Time to Act—Not Panic—About Physician Burnout
Over the past several years, concern about physician burnout has reached a near-fever pitch. The official response has bordered on a level of panic not witnessed in healthcare circles since the Libby Zion case. Physicians have thus been bombarded with countless articles, news reports, talks, YouTube videos, and webinars on the subject. Many have been subjected to mandated psychological evaluations, educational sessions, and mitigation exercises.
The response has not always been favorable. Some physicians have reacted with great cynicism. Some have taken a more nihilistic approach: “Sure we’re burning out, but do you really think some mindfulness training and yoga classes are going to fix that?” Some have weaponized the alarm, aggressively taking to task healthcare systems for the commoditization of their providers. Some have paid so much heed to the alarms that they now approach their work with great trepidation. Others cite the “hubbub” generated over the issue as they scoff at the newest generation of providers for their supposed self-indulgence and lack of work ethic.
Such negative responses underscore the fact that the popularization of the issue has taken it in some unintended directions. In order to help reframe the related discussion and reorient its direction, we offer the following observations:
First, burnout in medicine is real, and it can ultimately impact patient care. It is not a new phenomenon; it has affected providers for time immemorial. Millennials and those of Generation Z are not uniquely prone to the problem. Burnout can and will impact even the hardiest and most resilient of our tribe. But it is manageable—not with a handful of seminars, but with a persistent focus on provider resilience and well-being.
Second, despite claims that large numbers of physicians are in the process of irretrievably crashing, we would argue that the rates of severe burnout are overestimated, and that it is neither a unidirectional or terminal disease. Concern about burnout should not engender amongst physicians a paralyzing work ambivalence, but rather a desire to optimize the work environment. This is accomplished when physicians approach their work with positivity, wonder, fascination, creativity, and gratitude, and when they are given adequate support, resources, and decision latitude to do their best for their patients. Healthcare will always be demanding, but under such circumstances, it can and should be one of the most rewarding and fortifying occupations out there.
Third, healthcare systems must take note of the problem of burnout and promote better physician work environments. Systems should focus on maximizing their “user friendliness” such that providers are freed to see sickness and injury, not the infrastructure of care, as their principal challenge. This will be realized far more swiftly through dialogue than through antipathy.
Finally, physicians must be invested in the promotion of their own well-being. This may be enacted through a selection of measures including: the open discussion and debriefing of stressors, the harvesting of uplifts, the counting of blessings, the maintenance of important relationships, the seeking of wonder, the seeing of the familiar in unfamiliar ways, the maintenance of healthy habits, the building of relationships with leadership, the learning of conflict management skills, the learning of leadership skills, the learning of skills in crucial conversations, the taking of regular breaks in the action, the taking of prolonged periods away from work, and more.
The burnout discussion has become somewhat of a runaway train. But it is nonetheless a subject that deserves serious consideration from every healthcare institution and every provider. The alternative is to continue as is, with large numbers of physicians feeling miserable and making those around them miserable, and with many physicians heading toward personal mishaps and profound psychological ailments. The noise surrounding the discussion can be tuned out, but the central message should remain: Physicians must learn, as critical skills, self-compassion and self-care, and healthcare institutions must do all in their power to facilitate this.
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Gary R. Simonds, MD, MHCDS, and Wayne M. Sotile, PhD, are coauthors of Thriving in Healthcare: A Positive Approach to Reclaim Balance and Avoid Burnout in Your Busy Life and The Thriving Physician: How to Avoid Burnout by Choosing Resilience Throughout Your Medical Career.