A Physician's Guide to Burnout Prevention | eMedEvents

 Physician burnout is on the rise, which can cause the practice of modern medicine to suffer. It is an issue that affects the entire healthcare system and every type of healthcare professional—not only physicians themselves. At a glance, physician burnout is primarily identified and categorized by: emotional exhaustion, depersonalization, and feelings of diminished accomplishment.

A variety of workplace factors contribute to burnout in healthcare professionals; the major ones include long shifts, demanding on-call responsibilities, lack of appreciation from both coworkers and patients, and poor workplace relationships. Prolonged burnout can result in depression, substance abuse, and even suicidal ideation, alongside an overall poorer quality of patient care rendered by the affected practitioner.

The potential for serious medical errors multiplies when HCP burnout comes into play. It is crucial for hospital management and healthcare professionals themselves to quickly identify and address cases of burnout before patient harm can occur. Healthcare expenditures are under more scrutiny than ever before due to the plethora of lawsuits arising as a result of medical errors.

“Burnout” is a psychological syndrome that can be described as “emotional and tiring situations associated with the working environment”. It typically occurs as a result of various workplace stressors, including an excessive workload, long hours, clerical burdens, managing electronic medical records (EMR), inefficient work processes, difficult patient decisions, poor work-life balance, hostile working environments, and organizational factors—misaligned organization culture, values, and leadership styles.

When a healthcare professional is suffering from burnout, the potential for all types of error increases greatly, such as medication errors, diagnostic errors, and poor decision-making. In these situations, the “best” case scenario is damage to the patient's trust rather than their physical person; yet a patient who does not trust their physician is less likely to adhere to treatment and medication regimens. Additionally, physician burnout has been linked to early retirement, poor overall productivity, job dissatisfaction, higher rates of absenteeism, and difficulty maintaining relationships outside of the workplace.

There is a 22-item, gold-standard self-report questionnaire called the Maslach Burnout Inventory (MBI) that is used to assess burnout. MBI primarily measures three components: exhaustion, depersonalization/cynicism, and personal accomplishment/efficacy. However, it disregards other common symptoms of physician burnout syndrome such as forgetting the purpose of one’s work and resource loss. The MBI's strong emphasis on the emotional process rather than the behavioral and cognitive is another major limitation.

Burned-out medical professionals experience emotional exhaustion, a disconnect from their patients, and a loss of confidence in their abilities. They are also three times more likely to make serious medical errors and twice as likely to get into a serious or near-serious automobile accident, even when adjusting for fatigue.

When doctors spend so much of their time handling insurance paperwork, workers’ compensation claims, or hospital intake requirements, these doctors may experience a loss of motivation and begin to lose sight of why they began practicing medicine in the first place.

6 Signs You May Be Experiencing Physician Burnout

Identifying the symptoms of burnout is a crucial first step in addressing it, whether you are experiencing it yourself or beginning to notice it in your coworkers.

There are 6 main warning signs to watch out for:

1. Stress — Doctors working in high-stress environments are 15 times more likely to burn out. If you have a high threshold for stress, it is possible that you won't immediately notice the strain of a busy ER or an extended workweek. However, even if you are not experiencing the psychological strains, it s essential to remain aware of the other ways in which your body may be signaling to you that you are stressed.

2. Depersonalization of patients — Burnout can be most easily identified within physicians when observing how they interact with their patients. If a healthcare professional is suddenly receiving an influx of complaints regarding their behavior, there is a strong possibility that they are suffering from burnout.

3. Emotional exhaustion — It is not normal to feel intensely drained at the end of every workday. If your emotional exhaustion persists for several consecutive days, you may be experiencing the onset of burnout.

4. Poor personal health — Skipping workouts, poor eating habits, or resorting to unhealthy coping mechanisms are ways that healthcare professionals may try to combat feelings of burnout. Even if these behaviors have not yet developed into serious problems, negative changes in personal care routines or a new reliance on alcohol to relax can indicate burnout. 

5. Persistent mistakes — Burned-out healthcare professionals make more mistakes—usually of increased severity—than HCPs who are not experiencing feelings of burnout. 

6. Depression — Whether you start out feeling emotionally exhausted or depersonalizing patients, research shows that the result of burnout in healthcare professionals is virtually indistinguishable from clinical depression; this means that when burnout occurs, seeking professional help may be the best course of action.

Burnout Prevention Tips for HCPs 

It is exceedingly common for all people—not just healthcare professionals—to feel as though they ought to “work through their burnout. However, research shows that taking the time to properly address burnout leads to fewer errors overall, better patient outcomes, and the delivery of higher-quality care. 

Here are a few effective strategies for stopping burnout before it begins:

Plan time away from the office — In many cases, physician burnout is caused by difficult patients, loads of paperwork, and hard conversations—not overworking. Regardless of the cause, taking extra time away from the clinic (whether this means taking an extra coffee break, an afternoon off, or an extended vacation) can provide much-needed emotional distance from stressful situations. 

Maintain a flexible schedule — Varying the amount, length, and intensity of your shifts (or adjusting your patient hour stobe longer or shorter during certain parts of the week) can keep burnout at bay and does not necessarily require working less. Remember that your health is just as important as your patients’ and refrain from excessively sacrificing personal time for work.

Pursue your passions — Research suggests that burnout occurs when the threshold in which healthcare professionals do the work they are passionate about drops below 20% of their workweek. Whether it is one-on-one time with patients, doing research, or heading up a hospital committee, studies show that taking some time to focus on your passions can promote overall happiness and engagement with your profession.

Pay attention to personal relationships — Spending time with the people you love does not only bolster your work performance it can also treat burnout! Many doctors were trained with the traditional ideal of the self-sacrificing physician who works around the clock. While this mindset may prevent you from getting help when you're burned out, your friends and family are not

beholden to the same ideal. If they begin suggesting that you need a break, try to heed their advice.

Develop a system for handling administrative tasks — Being responsible for many administrative duties is one of the major causes of physician burnout. While delegating all of your paperwork isn't often an option, many doctors have used dictation software, set aside certain hours of the workday for paperwork, expanded their use of EMR software, or started using smart-

billing automation to submit claims on the go. If a certain aspect of your job is unappealing to you, take the time to discover little ways to make it less painful for you.

How to Combat Burnout & When to Seek Assistance 

While prevention is always the first course of action when dealing with burnout, it can sometimes develop despite your best efforts. Treating it is essential, yet that may not always be immediately possible. The unfortunate truth of working in medicine is that healthcare professionals do not always have the luxury of putting their health first. Staff shortages, unexpected influxes of difficult or severely ill patients, and the demands of the job itself can make it impossible to treat burnout—at least, for the moment. 

So how can you deal with it in the meantime?

The first step is remembering the signs. Many doctors who feel burned out also lose their sense of professional effectiveness. If you have been irritable with patients, making mistakes, or impatient with your friends and family, that can lead to feelings of inadequacy as a  healthcare professional, family member, or friend. However, recognizing that these behaviors are common symptoms of burnout can help alleviate some of the feelings of stress and keep the problem from spiraling into a cycle of self-blame. 

Furthermore, it s essential to call out of work when you are sick. For many healthcare professionals, a heavy workload can keep you going to the clinic when you really should stay home. However, working while under the weather can exacerbate symptoms of burnout and I leave you feeling even worse. Calling out sick may seem like a luxury when you have many patients who depend on you, but doing so will help keep you—and your patients—safe. 

Studies show most physicians enter the profession for altruistic reasons and do not often respond to external rewards, which is one reason why (unlike other professions) receiving higher pay does not protect doctors from developing burnout. 

An effective recourse is to look to internal motivators to find a way through if you have a long workday (or month) ahead of you. If you are struggling to complete a task now, is it possible to come back to it later when you may be in a better mindset? If you feel like you do not mesh with the general atmosphere of your workplace, would build stronger connections with your patients and coworkers help mitigate that feeling? 

Even something as seemingly small as reframing your outlook on a situation—such as seeing a stressful period of your work life as an opportunity to hone your skills or personal resilience—can prove a wonderful balm to burnout and help tide you over to a time when you can treat it properly. 

While you may have no choice but to push through burnout temporarily, the repercussions of “pushing through” for longer than you can handle can lead to serious problems like substance abuse or suicide. This is why many medical organizations are creating task forces to deal with HCP burnout. 

At the very least, talking to a trusted mentor, colleague, friend, family member, or therapist about what you are feeling is a good place to start.

The Value of Time Management 

While effective time management will not cure burnout on its own, it can lessen your day's stress and help you feel more in control of your work; feeling as though you lack control is another leading contributor to burnout. It can happen when you feel like things that are % important to you (such as research time, passion projects, or dealing with patients) continuously get put on the back burner in favor of more pressing tasks (such as a never-ending onslaught of paperwork or covering shifts amidst a staff shortage). In these situations, possessing good time management skills is vital to staving off burnout. 

As mentioned before, many physicians use technology to streamline administrative work; for example, using mobile billing apps to submit claims quickly so you won't need to spend hours at the end of the week adding up every procedure and routine you've done. 

Blocking off your time is another way to make good use of technology in burnout prevention: checking your email or EMR inbox only once or twice a day, setting aside designated paperwork time, or doing certain tasks (like setting referrals) in 90-minute blocks can make your workload seem more manageable. 

Finally, remember to prioritize the activities that are important to you, even f they are not urgent; setting aside time to complete your research, attend committee meetings, or take part in a hospital task force is one way to make sure the things you enjoy don't slide to the back burner. With good habits and time management skills, you can feel more in control of your workday—and have more time for the things that matter. 

Whatever coping method you decide on, always remember that it is okay to seek assistance when you need it. The symptoms of physician burnout can be almost indistinguishable from clinical depression; asking for help as soon as you feel like things are too big for you to handle  (or, better yet, before it gets to that point) is crucial for your mental well-being and your physical safety.