Recently I was speaking with a colleague about physician burnout, which is a topic near to my heart.
Several years ago, I arranged a showing of the excellent film Do No Harm, about physician suicide. The response was overwhelming, and it was clear that a conversation about the stresses we face and have faced in medical training and practice was desired and overdue.
While my intent was to use this as the beginning of a robust program to promote physician well-being, my efforts did not lead to much more than an agreement that something was needed and a plan that was never fully implemented. Like any complex problem – and physician burnout is a complex problem – starts and stops to address it are the norm and forward momentum – no matter how slow – is the goal.
When our small workgroup got together over several months, we developed a data-informed game plan. Based on national research and internal survey data, we identified the following approaches to promote well-being (which in turn helps prevent and even treat burnout).
Improve the system in which we practice. If we have multiple physicians burning out across the system (whether that is local or national), then it's probably not that all of those individual physicians have a personal problem that needs to be fixed, but rather that they are operating within a system that is not designed optimally.
Key parts of fixing the system that are achievable on a local scale include optimizing the electronic health record and care team to minimize documentation burden and EHR "pajama time" (time spent after hours, in your pajamas, finishing notes and clearing out your electronic in-basket) and being part of decisions that impact them.
This latter idea is particularly important, as a lack of autonomy is an important contributor to burnout. This can be as simple as knowing who is making decisions, being able to have a say in those decisions, and understanding the why.
Strengthen your squad. Your professional squad — those team members and colleagues you interact with every day — are an important part of your overall happiness or unhappiness with work and can be essential to your sense of well-being at work.
Thinking back to one of the great sitcoms of my childhood, Cheers, I think we all want to spend time "where everybody knows your name, and they're all so glad you came." This requires individual effort — introducing yourself, smiling, saying thank you, and sharing whatever part of your personal life you are comfortable with.
For some people, this may include being Facebook friends or socializing outside of work, or it may be more strictly professional. Whichever way you lean, it remains important to feel a strong connection to the team with whom you spend the majority of your workday.
Get a mentor, be a mentor. I am a big advocate of formal mentoring — that person who helps chart your professional course. However, in this sense I am talking more about life mentoring — connecting with other physicians who have been there or are going through something you've been through.
Many of us have juggled working and young children. I happen to be beyond that stage but still remember enough of the challenges that I can help coach younger moms about ways to succeed and how to fight mom-guilt. On the other hand, as we are slowly launching our older children from the nest, I am interested in hearing from my colleagues who are now in the post–day-to-day parenting phase of their lives and hear how they've successfully transitioned to a new pace of life.
Utilize social networking. Many studies expound on the benefits of social connections to our overall happiness and well-being. Medicine, despite the fact that we usually care for patients as part of a team, can be lonely. The hours are long and the responsibilities are fierce, which can be isolating.
Sometimes physicians are just a bit more socially awkward or haven't spent enough time learning how to make friendships and connections that aren't purely professional. Yet, we all need this. Our colleagues do not need to be our best friends but it is highly likely that, if you are practicing with enough other physicians, there are some potential friends in the group. Life is just more lovely and full when we have good friends to share the journey with.
Look for opportunities to turn professional connections into friendships — your life will be richer for the effort.
This is just a partial list of actionable items that both individual physicians and systems can tackle to help regain the lost territory of physician well-being. More than ever, in our post-pandemic world, it is essential that there is recognition of the need for and partnership in both preventing and addressing burnout.
How about you and your health system? Are you engaged in burnout prevention or recovery solutions? What has been the impact?
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