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This Year, Strive to Avoid Stress

If you are like most of us, decreasing tension in 2016 is a laudable New Years' resolution.
By Joseph P. Shovlin, OD

2/15/2016


Many of us in practice—especially for 10 years or more— know all too well how stress can lead to some amount of professional “burnout.” It has a pervasive effect on nearly every action we perform daily, from the degree of care we provide our patients to our relationships with friends, family and coworkers. Symptoms of burnout include mental and physical exhaustion, stress, depersonalization (i.e., cynicism and sarcasm) and a reduced sense of accomplishment.1-6 While burnout is common in most industries, it’s on the rise among health care professionals in particular.2 

A recent Mayo Clinic study assessing the incidence of burnout symptoms such as work/life imbalance, depression and suicidal ideation among physicians found that 54.4% of those surveyed reported one or more symptoms of burnout in 2014, compared with 45.5% in 2011 (p=0.001).4 With respect to individual symptoms, the rate of physicians with a healthy work/life balance decreased in the three-year span measured, with only 40.9% of practitioners reporting they had sufficient time for personal and family life in 2014.2,3 Long-term consequences linked to burnout included: (1) lower patient satisfaction and quality of care; (2) higher medical error rates and risk for malpractice; (3) higher physician and staff turnover; (4) physician alcohol and drug abuse; and (5) physician suicide.4,5

Low Battery 
What is causing this epidemic? Mark Linzer, MD, offers a list of specific drivers below:5 

Stress. Research has demonstrated you’re 15 times more likely to burn out if you operate under constant stress. Ongoing concern for medical errors and potential malpractice cases also raises stress levels; additionally, payers may obstruct tests that you deem necessary, limiting your ability to provide the best patient care possible. 

Chaos. Caring for patients is what keeps most doctors motivated, but caring for too many of them under a stressful environment is generally what burns them out. Recent changes imposed by government entities and payers have further heightened the demand.

Discord. Motivation wanes quickly if your practice ideals and values don’t match, or if a healthy camaraderie does not exist between members of your practice.

Depersonalization. We often serve as the emotional buffer between the patient and our own environment, sometimes limiting our ability to connect with them. And, after years of practice, things can begin to seem mundane or depersonalized.

Interference. Leaving insufficient room for personal schedule changes and needs in daily life can lead to negative spillover into work life, and vice-versa.

Neglect. Self-care is critical—when you neglect yourself, you neglect your patients. Taking time to relax to ensure you can focus when needed and provide the best care possible. 

Physician, Heal Thyself
Let’s face it—work is stressful. Indeed, that’s why they call it work. But the difference between manageable levels of stress and complete professional burnout is the ability to recover when not working.6 Personal downtime is key, and we all need an activity that brings us joy. It is vital that we carve out some time from our workweek to do the things we love. 

Research has shown prevention and treatment measures for burnout should be approached both on the personal and organizational level.6 Personal burnout prevention measures involve maintaining self-awareness, appreciative inquiry, narrative medicine and maintaining a healthy work/life balance.5,6 Measures that can be taken at the organizational level include the creation of specific programs to support health care providers and the allowance for flexible work hours.

Remember, we have a lot to bring to the battle against burnout: intelligence, good incomes, support from family and friends, life outside of health care, and an overall investment in education and self-growth.6 None of us are immune to burnout—make avoiding it your resolution for 2016.  

1. Drummond D. Physician burnout-the three symptoms, three phases, and three cures. The Happy MD. 2015 Oct.
2. Swift D. Physician burnout climbs 10% in 3 years, hits 55%. Medscape; 2015 Dec.
3. Peckham C: Physician burnout: It just keeps getting worse. Medscape; Jan, 2015.
4. Drummond D. Physician burnout: Its origin, symptoms and five main causes. Family Practice Management, 2015 Sept/Oct;(5):42-7.
5. Linzer M. How to beat burnout: 7 signs physicians should know. AMA Wire. 2015 Mar.
6. Drummond D. Physician burnout: Why it’s not a fair fight. The Happy MD. 2015 Sept.



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