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Reducing Physician Burnout
Fried … Crispy … Done ….
However the feeling is labeled, burnout is endemic among physicians—and on the rise. Recently, 250 physicians and senior administrators from across Johns Hopkins Medicine gathered at a leadership retreat in the Washington, D.C., suburbs to discuss ways of regaining and maintaining positive feelings about their work.
The statistics for physician burnout are alarming: More than half of the physicians—54 percent—who responded to a national survey in 2014 reported losing enthusiasm for their work and feeling that it was no longer meaningful. The survey of 6,880 physicians, conducted by the American Medical Association and Mayo Clinic, showed that burnout was 9 percentage points higher than it had been three years earlier.
Burnout not only “saps the joy from practice” but can also compromise patient care, says Redonda G. Miller, president of The Johns Hopkins Hospital. “If you can’t take good care of yourself, it’s harder to take care of others.”
She shared these thoughts at the leadership retreat held in May at the Chevy Chase Club in Chevy Chase, Maryland. The daylong program was organized by plastic surgeon Diane Colgan, chair of the Suburban Hospital medical staff, and featured speaker J. Bryan Sexton, director of Duke University’s Patient Safety Center and former co-director of the Johns Hopkins Quality and Safety Research Group.
The 2014 study found that practitioners at the front lines of medicine exhibited the highest levels of burnout. But physicians across all specialties are twice as likely as other professionals to report symptoms of burnout. (See the accompanying chart showing burnout by specialty, based on a 2015 survey by Medscape.)
What’s more, burnout is contagious, says Sexton. He cited one study that found some neonatal intensive care units (NICUs) with high levels of burnout and some with low ones. But within each NICU, there was little variability in burnout level. Team members from the same NICU had similar levels of burnout, especially when they had worked together for at least six months.
Sexton blamed long hours, poor work-life balance, and an often overwhelming amount of paperwork and documentation for contributing to career exhaustion. He offered two exercises to help physicians reconnect with their love of medicine and clinical practice. He advised them to:
- Write down three things that went well that day, just before going to bed. For example, one entry might be, “My first patient was on time and showed improvements in symptoms.” Also, provide details of what you did to create or contribute to this event and how it made you feel.
- Write a letter expressing gratitude to a person who has had a positive and lasting impact on your life and share the letter, preferably by reading it aloud to its recipient. If the person is deceased, read the letter aloud to someone who knew that person well.
Both exercises seek to extract the gold from the dross in medical practice by encouraging physicians to see beyond drudgery and frustration to focus on what’s meaningful and fulfilling in their work.
Sexton urged his listeners to help colleagues realize their strengths and reach their full potential. “Such meaningful connections are the strongest guard against burnout,” he said. “Chase meaning to get happier—and to rediscover your love of medicine.”