Page 6 - Mecklenburg_Medicine_April-2016

Feature
Physician Burnout: Don’t Let Fatigue
Lead to Failure
By Lee McCracken, Contributing Writer
I t wreaks havoc on your life and the lives of your patients. It can tear
apart your family. It can end your career.
Physician stress and burnout affects some 45 percent of doctors
in the United States. It is real, and it is pervasive. Physicians
and surgeons can experience emotional exhaustion and a loss of
enthusiasm, depersonalization/distance from patients and a feeling of
low personal accomplishment.
Not surprisingly, the number of stressors impacting physicians is
continually increasing. These include time demands/work-life balance,
productivity and economic pressures, advancing technology, higher
patient expectations/lower patient satisfaction and personal finances
(paying off medical school loans, raising children, etc.).
And, hospital-based physicians experience the most stress-related
health problems due to work culture/environment. Research has
shown some 60 percent of emergency department doctors burnout,
according to expert Tait Shanafelt, MD, in the Journal of the
American Medical Association’s “Enhancing Meaning in Work:
A Prescription for Preventing Physician Burnout and Promoting
Patient-Centered Care,” 2009.
James Hall, MD, the director of gynecologic oncology at Carolinas
Medical Center/Levine Cancer Institute and a past-president of
Mecklenburg County Medical Society, emphasizes the importance of not
letting physician stress go unchecked. “I’ve had talks over the years with
some colleagues about mental and physical fatigue. For anyone in any
field, long working hours and job pressures can cause a loss of focus. In
medicine, you can’t afford it.”
The Mayo Clinic reported on medical error in 2010, citing from the
article “Burnout and Medical Errors Among American Surgeons,” by lead
researcher Dr. Shanafelt in Annals of Surgery, 2010. The article noted that coach, Dr. Drummond emphasizes how to avoid what he calls
“Physician, heal yourself.”
— Luke 4:23
April 2016 is National Stress Awareness Month
and National Counseling Awareness Month
What you can do:
Pause for deep breaths and stretching throughout the day.
Exercise during time off.
Be present and enjoy time with family/friends when you are with them. to be tapped out at work. But physician stress is both preventable
Engage in a hobby.
Find a mentor who can understand and encourage you.
Remember you are human. God is God.
6 | April 2016 • Mecklenburg Medicine
9 percent of surgeons said they were concerned they had made a major
medical error in the past three months.
Burnout can happen in family medicine, internal medicine
and other specialties, too. “Over the past 20 years, medicine and
physicians have undergone massive changes from private practice
to being employees of large corporations, from simply trying to do
what’s right to being told by myriad regulations, from old charts to
different EMRs ... all of which have increased the pressure and loss
of time for physicians,” says Hall.
Anthony Montgomery is a well-known researcher on physician
burnout at the University of Macedonia, Greece. In the journal
Burnout Research, he authored “The Inevitability of Physician
Burnout” (June 2014), saying “The increasingly high levels of job
burnout observed among physicians globally is set to continue, as
fewer resources and tighter budgets ratchet up the personal and
professional pressure.”
The Liaison Committee on Medical Education stated in 2012 that
medical schools don’t prepare future doctors to handle being part of
an organization/healthcare system, primarily providing theoretical
knowledge, ethics, skills and clinical competence. New physicians may
be unprepared to deal with the business of medicine.
Hall, however, says he sees young doctors entering the scene
with a new mindset. “They have a quality-of-life outlook. They’re
into running and yoga, and their focus isn’t ‘Everything is all about
medicine.’” He continues, “I think some 30- and 40-something doctors
are all-in — their job is their identity.”
Dike Drummond, MD, is a Mayo-trained family practice physician
and the owner of TheHappyMD.com. He also wrote “Stop Physician
Burnout” (Heritage Press Publications, 2014). A speaker and physician
“compassion fatigue.”
In a May 2012 blog post on burnout, he says, “You can’t give what
you don’t have. … If your emotional needs are not being met, you
can’t be there emotionally for your patients when they need you the
most. And no one teaches you how to get your own emotional needs
met in medical school or residency.”
Drummond warns, “Here’s the unspoken tragedy: If you can’t
be emotionally present for your patients because of compassion
fatigue, you can’t be there for your spouse, significant other,
children or friends either. Everyone loses when you allow yourself
and treatable.”
Hall agrees. “Counseling and support are imperative,” he says.
“There are a lot of built-ins at our hospital systems to help doctors if
they are feeling stressed. And young doctors need to identify a mentor
— someone with whom they can really feel comfortable talking.”