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Clinician Burnout: Global Medicine as a Possible Prevention and Treatment Strategy

      To the Editor:
      Physician burnout, composed of emotional exhaustion, inefficacy, and cynicism, leads to diminished job satisfaction and can eventually harm clinicians, their patients and colleagues, and society. Although burnout is a common phenomenon, few consistently successful interventions exist. Institutions rarely address substantive worksite stressors, a major contributor to burnout.
      Studies show that regular volunteering improves mental health and that short-term global medicine experiences, while providing needed global assistance, may also reinvigorate and reengage clinicians on the verge of or experiencing persistent burnout syndrome.
      • Campbell C.
      • Campbell D.
      • Krier D.
      • Kuehlthau R.
      • Hilmes T.
      • Stromberger M.
      Reduction in burnout may be a benefit for short-term medical mission volunteers.
      Over the past few decades, clinician interest in short-term global health experiences has been growing rapidly. The most common global medicine experiences are short-term assignments that may be voluntary or minimally reimbursed and last anywhere from a few weeks to a year.
      Physicians and other health care workers regularly take time off to help populations around the world. In this role, clinicians may provide direct patient care, either through episodic involvement or as part of a sustained effort; clinical and nonclinical teaching; disaster relief; public health interventions; or administrative support for the local health care system.
      In the proper circumstances, short-term global activities can benefit both clinicians and target populations. They are most effective when clinicians participate in either organized disaster relief or in long-term sustainable projects. To be successful, they need appropriate preparation and adequate support from their home institution and family.
      To maximize the benefits from their global medicine stints, clinicians should develop realistic expectations for what they will be able to achieve, what they may experience on site, and how they plan to react to both. This involves locating meaningful programs that require their skill set, meet their goals, and match the periods they have available. Clinicians' health care organizations can help locate groups with which to work.
      • Iserson K.V.
      The Global Healthcare Volunteer's Handbook: What You Need to Know Before You Go.
      (pp261-308)
      In advance of an assignment, clinicians should also learn as much as they can about the host country's history and culture. Experienced colleagues or the organization itself can help them understand the employment and the living conditions they can expect to encounter. This preparation will enhance both their efficacy and the quality of their experiences.
      • Iserson K.V.
      The Global Healthcare Volunteer's Handbook: What You Need to Know Before You Go.
      ,p124
      In preventing or treating burnout, “one size does not fit all.” Future research should investigate what works best for individuals with different burnout patterns and clinical stressors.
      • Leiter M.P.
      • Maslach C.
      Latent burnout profiles: a new approach to understanding the burnout experience.
      With that in mind, the wide array of available short-term global health experiences may provide an avenue/offer a strategy to prevent and treat physician burnout while providing substantial benefit to underserved populations.
      As Campbell et al noted, “People may volunteer for missions with the idea that they will provide necessary services to needy recipients. Yet, a common remark heard among those returning from such mission trips is, ‘I didn't realize how much I would benefit from doing this. I thought I was giving to them, but they actually gave to me.’ ”
      • Campbell C.
      • Campbell D.
      • Krier D.
      • Kuehlthau R.
      • Hilmes T.
      • Stromberger M.
      Reduction in burnout may be a benefit for short-term medical mission volunteers.

      References

        • Campbell C.
        • Campbell D.
        • Krier D.
        • Kuehlthau R.
        • Hilmes T.
        • Stromberger M.
        Reduction in burnout may be a benefit for short-term medical mission volunteers.
        Mental Health Religion Cult. 2009; 12: 627-637
        • Iserson K.V.
        The Global Healthcare Volunteer's Handbook: What You Need to Know Before You Go.
        Galen Press, Tucson, AZ2014
        • Leiter M.P.
        • Maslach C.
        Latent burnout profiles: a new approach to understanding the burnout experience.
        Burnout Res. 2016; 3: 89-100