by Heath Mackley, MD, FACRO
I don’t know any physician that doesn’t struggle with the work-life balance. We didn’t become physicians because we expected an easy job. And most of us understand that to be truly good at anything, it probably takes some talent, but it definitely requires a lot of work. There is no substitute for investing your time, from studying in medical school, working and studying in residency and fellowship, and working while continuing the learning process as an attending physician. But it doesn’t stop there. To deliver quality health care to each individual takes time. Time to understand their stories, time to develop evidence based plans for rarely seen diseases, time to talk to your colleagues to coordinate complex care. And it takes time to document each encounter correctly. And it takes time to fulfill employer requirements if you’re employed, or it takes time to administer the practice if you’re independent. And it takes time to supervise and train your team. And it takes time to educate learners if you work with them, and patients no matter where you work. And it takes time for continued medical education (CME). And it takes time to work on your professional development. Medicine is undeniably a labor of love for most of us. But it is labor.
But we all have a life outside of work. We have family and friends. We have hobbies, causes, religious activities, sports, artistic endeavors, and countless other things that make life full and meaningful. But we also need time to care for ourselves, to eat well, to sleep enough, and to see physicians for our own personal medical issues. The tension between being a good physician and these important aspects of life is relentless. And that is just one source of stress. Physicians see death, suffering, lawsuits, unfair insurance policies, and countless small offenses that can add up.
It is no surprise that about 50% of physicians are suffering burnout. Burnout is a syndrome involving emotional exhaustion, depersonalization, and a sense of reduced personal accomplishment . Burnout is not a sign of weakness, it is a consequence of chronic stress. As physicians, it is often easy to focus on our work instead of acknowledging the warning signs exhibited in ourselves or our colleagues. It is common for us to identify denial in our patients; it is less common for us to identify it in ourselves. This impacts all of us in the house of medicine. Studies have shown burnout scores are associated with decreased work effort, an increase in major medical errors, and suicidal ideation. Even in less extreme situations, burnout’s association with lower job satisfaction has ripple effects on the morale of the entire clinic. With few exceptions, no physician is an island that burnout cannot reach.
Pennsylvania Medical Society (PAMED) represents and advocates for physicians on many levels. As part of its educational programs offered to members, there are three programs, adding up to four hours of CME, that help physicians identify burnout, develop resilience strategies, and intervene on behalf of their colleagues. For most of us, this is not something we learned about in medical school. Just like other medical problems we learn about, there are evidence-based interventions that can be helpful, both on the individual level (small group curricula, stress management and self-care training, communication skills training, mindfulness-based approaches), and the institutional level (modification of work processes, shortening of work shifts). The average benefit of these interventions reduces the relative risk of developing burnout by about 10%. Sometimes, we need more than CME to address a problem. The Foundation of PAMED, which has a long-standing commitment to helping physicians in need, recently led a successful “Resiliency Retreat” in November. Stayed tuned for further retreats in the future.
When one considers the potential impact of avoiding a “crash and burn” experience, all of us need to be more proactive with physician burnout. I would encourage everyone to learn more. And remember, PAMED is here to help!
Dr. Mackley is a Radiation Oncologist at the Penn State Cancer Institute and 5th District Trustee for PAMED, representing physicians of this county.