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Burnout Relief Must Include Workplace Changes

One in two physicians experience burnout, with one study showing 42 percent of otolaryngologists suffering from the condition. Tuesday’s session “Moving from Burnout to Wellness” described the signs and consequences of burnout and offered solutions.

Burnout is not acute stress; it’s the buildup of stress over time. It has three primary characteristics:

  1. Emotional exhaustion—feeling spent at the end of each day
  2. Depersonalization—feeling callous to people around you (students, patients)
  3. A low sense of personal accomplishment—those times you ask yourself, “Have I really done anything? Have I really made a difference?”

Managing self-care is critical to preventing and reducing burnout. Florida Hospital developed a philosophy called CREATION Health designed to help individuals achieve maximum health and wellness, as explained by Michael D. Seidman, MD, director of otologic/neurotologic skull base surgery and director of Wellness Celebration Health at the University of Central Florida. Each letter in “creation” stands for:

  • Choice—establishing control over your life
  • Rest—proper sleep and relaxation
  • Environment—creating pleasant surroundings
  • Activity—physical and mental exercise
  • Trust—nurturing trust in your relationships
  • Interpersonal relationships—social connections nourish the body and mind
  • Outlook—positive attitudes can strengthen health
  • Nutrition—eating healthy

Dr. Seidman shared a few ways that he remains connected to his work. He said he believes it’s important to form emotional attachments to patients. He doesn’t wear a white coat or stand with his arms crossed. He makes sure his cellphone is off. He hugs and prays with his patients when appropriate. “It’s important to be here and now. If I’m in a hospital room, there’s nothing more important to me than that patient,” he said.

While self-care is important, it shouldn’t be the sole focus of solving the burnout crisis. Solutions must expand to include workplace, organization, and national factors, said clinical psychologist Sian Cotton, PhD, founding director of the University of Cincinnati Center for Integrative Health and Wellness and UC Health Integrative Medicine. “Physician burnout is not an individual failure. This is a work-related syndrome,” Dr. Cotton said.

As one session attendee described, physicians can meditate, exercise, do yoga, and eat well but still suffer burnout because it’s harder to overcome the demands placed on them at work. Institutions require them to add more patients throughout their day, while paperwork requirements continue to grow.

It is important for physicians to speak out at their institutions about the systems that are contributing to healthcare provider burnout, perhaps by joining or starting a physician well-being committee. “I would encourage each of you to think what you can do within your own work unit or organization to be a voice for change in that area,” Dr. Cotton said.

Considering how physician burnout affects costs, patient outcomes and physician health, it should be recognized as a public health crisis, the panelists agreed. “What’s going to end up happening is you’re not going to have enough workers to be able to take care of everybody else,” said Matthew M. Smith, MD, assistant professor at Cincinnati Children’s Hospital Medical Center. “[We need to] advocate for ourselves and get a seat at the table and use the data that we have to show what is happening right now is not effective healthcare.”