Watercooler wisdom 2: Preventing (and treating) physician burnout
Dr Schuman offers a plan to recognize the symptomology and overcome its effects.
There has been a lot of activity around our watercooler lately. After having an exhaustive discussion around the watercooler regarding the issue of “patient satisfaction” (see Peds v2.0, Contemporary Pediatrics, August 2016), my colleagues and I are now engaged in conversations regarding “job satisfaction,” and are considering a variety of ways to improve our practice for our patients and for ourselves.
Physician “burnout” has become a popular topic in medical journals. It is worthwhile to discuss this important topic so we can recognize the symptoms of burnout, seek help when necessary, and change our work environment to prevent burnout and its consequences. Unfortunately, nearly 1 of every 2 physicians is experiencing burnout. The purpose of this article is to educate pediatricians regarding burnout symptomatology and, more importantly, how to remedy the problem when identified!
What is burnout?
Burnout is a well-recognized clinical syndrome associated with a loss of enthusiasm for work, negative feelings, and a low sense of personal accomplishment. Additional symptoms include fatigue, poor judgment, guilt, and feelings of ineffectiveness.1 In other words, if you don't look forward to coming to work, can't wait for your day to end, and believe you are losing your edge, you likely are experiencing burnout.
The condition was described in detail by psychologist Christina Maslach, PhD, professor of Psychology at the University of California-Berkeley. In the 1970s, she developed a burnout assessment tool called the Maslach Burnout Inventory, which is considered the gold standard for measuring burnout symptoms. We'll discuss performing a burnout "self-assessment" later in this article.
How common is burnout?
Unfortunately, numerous studies have looked at symptoms of physician burnout and the results suggest too many physicians are affected. A recent article published in Pediatrics, co-authored by Gary Freed, MD (member of the Contemporary Pediatrics Editorial Advisory Board), surveyed 864 early-career pediatricians to quantify burnout rates. The results of the study indicated that 30% of the surveyed pediatricians experienced burnout.2 However, on a positive note, the majority of pediatricians reported that they are satisfied with their career (83%) and life quality (71%).
Other surveys have looked at the physician population overall. One survey of 7288 physicians found that 45.8% experienced at least 1 symptom of burnout, with the highest rates of burnout noted in primary care and emergency physicians.3 In another survey, 6880 physicians were assessed using the Maslach Burnout Inventory, with 54.4% of the physicians reporting at least 1 symptom of burnout in 2014 compared with 45.5% in 2011.4
The newly published Physicians Foundation 2016 Survey of America’s Physicians is the most recent survey of physician’s opinions regarding medical practice, and for the first time it asked physicians questions about “burnout.” In this survey of more than 17,000 physicians, 48.6% of those surveyed reported frequent or constant feeling of burnout. More frequent burnout rates were reported by female physicians, as well as by physicians aged older than 45 years, and rates were comparably high in primary care and specialty care providers (Table 1).5 The unfortunate conclusion from all these surveys is that burnout is common among physicians and it appears to be on the rise!