficulties, disruptive behavior, addiction, or suicide. In my experience in anesthesiology education, I have found that most anesthesiologists in practice have been impacted by the death of a colleague who, unforeseen to those around them, ended up purposefully or accidentally causing self-harm by addiction or suicide.
I believe that we all need to focus on achieving a proper work life balance as a means to avoid burnout. Each one of us will have different ways to achieve these goals, but we need to begin to put a focus on these issues so that we can return to work refreshed both physically and mentally in order to care for our patients expertly and confidently.
The solution to the issue at hand can be quite elusive and I do not claim to have answers to the problem. I do, however, wish to bring the issue to the forefront so that it can be discussed openly among colleagues. It is my hope that we can better care for ourselves and our colleagues and recognize when a colleague is suffering or at risk. Although we may not be able to heal ourselves, perhaps we can recognize the situations that put us at risk and take the time to address the issue of burnout so that we can be better physicians, friends, and family members. ♦
1-Busireddy KR, Miller JA, Ellison K, Ren V, Qayyum R, Panda M. Efficacy of Interventions to Reduce Resident Physician Burnout: A Systematic Review. J Grad Med Educ. 2017 Jun;9(3):294-301.
2- Dyrbye LN1, Thomas MR, Shanafelt TD. Medical student distress: causes, consequences, and proposed solutions. Mayo Clin Proc. 2005 Dec;80(12):1613-22.
