Physician burnout is real and the burnout flame is far from extinguished.
The 2016 Medscape Lifestyle Report polled more than 15,800 physicians across more than 25 specialties, and found burnout rates of 55 percent for female physicians and 46 percent for male physicians.
Burned out physicians do not bode well for patient care, as these physicians are more likely to be disengaged, cynical and unenthusiastic about their work. And burnout is not just plaguing the older generation of physicians, overwhelmed by bureaucratic tasks, lengthy workdays and burdensome computerized tasks. Burnout has made its mark among resident physicians, as well.
Tom Jenike, MD, a family medicine physician at Novant Health in North Carolina, knows the emotion. He started experiencing a "feeling of diminishing return of joy in practicing medicine" about 10 years into practice.
"I love being a doctor and love my patients. What I found, was that the pure joy and satisfaction of that started to diminish," says Dr. Jenike. "I didn't feel the full appreciation of what I was doing — it became, I was doing 'doctoring' and not really 'being a doctor' anymore."
Still, Dr. Jenike wouldn't have called it "burnout" at the time, and like most of his colleagues he didn't address his shift in mood. But, the symptoms of dissatisfaction and general fatigue eventually caught up with him, and everything broke down.
To regain a hold of his life, Dr. Jenike met with an executive coach for about six months. During these bi-monthly meetings, he discussed his career and life in general, but Dr. Jenike recognizes that most physicians won't follow this path.
So, he set out to support his colleagues and the healthcare industry, overall, by helping extinguish the burnout flame. Dr. Jenike says he believes the industry now appreciates physician burnout as a serious issue, but it falls short of taking measurable steps to address the problem.
"We need to allow a space for the conversation to happen," says Dr. Jenike. "Doctors want to be perceived that they have their stuff together, so very rarely are they going to volunteer [to share their burnout feelings]."
He suggests institutions establish a forum to discuss these issues in a safe place that doesn't feel punitive. Especially with the impending shift to value-based care, physicians may experience heightened burnout. Although the new value-based model doesn't incentivize physicians to do as much as possible, the change will be rocky.
"The transition from the known to the unknown is unsettling for people," says Dr. Jenike. "In the interim, it's going to increase internal angst."
Dr. Jenike helped establish the Novant Health Leadership Development Program. Designed as a self-leadership process, the program helps physicians achieve an effective personal and professional life.
"The general theme of what I wanted to do was create a new conversation where we didn't have to wait until there are extreme situations, but really have the conversation early," explains Dr. Jenike.
Instead of focusing on external factors of burnout, the program emphasizes the "internal game," reflecting on a physician's mindset about healthcare, his or her job and his or her behaviors. "Through this self-awareness work, they will be very authentic, vulnerable and real," adds Dr. Jenike.
Dr. Jenike hopes the program will help physicians realize what drives their reactions to the external environment. For example, Dr. Jenike realized he said "yes" to everyone and never allowed himself a break.
Ultimately, the Novant Health Leadership Development Program outlines three goals:
- To have an enhanced experience of your life
- To have those around you have an enhanced leadership experience of you
- To have a deep awareness of your own internal conditioning of your patterns, as in identifying which patterns result in success and which "lead to headwinds"
Interested physicians may participate in the program via a variety of versions, with one involving a three-day retreat.
Since launching in May 2013, the program has helped more than 500 Novant Health physicians regain their commitment to the pursuit of medicine, says Dr. Jenike. A 2015 survey of Novant Health clinic and acute care physicians revealed those who participated in the program scored 50 percent higher than nonparticipants on measures such as, personal fulfillment, Novant Health's mission and vision alignment as well as engagement and positive attitudes toward the organization.
Also, the program has indirectly impacted other clinical and acute care providers who work with the participating physician leaders — many of whom have also identified ways to improve their overall wellness, adds Dr. Jenike.
"My hope is that our program can help [physicians] prepare for the rapidly changing healthcare environment. We want to validate the real problems," says Dr. Jenike. "If you give [physicians] the choice to re-choose [healthcare], there are redemptive powers in that."