Most physicians feel the weight of their jobs' long working hours and stressful responsibilities pile up over the course of their careers. While it may be easy to succumb to physician burnout, Shaina Drummond, MD, of Dallas-based University of Texas Southwestern Medical Center revealed her tips and methods for avoiding such scenarios.
Dr. Drummond is speaking on a panel titled "Work Life Balance: Myth or Possible? Physician Burnout and How to Avoid It" at the Becker's 15th Annual Spine, Orthopedic and Pain Management-Driven ASC Conference + The Future of Spine, June 22 to 24, 2017 in Chicago. Click here to learn more and register.
Q: How should young physicians pace themselves appropriately to avoid future long-term burnout?
Shaina Drummond: In today's patient satisfaction driven culture of medical care, it's easy for young physicians to neglect their own basic self-care and acquire bad habits of inadequate sleep, lack of exercise and poor nutrition. Creating and maintaining healthy boundaries between home and work life is essential for the prevention of burnout. The early development and implementation of a program of regular self-calibration is an important and often neglected component of professionalism in medicine. Taking care of themselves allows a physician to be at their best and to provide better care for their patients. Young physicians should not be afraid to discuss burnout with their peers and their leadership and suggest ways to improve their work environments. It is also important to be able to recognize that if a job becomes so stressful that is starts to affect both your mental and physical well-being, it may be time to seek a new place of employment.
In addition to creating a healthy work-life balance, it is also important for young physicians to find opportunities to increase their levels of engagement in the workplace. Several ways to do this include attending leadership development opportunities such as conferences/meetings and finding opportunities for mentorship. Studies show that there is a definitive link between a lack of engagement at work and increased levels of burnout. It is important to remember that mentorship can be both vertical and horizontal. Learning from others with similar career goals and leadership aspirations in the same peer group can also provide a valuable support and advisory system.
I also think it is important to learn how to shift one's mindset from a negative to more of a positive outlook. According to a recent article in the New York Times by Jane E. Brody titled "Turning Negative Thinkers into Positive Ones," research shows that repeated brief moments of positive feelings can act as a buffer against stress and depression and foster both physical and mental health. This is not to say that you should be walking around all day with a fake smile on your face, but rather trying to change your outlook by seeking out small "micro" moment of positive emotions.
The brain is "plastic" and capable of generating new cells and pathways and it is possible to train the circuitry in the brain to promote more positive responses — essentially saying that a person can learn to be more positive by practicing certain skills that foster positivity. According to Barbara Fredrickson, a psychologist at the University of North Carolina, activities such as doing good things for other people, learning to appreciate the world around you, developing and bolstering relationships, establishing goals that can be accomplished, learning something new, practicing resilience and mindfulness and choosing to accept yourself are all ways to develop positive emotions.
Q: How do you best manage your work/life balance?
SD: Medicine has become so complex that it is easy for physicians to become overly burdened with extra clinical and non-clinical work outside of the hospital/clinic resulting in a vicious cycle of losing their non-medical identity. Many times physicians feel that we should excel in every aspect of our lives, and when we do not, it becomes uncomfortable and stressful.
For me, exercise is an outlet for relieving stress in my life. I try to find time to work out or take an exercise class for at least 30 minutes every other day. I also make it a priority to eat at a new restaurant with my friends at least once a month. Simple social interactions work to reaffirm my identity. In addition, I have been learning how to practice mindfulness and have taken several meditation courses to help me learn how to let go of the things I cannot control and focus on the present. Additionally, the simple act of stepping out of my comfort zone by trying something new can instill a sense of achievement, self-confidence and resilience. Activities such as learning a new language, sport or musical instrument, taking a cooking or art class or trying a new restaurant are all ideas to help re-build my non-medical identity.
With regard to my work, I try to make time to attend both leadership and wellness conferences, so I can become a better leader when faced with challenging situations both inside and outside of the operating room. Lately, I have been seeking out short weekend courses that do not focus strictly on medicine, but rather, on ways to improve my communication skills so that I can become a better team leader. I also try to seek out speaking engagements whenever possible because public speaking is an area that is a constant challenge for me. Learning how to face my insecurities by speaking in public has given me a sense of accomplishment in a venue outside of medicine.
Q: Will this balance become more difficult or simpler to maintain in the future?
SD: There are major challenges to overcome with regard to burnout and our medical system. The increased automation of medical care (resulting in the loss of the "art" of medicine), rising levels of bureaucratic tasks, lack of physician engagement resulting in feeing like one is a "cog in the wheel," falling salaries/reimbursements, rising practice expenses, increased number of work hours and the shift from traditional private practice models to employed positions all threaten the ability to maintain a healthy work/life balance. There is also a large growing body of evidence showing that EHR keeping systems are a major cause of physician burnout. Until these systems become more user-friendly and less time consuming, it is unlikely that we will see burnout levels decrease.
However, I do think that we have reason to be hopeful because hospital leadership and institutions are now openly discussing these issues. In the past, physician burnout was considered somewhat taboo and was very rarely ever a topic of discussion. The surgeon general, large medical institutions and many prominent health system CEOs have begun to acknowledge the importance of physician burnout, particularly since it can affect healthcare costs, high quality patient care, patient safety and patient satisfaction. Healthcare systems and hospital groups are starting to offer more flexible work hours (shift and part-time opportunities), increased autonomy, appropriate rewards for meeting certain benchmarks, a sense of community and fairness and opportunities for physician leadership and engagement.
The Institute of Medicine has even launched an "Action Collaborative" to promote clinician well-being and combat burnout in hopes of enhancing research and funding to address the issue of burnout. There are also large multispecialty national conferences dedicated to improving physician wellness and resilience, such as the International Conference on Physician Health sponsored by the American Medical Association. The bottom lines is that deliberate, sustained and comprehensive efforts by healthcare leadership and organizations are the keys to making progress on physician burnout so that we can continue to improve the quality of the lives of physicians and thereby improve the quality of medical care provided to their patients.
More articles on practice management:
This independent physician network balances physicians' needs and desires — 5 takeaways
Geisinger physician from Egypt faces legal battle to stay in US
U.S. to give states $500M to fight opioid epidemic — 4 insights