Physician Burnout: Higher Resources of the Christian Psychiatrist
November 29, 2016
by Tom Okamoto, MD
A nationwide survey was recently published by The Physicians Foundation, a non-profit organization supporting physicians. They found that 49 percent of 17,000 physicians reported symptoms of “burnout.” The survey cited the primary sources of dissatisfaction were regulatory and paperwork burdens, as well as loss of clinical autonomy.
The concept of “burnout” has been in use for more than 40 years. It includes multiple facets, including exhaustion, work-life imbalance, clinical depression and “weariness.” It has been described as a three-dimensional syndrome of exhaustion, cynicism and inefficacy.
Clearly, being a physician in this era of healthcare is highly challenging, and the risk of burnout is increasing. Under the Affordable Care Act, risk factors for burnout have intensified due to a stronger emphasis on performance and quality measures. Those of us who entered medicine and psychiatry believing in the primacy of the doctor-patient relationship battle to keep from drowning in documentation and regulatory requirements.
The term "psychiatry" was first coined in 1808 by the German physician Johann Christian Reil. It literally means the “medical treatment of the soul.” As Christian psychiatrists, we can claim our mission as medical “soul healers.” We steward our mission to care for patients’ minds and souls expressed through their brains and bodies, while healthy or ill, as they are created and loved by God. It is hard to maintain this stewardship in a non-relational environment of computer screens, EHRs and satisfaction ratings.
As psychiatry moves toward a productivity-driven focus away from the relational process of healing, a highly motivated, caring physician can become exhausted, cynical, depressed or at least soul-weary. As we lose our identity as caring soul healers, we lose the connection with our medical legacy. As Christian psychiatrists, when we are no longer providing soul care, we can feel the loss of meaning and relationship with the patient. When we lose our professional identity and meaning, we can become “burned out.”
As Christian psychiatrists, we practice modern medicine, while also believing in the higher benefits of Christ’s healing through our work. This is healing that other mental health practitioners can’t fully appreciate or appropriate. This is true in our psychiatric practices as well as in our personal lives.
When we ourselves become depressed and burned out, the standard prescription for treatment is limited. Recovery includes a better work-life balance, stress reduction techniques, resilience training, treatment for depression and workplace change.
As Christians, we have a higher resource. Our biggest advantage is our relationship with the Great Physician. We also have the spiritual legacy of the church, with its long history of renewal practices and guidance.
As Elijah fled from Jezebel to Beersheba, his exhaustion and weariness has often been interpreted as an example of depression. His prayer to die is not diagnostic, but provides at least a picture of “burnout.” He is exhausted, so he sleeps. An angel of the Lord then directs him to eat and drink. He touches Elijah, who eats, drinks and sleeps again to become strengthened. This is a picture of the treatment of burnout, soul restoration and self-care directed through God’s representative. As his soul is rested and renewed both physically and mentally, Elijah’s ministry is restored. He is then given directions for returning to his mission.
In Psalm 23, David describes his own restoration, “He makes me lie down in green pastures; He leads me beside quiet waters; He restores my soul…You prepare a table before me…You have anointed my head with oil; My cup overflows” (Psalm 23:2-5, NASB).
This description of God’s renewal reminds us to foster our relationship with Him. As we move to “dwell in His house,” we are led to our souls’ rest. Jesus often broke away from His ministry, retreating to be with God. God’s presence, provision of care and His relationship are renewing. He overflows our cup toward restoration.
When we recognize our own work-life imbalance, become exhausted, become depressed or become weary of our work as Christian psychiatrists, we can remember to obtain self-care, treatment and turn toward God’s restoring relationship. He can then renew us for our privileged mission to heal souls through psychiatric medicine.