Preventing Medical Burnout: The Increasing Dangers of Physician Fatigue

Doctors spend so much energy worrying about the health of their patients, often times their own issues go unresolved.  Consequently, physician incidences of medical burnout are increasing at an alarming rate.

In fact, career fatigue is more common among doctors than any other U.S. worker. A recent study by the Archives of Internal Medicine found that out of 7,000 participating physicians more than 41% reported at least one symptom of burnout.

“We’re not talking about a few individuals who are disorganized or not functioning well under pressure; we’re talking about one out of every two doctors who have already survived rigorous training,” said Dr. Tait D. Shanafelt, the study’s lead author and a professor of medicine at the Mayo Clinic in Rochester, Minnesota.

What is burnout?
Burnout is characterized by a state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress. Although it can occur in any field, burnout occurs most amongst people in the caring professions of medicine, nursing, social work, counseling, and teaching.

Incidences are even greater among specialties at the front line of care such as family medicine, emergency medicine, and general internal medicine.

The danger lies in the fact that physicians who suffer from burnout are more disposed to errors, provide less quality of care and receive lower patient satisfaction. It can lead to higher rates of depression, alcoholism, and even suicide.

“Burnout can lead to misdiagnosis,” said Paul Griner, MD, professor emeritus at the University of Rochester (N.Y.) School of Medicine and Dentistry and author of The Power of Patient Stories: Learning Moments in Medicine. “Doctors need to be in tune with their patients, asking, listening, and connecting the dots. They can’t do that effectively if they’re burned out.”

Symptoms
Burnout is a gradual process that increases over time. It doesn’t happen from one day to the next but can sneak up on you if you’re not paying attention to the warning signs.

Physical Signs	Emotional Signs	Behavioral Signs
Feeling tired and drained most of the time Lower immunity, feeling sick more often Frequent headaches, back pain, muscle aches Change in appetite or sleep habits	Emotional exhaustion Detachment or de-personalization from patients Sense of failure and self-doubt Feeling helpless, trapped and defeated Loss of motivation Increased cynicism Decreased sense of accomplishment	Withdrawing from responsibilities Isolation from others Procrastination Using food, drugs or alcohol to cope Taking out your frustration on others Skipping work or increased tardiness

Causes
Experts agree that incidences of physician burnout are greatly underreported.

“It is always amazing to me how often burnout is actively ignored in healthcare. Research shows one in three doctors are burned out on any given office day,” said Dr. Dike Drummond, a life and career strategist for physicians who focuses on medical burnout.  He began The Happy MD in response to the emerging burnout epidemic amongst physicians.

Long hours, mounting pressure to see more patients, increased government interference, and non-patient centered duties all contribute to physician burnout.

Streamlining office duties with a comprehensive practice management system can greatly decrease stress levels associated with the day-to-day hassles of running a practice.

Don’t avoid delegating most of the office’s administrative duties to your staff. In the end, that’s why you hired them, and, you never know, they just might surprise you with fresh ideas for a more productive practice.

Prevention and Treatment
By now, you’re probably feeling pretty bogged down. Don’t fret. PYP has compiled a list of stress management techniques, which may help prevent a breakdown.

• Start your day by relaxing. Instead of pouncing out of bed like a frightened lemur, spend a few minutes meditating, doing gentle stretches, reading inspiring words or practicing breathing techniques. A proven yoga relaxation technique is called box breathing. Try it next time your feeling overwhelmed.
• Incorporate healthy eating, exercise, and sleeping habits. Eating right, regular exercise, and plenty of sleep will give you the energy to face a challenging day at the office. Also, promote healthy living at your office.
• Set personal boundaries. Don’t overextend yourself. Learn how to say “no” to certain things. If spending more time with your family is important, then always aim to leave work at a certain time.
• Take a break from technology. Set aside a few minutes a day where you completely disconnect from your laptop, cell phone, and e-mail.
• Nurture your creative inclinations. Start a hobby that has nothing to do with work. Creativity can be a powerful ally against burnout.
• Rediscover the joy of practicing medicine. Take a moment to reconnect with the reason you got into medicine in the first place. Think back to a moment where you felt happy and appreciated. Write it down and strive to achieve that feeling at least once a day.
• Take time off. If burnout seems unavoidable, take a break from work. Go on vacation. Use the time off to recharge and gain perspective on your priorities. The world won’t end. We promise.

What do you do when your feeling overwhelmed?  What advice would you give up-and-coming doctors about managing stress levels?