Burnout: A Slow Death
By Robert E. Cranston, MD, MA (Ethics) | April 13, 2017
by Robert E. Cranston, MD, MA (Ethics)
On The Point blog last month, Dr. Autumn Dawn Galbreath penned a stirring essay on physician suicide. Besides the terrible personal tragedy of the suicide, the person, or in this case physician, who chooses suicide leaves a gaping hole in the lives of their family, as well as the lives of their colleagues, patients and society in general. A short-term “solution” creates more long-term consequences than can be imagined by the despairing man or woman. I have dealt intimately with middle-aged survivors who, 50 years after the event, still wonder what life would have been like with a “real” father or mother, and if there was something about them personally that may have contributed to their loved one’s tragic choice. Suicide is not the answer.
Some of the same stresses that precipitate actual suicide in almost 400 physicians per year, contribute daily to what might be labeled a slow death—burnout—characterized by a sense of helplessness, hopelessness, lack of efficacy, disengagement, chronic exhaustion and cynicism. Recent research shows a rise in burnout among American physicians, and it is estimated that currently half or more of us are experiencing at least one of the major signs of burnout.
The reported causes of burnout include increasing work demands, a sense of lack of control over work, a sense of not being appreciated by others, high stress environments, the electronic medical record, changing state and federal documentation demands, the rapid pace of society in general and, I would posit, the changing demands of our patients. IWWIWWIWI—I want what I want, when I want it—is seemingly the new mantra of many Americans, and this certainly includes our patients.
The physician personality and educational process predispose physicians to burnout. Dike Drummond describes five common personality characteristics among physicians that increase our risk of burnout:
- Workaholic tendencies
- Superhero complex
- Perfectionistic tendencies
- The Lone Ranger mindset
- Emotion-free practice style
Drummond then outlines a number of personal corrective strategies:
- Active coping style
- Physical exercise
- A positive outlook
- A strong moral compass
- Social support
Additionally, a number of systemic factors can be addressed by clinics, hospitals and physician groups, including:
- Better teaching and continuing education regarding use of the electronic medical records.
- Cultivating a true sense of professionalism—self-monitoring of ourselves and our colleagues in a supportive manner.
- Working to re-establish social connections at work with fellow physicians and all healthcare workers.
- Supportive ancillary services—easier access to day care, food delivery services, laundry services, more flexible work hours and other logistical supports.
- A grassroots and top-down commitment to work-life balance among physicians
- Physician and employee assistance programs for those among us with addictions, personal and family crises, mental illness and burnout
- Perhaps most importantly, beginning to instill respect for our own limitations and interconnectedness among students from the first year of medical school, going forward.
As Christian healthcare professionals, we should be characterized by each of Drummond’s six correctives. We are to actively engage the tasks God has ordained for us. We should treat our bodies as the temples of God that they are, and exercise is a part of that, along with proper diet and sleep. We can be positive, because we know the Lord is on our side, loves us and will enable us to complete the call He has given us. Our strong moral compass is Scripture-based and Spirit-guided. We should support each other and be known by our love for each other. Since we know the truly important things in life, and as God enlightens us, we can recognize the many things we can be flexible on and the essential truths we will not compromise.
1 Corinthians 12 tells us that as Christians (and Christian healthcare professionals, in this case), we cannot go it alone. Paul reminds us of the importance of an interdependent mindset, and many Scriptures remind us of our utter dependence on God. When we find ourselves veering toward burnout, we can seek God’s help as we employ His tools for restoration, and as we see our colleagues headed that way we can gently encourage and support them, reminding them of God’s continuous love and support and coming alongside them with our persevering presence and support. We are not alone.
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