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How Physicians can Burn In, Not Burn Out

Discussion in 'Doctors Cafe' started by Hadeel Abdelkariem, Mar 28, 2019.

  1. Hadeel Abdelkariem

    Hadeel Abdelkariem Golden Member

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    Physicians are leaving medicine due to being physically and mentally exhausted. Most tragically, the United States loses one physician a day to suicide — an astronomical number. Physician burnout is a crisis that has been brewing in medicine for years. Administrative tasks, long hours, EHRs and a complete lack of work-life balance are all contributing factors of burnout.

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    Burnout affects almost half of physicians and is now considered a public health crisis. We are starting to see some progress — a new report found that the physician burnout rate has dropped below 50 percent among doctors in the U.S. for the first time since 2011 — yet there is still much more work to be done.

    Individual physicians hold the power to change the narrative of burnout. Health care organizations are on notice; a long-term solution to physician burnout is drastically needed. In our opinion, it’s time to “burn in.”

    How physicians can burn in, not burn out

    Many physicians choose to go into medicine because the desire to help people heal is a passion rooted at their core. Medicine is a notoriously rigorous and challenging sector, and very few physicians who take this path are naive about the difficulty of the journey. However, the level of sacrifice expected of physicians (beginning in medical school) is unacceptable and has led to the burnout crisis as we know it.

    When physicians burn out, they often leave the practice of medicine. Those who stay endure an extreme physical and mental toll — they suffer, their patients suffer, hospitals and health systems suffer. In the most serious cases, physicians commit suicide. Physicians are often offered yoga and meditation as a solution to their burnout, but these band-aids don’t change the fundamental issues leading to burnout across the profession. Burning in, on the other hand, is when a physician takes their personal frustration and sadness about their career in medicine and uses it as fuel to create positive change for everyone.

    It’s a brave thing to speak up and admit that you’re struggling, especially in medicine — doctors are expected to be healers, not in need of healing themselves. Yet the act of addressing the proverbial elephant in the room helps those around you feel safer to open up about their struggles of the same nature. The work doesn’t stop there, though. Burning in means asking tough questions of your employer, advocating for others who may be dealing with burnout, joining committees and communicating with medical associations about changes that need to be made.

    Burning in enables physicians to use their unfortunate circumstance with burnout to heal health care and create a better experience for themselves and physicians around them who have invested their heart and soul into medicine.

    Modernizing medicine

    With physician burnout peaking, we’re seeing many in the medical community burning in on burnout. The American College of Physicians (ACP) recently launched an initiative to improve physician job satisfaction with the hopes of reducing the number of clinicians leaving the field due to burnout. “Obviously, changing the intricate, complex labyrinth we call the U.S. health care system will take time. In the meantime, we must take care of our physicians and physicians-in-training who are suffering,” explains Susan Thompson Hingle, MD, MACP, and Immediate Past Chair of the Board of Regents of the ACP.

    AI and other technologies can greatly help improve physician wellness. For example, many physicians don’t take vacation time because it’s too difficult to schedule. According to an internist quoted in the Medscape National Physician Burnout, Depression & Suicide Report 2019, “It’s too hard to schedule time off; the rules on clinic cancellation plus poor administrative support to help organize and plan anything make it impossible.” Physicians can champion for the adoption of AI technologies that can optimize even the most complex physician shift schedules, across specialties, giving physicians greater flexibility, more control, and better work-life balance.

    Burning in for medicine’s next generation

    A 2018 Future of Healthcare survey found that 7 out of 10 physicians are unlikely to recommend health care as a profession. Additionally, 54 percent plan to retire within the next five years because of the current challenges in the field.

    Physicians who can burn in instead of burn out will communicate to medical students and residents that being a physician doesn’t mean suffering in silence and trying to maintain the status quo of unrealistic expectations that were set decades before. Physicians can champion for change and guide the next generation coming in and arm them with the skills and tools to understand how they can have a thriving career in medicine despite burnout. Young physicians shouldn’t feel that they can’t have families, pursue hobbies, or find a healthy balance in their life if they choose to practice medicine.

    “A physician looks like somebody who does yoga, who paints, and who enjoys cooking,” says Rana Awdish, MD, FCCP, in Procedure: Women Remaking Medicine (Vol. 1). “I want us doctors to accept that there are different phenotypes and to show others this is what a physician looks like. A physician can take time for self-care. A physician doesn’t have to burn out before they find something powerful that rejuvenates them.”

    Burning in will help us rewrite the story on physician burnout. Symptoms of burnout can be reframed in a way that fires physicians up to change an antiquated system that hasn’t really worked well for anyone. It’s time to turn these negative feelings that so many physicians share into action and change. Only then can we better our healthcare system for all providers and ultimately all patients.

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