Practice of Medicine

Article

Developing Resilience and Avoiding Physician Burnout, Part One

March 21, 2017

Introduction

Physicians seldom receive training on time management and/or self-care at any point in their career. As a result, many physicians have difficulty creating balance in their lives or incorporating self-care into their schedules. Persons who do not care for themselves are less effective at providing optimal care for others. Approximately 50% of physicians report burnout and the suicide rate among physicians is significantly higher than observed for the general population. In addition, burnout exposes physicians to the risk of medical errors and litigation. In recent decades, the role of physician fatigue in causing medical errors has led to the implementation of duty hours for physicians in training. There is now growing attention to the need for strategies to prevent and treat fatigue/burnout among practicing physicians. 

Persons who recognize when they are becoming overextended and implement corrective strategies are less likely to end up completely burnt out than persons who do not make an effort to address their fatigue. The following series of four articles outlines recommendations for managing potential risks, fostering resilience, avoiding fatigue and addressing burnout.

Series Part One: Preventing Burnout by Managing Potential Risks

Burnout is physical and/or emotional exhaustion due to an extended period of stress and/or frustration. Multiple factors put physicians at risk for burnout including their specialty/sub-specialty. For example, the risk of burnout is significantly higher for emergency medicine physicians compared to physicians who specialize in preventive medicine. Physicians who practice in specialties that are more prone to burnout may benefit from taking additional precautions to avoid burnout. Factors implicated in physician burnout are listed below.

Professional causes of physician burnout:

  • Lack of autonomy/control over your work
  • Long work hours
  • Too many responsibilities
  • High patient volume
  • Complex patients
  • Information overload
  • Unclear or overly demanding job expectations
  • Short deadlines
  • Unpleasant work environment
  • Monotonous tasks
  • High stress tasks
  • Frequent exposure to adverse events
  • Feeling unappreciated
  • Threat of malpractice suits

Personal causes of physician burnout:

  • Inadequate time for recreation, relaxation and/or sleep
  • Inadequate time spent socializing
  • Poor stress management skills
  • Lack of confidence
  • Lack of supportive relationships/feeling isolated
  • Type A personality/perfectionistic tendencies
  • Pessimistic view of yourself and the world
  • Financial stress

Eliminating stress completely is not feasible; however, burnout can be avoided by removing stressors where possible and adapting your response to stressors that cannot be controlled. Below are recommendations that may improve the ability to avoid burnout by modifying stressful circumstances.

  • Work in teams to decrease workload
  • Incorporate periods of down-time when working long shifts
  • Don’t use down-time to complete charts or perform other work related activities
  • Develop time-management skills (more details in part 2 of this series, “Fostering Resilience”)
  • Know the policies and procedures at your facility/institution for handling burnout and utilize available resources
  • Avoid excessive workloads by saying no when appropriate
  • Pack meals/snacks if you don’t have easy access to healthy meals while at work
  • Get adequate sleep - between 7 to 8 hours of sleep is recommended per night to avoid fatigue
  • Foster personal relationships and avoid spending prolonged periods in isolation
  • Seek advice on managing finances. Many physicians start their career with large student loans. Obtaining advice from a financial counselor can alleviate financial stress

Go to part two. 

Go to part three. 

References and Resources:

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 Dec;90(12):1600-13

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 Oct 8;172(18):1377-85

E. Amoafo, N. Hanbali, A. Patel and P. Singh. What are the significant factors associated with burnout in doctors? Occupational Medicine 2015;65:117–121 https://wire.ama-assn.org/practice-management/8-things-can-put-you-risk-burnout

Disclaimer

The information provided in this resource does not constitute legal, medical or any other professional advice, nor does it establish a standard of care. This resource has been created as an aid to you in your practice. The ultimate decision on how to use the information provided rests solely with you, the PolicyOwner.