Advertisement
Mayo Clinic Proceedings Home

Physician Burnout: A Leading Indicator of Health Performance and “Head-Down” Mentality in Medical Education—I

      To the Editor:
      In the editorial by Olson
      • Olson K.D.
      Physician burnout—a leading indicator of health system performance [editorial]?.
      published in the November 2017 issue of Mayo Clinic Proceedings, we are alerted toward the looming, seemingly untenable malady of physician burnout by the author's underscoring the fact that creative approaches must be applied to address this critical issue.
      Parenthetically, similar to the United States,
      • Shanafelt T.D.
      • Boone S.
      • Tan L.
      • et al.
      Burnout and satisfaction with work-life balance among US physicians relative to the general US population.
      in some relatively recent studies from other parts of the world, a comparative assessment has revealed a similar, if not higher, prevalence of dissatisfaction with work among practicing physicians.
      • Sharma M.
      • Goel S.
      • Singh S.K.
      • Sharma R.
      • Gupta P.K.
      Determinants of Indian physicians' satisfaction & dissatisfaction from their job.
      • Welp A.
      • Meier L.L.
      • Manser T.
      Emotional exhaustion and workload predict clinician-rated and objective patient safety.
      • Wall M.
      • Schenck-Gustafsson K.
      • Minucci D.
      • Sendén M.G.
      • Løvseth L.T.
      • Fridner A.
      Suicidal ideation among surgeons in Italy and Sweden—a cross-sectional study.
      These similar findings confirm that physician burnout is a critical pandemic rather than an epidemic confined only to the United States. Hence, without undermining the need for transformation of the health care system, a more pragmatic, quick, and sustainable approach to address this issue should be geared toward providing physicians at any level of their career anywhere on the planet with a “tool bag” for self-care.
      The imminent answer to burnout is an individual and proactive strategy with a goal to equip health care professionals at any level of their career (starting at or even before medical school) with practical tools to transform the debilitating effects of day-to-day stress into clarity of vision and practical creativity.
      This goal can be easily and effortlessly accomplished through various ancient holistic self-care techniques that enable us to make a critical choice in a critical situation while the organizational changes take the time needed to be implemented. Studies have shown that such a strategy significantly improves Maslach Burnout Inventory scores for emotional exhaustion, depersonalization, and personal accomplishment (the 3 major domains of physician burnout).
      • Fortney L.
      • Luchterhand C.
      • Zakletskaia L.
      • Zgierska A.
      • Rakel D.
      Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study.
      • Goodman M.J.
      • Schorling J.B.
      A mindfulness course decreases burnout and improves well-being among healthcare providers.
      • Regehr C.
      • Glancy D.
      • Pitts A.
      • LeBlanc V.R.
      Interventions to reduce the consequences of stress in physicians: a review and meta-analysis.
      Einstein said, “we cannot solve our problems with the same level thinking that created them.” With a wide variation in the structure and function of health care organizations all over the world plus various stages in the journey of a health care provider (from being a medical student to even an organizational executive), the answer is not “within the matrix” but outside it. Self-care converts disillusionment in the individual health care professional into vigor, dedication, and absorption in work.
      My experience over the past 9 years and the published reports have revealed this intervention to be a low-cost, engaging, time-efficient way to improve well-being and manage physician burnout symptoms by providing user-friendly tools that health care professionals can apply to their own care as well as the care of their patients. Ultimately, we take the same mind (equipped with the toolkit) with us wherever we go!

      Acknowledgment

      I thank Aadya Kaushik for help with proofreading.

      References

        • Olson K.D.
        Physician burnout—a leading indicator of health system performance [editorial]?.
        Mayo Clin Proc. 2017; 92: 1608-1611
        • Shanafelt T.D.
        • Boone S.
        • Tan L.
        • et al.
        Burnout and satisfaction with work-life balance among US physicians relative to the general US population.
        Arch Intern Med. 2012; 172: 1377-1385
        • Sharma M.
        • Goel S.
        • Singh S.K.
        • Sharma R.
        • Gupta P.K.
        Determinants of Indian physicians' satisfaction & dissatisfaction from their job.
        Indian J Med Res. 2014; 139: 409-417
        • Welp A.
        • Meier L.L.
        • Manser T.
        Emotional exhaustion and workload predict clinician-rated and objective patient safety.
        Front Psychol. 2015; 5: 1573
        • Wall M.
        • Schenck-Gustafsson K.
        • Minucci D.
        • Sendén M.G.
        • Løvseth L.T.
        • Fridner A.
        Suicidal ideation among surgeons in Italy and Sweden—a cross-sectional study.
        BMC Psychol. 2014; 2: 53
        • Fortney L.
        • Luchterhand C.
        • Zakletskaia L.
        • Zgierska A.
        • Rakel D.
        Abbreviated mindfulness intervention for job satisfaction, quality of life, and compassion in primary care clinicians: a pilot study.
        Ann Fam Med. 2013; 11: 412-420
        • Goodman M.J.
        • Schorling J.B.
        A mindfulness course decreases burnout and improves well-being among healthcare providers.
        Int J Psychiatry Med. 2012; 43: 119-128
        • Regehr C.
        • Glancy D.
        • Pitts A.
        • LeBlanc V.R.
        Interventions to reduce the consequences of stress in physicians: a review and meta-analysis.
        J Nerv Ment Dis. 2014; 202: 353-359
        • Afifi N.
        The Heart and Science of Yoga conference review: have you met your inner wisdom?.
        (SCPMG Physician Wellness website) (Published January 23, 2017. Accessed December 25, 2017)

      Linked Article

      • Physician Burnout—A Leading Indicator of Health System Performance?
        Mayo Clinic ProceedingsVol. 92Issue 11
        • Preview
          Like the proverbial canary in the coal mine that alerts miners to the need for course correction, physician burnout provides an early indicator of health system dysfunction in time for decision-makers to change course and avoid health system failures. In this issue of Mayo Clinic Proceedings, Sinsky et al1 report that physicians may be exiting their careers in medicine faster than they enter; their intentions to withdraw are highly correlated with burnout (odds ratio [OR] 5.8). Also in this issue, Shanafelt et al2 advocate to proactively monitor and manage professional burnout and wellbeing in individuals as a way to avert crises.
        • Full-Text
        • PDF
      • In Reply—Physician Burnout: A Leading Indicator of Health Performance and “Head-Down” Mentality in Medical Education—I and II
        Mayo Clinic ProceedingsVol. 93Issue 4
        • Preview
          I agree with Drs Peck and Viswanath, that residents should be transitioning into their careers “invigorated and excited.” The fact that most physicians are experiencing burnout, and it is particularly high among residents, indicates a need for course correction. I concur with the logic that it is best to treat the root cause rather than its adverse effects. As I indicated in my editorial, the evidence suggests that the work and workplace stressors are the predominant drivers of physician burnout and the ensuing withdrawal from clinical practice, which frustrates our ability to provide the population with access to affordable high-quality patient-centered care.
        • Full-Text
        • PDF