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    Watercooler wisdom 2: Preventing (and treating) physician burnout

    Dr Schuman offers a plan to recognize the symptomology and overcome its effects.


    Improve the work environment

    It is clear that we need to improve our working conditions and work environment, and, if possible, improve our ability to deal with stressful circumstances. Here is a strategy.

    I have spent the last 4 years writing articles about how to improve pediatric practice. Look at “Make pediatric practice great again!” (Peds v2.0, Contemporary Pediatrics, April 2016) to review some of my more important suggestions.

    Pediatricians can analyze and modify office workflow to streamline patient throughput; eliminate or reduce hassles by using patient portals so your staff responds to patients questions on your behalf; and use technology appropriately to expedite diagnosis and expand treatment options. Most importantly, physicians need to conquer inefficient EHRs. As discussed in my article “Expediting medical documentation” (Peds v2.0, Contemporary Pediatrics, January 2016), this can best be done by using scribes, virtual scribes, or mastering voice dictation software to expedite note completion.

    Next: Improve your practice with behavior evaluation and management portals

    Additionally, physicians need to learn to either ignore or sidestep some of the practice stressors associated with government oversight or insurance hassles. I believe it is foolish to participate in the ACA EHR incentive program and its many “meaningful use” requirements. Leave all Maintenance of Certification (MOC) requirements to the last year of your cycle, and use online prior authorization services so you and your staff can deal with the most important priority of your practice—good patient care. These measures alone will help reduce or eliminate many burnout-related stressors.

    Reduce stress levels

    Physicians need to reduce work- and life-related stressors, and there are many methods that can be used. Exercise has always been a very reliable way, not only to reduce stress, but also to improve overall health and focus. Consider going to a gym before work or during your lunch hour. Consider buying a treadmill or an elliptical trainer that you can use during the day. Alternative stress relievers may include activities such as yoga or meditation. Physicians should also schedule some breaks during the day to either catch up if needed, to exercise, or to just do something that relaxes you. Listen to music on your new iPhone 7. Buy a Jacuzzi and schedule a hot tub break during the day. Watch a movie on Netflix, read Contemporary Pediatrics, or play a video game.

    Consider taking up a new hobby, such as needlework, or painting either with finger paints (very relaxing) or perhaps watercolors. These activities can be done at home or in your office.

    Also important points are that you take plenty of vacation time and have a good team structure in your practice to accommodate busy times so that any 1 provider is never overwhelmed. This means having providers who will cover for one another and absorb excess patient visits if necessary, and that the practice is flexible enough to accommodate unfortunate life circumstances that affect everyone; ie, death of a loved one, a medical illness, divorce, and so on. We all need good support systems in place from friends, colleagues, and family.

    Watercooler wisdom

    After writing this article about burnout and how important it is to reduce office stress, I now frequently pause to contemplate the watercolor painting that hangs next to our watercooler. It’s a boat sailing on the ocean, a very relaxing view if even for a few moments before returning to patient care.

    Now that you know the causes and consequences of burnout, you can begin your own self-assessment and even consider implementing a program at work to reduce burnout rates. I hope this information has proved helpful.

    Send your recommendations or observations on physician burnout to [email protected]



    1. Balch CM, Freischlag JA, Shanafelt TD. Stress and burnout among surgeons: understanding and managing the syndrome and avoiding the adverse consequences. Arch Surg. 2009;144(4):371-376.

    2. Starmer AJ, Frintner MP, Freed GL. Work-life balance, burnout, and satisfaction of early career pediatricians. Pediatrics. 2016;137(4):e20153183.

    3. Shanafelt TD, Boone S, Tan L, et al. Burnout and satisfaction with work-life balance among US physicians relative to the general US population. Arch Intern Med. 2012;172(18):1377-1385.

    4 Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600-1613. Erratum in: Mayo Clin Proc. 2016;91(2):276.

    5. Physicians Foundation. 2016 Survey of America’s Physicians: Practice Patterns and Perspectives. Available at: http://www.physiciansfoundation.org/uploads/default/Biennial_Physician_Survey_2016.pdf. Published September 2016. Accessed October 12, 2016.

    6. Peckham C. Physician burnout: it just keeps getting worse. Medscape. Available at: http://www.medscape.com/viewarticle/838437. Published January 26, 2015. Accessed October 12, 2016.


    Andrew J Schuman, MD, FAAP
    Dr Schuman, section editor for Peds v2.0, is clinical assistant professor of Pediatrics, Geisel School of Medicine at Dartmouth, ...


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