Professional Well Being and Burnout
Professionals study and train to work intense hours. To feel successful, many professionals wish to make the world a better place. Transforming a city, relieving suffering, improving health care or education, and the protection of human rights and well being, are just some of the ways high performance professionals may define success.
Unfortunately, despite humanitarian goals and personal resiliency including developed and honed character strengths, many professionals are on the edge of burnout. For example, studies show that 70 to 80 percent of health care providers have features of vicarious trauma, also called compassion fatigue. Some of our hard working professionals despite trying to help others, are getting progressively exhausted. Eventually, the strain on the nervous system can lead to difficulties such as increased fatigue, decreased patience, poor sleep, and other erosions of personal resiliency.
BURNOUT
Burnout is increasing in high performance professionals. Experts in Burnout in centres such as the Mayo Clinic, Harvard, and Stanford are developing services, tools, apps, and programs to prevent burnout. Scientific studies are guiding experts in identifying key wellness tools that show what works, and what doesn’t. The science of wellness, or well being, is expanding.
What is burnout? Simply put, burnout is a state of lower quality of your daily life, despite an ability to function. Less enjoyment. Less fun. Less curiousity. Less positive outlook. Classically, burnout is defined as emotional exhaustion, depersonalization and a lost sense of personal accomplishment. Emotional exhaustion can look more like mental fatigue, or a weariness when starting the day.
Burnout is different than depression, which is why it can be important to have a medical expert discuss possible burnout with you. Depression will interfere with function and/or cause high distress, whereas burnout interferes with quality of life without significant impairment or distress.
HEALTHCARE PROVIDER BURNOUT
There are many reasons for burn out. For example, our health care system is seeing more burnout in health care providers, first responders, and other public safety personnel. The body of scientific research is growing, with studies showing those working in fields to provide services to protect and care for the general public, have increased rates of vicarious trauma, acute stress, occupational stress injury, PTSD, anxiety, and depression.
If we use doctors as an example professional population experiencing burnout, we can note that about 70% of physician residents across Canada are burned out, and approximately 50% of doctors or more are experiencing burnout. More doctors are leaving medicine than ever before. Rates of depression, suicidiality, and suicide are increasing (1,2).
Doctors, like many other professionals, avoid identifying or seeking help because of an often subconscious or unconscious concern of not looking strong enough, good enough, and feeling shame for the depth of suffering that can often show up in the face of a struggling health care system, increased stress and acuity, increased time pressures, complexity of cases, etcetera.
Recent studies on physician burnout indicate the following rates based on a Medscape survey (3) of over 15,000 physicians:
Urology: 54%.
Neurology: 50%.
Nephrology: 49%.
Diabetes and endocrinology: 46%.
Family medicine: 46%.
Radiology: 46%.
Psychiatry: 35%.
Otolaryngology: 35%.
General surgery: 35%.
Orthopedics: 34%.
Ophthalmology: 30%.
Public health and preventive medicine: 29%.
For male physicians, you may have developed emotional intelligence over the years of your training. However, there may be some aspects of adapting to the empathic response to patient suffering that you may be struggling with. Understanding how your male brain uniquely responds in an empathic way could help you reduce mental and emotional fatigue from your work, and find more lightness and success in your medical practice.
For female physicians, the rates of burnout can be higher than those for men. More than 70% of female physicians have reported gender discrimination, including disparaging or disrespectful treatment or comments, lack of career promotion, disparities in resources, rewards, and reimbursements. Lee Lipsenthal reports that women physicians have 1.6 times the odds of burnout, and that these odds increase when they work additional hours over 40 hours in a work week. Dr. Lipsenthal also notes that research shows that female physicians have a life expectancy ten years lower than that of the general population in the same socioeconomic category. Although these statistics are dated, there is a recognized greater complexity to the cases that comprise a female physicians practice, and there is a different counter-transference from patients towards female physicians. Understanding how to react more effectively to patient counter-transference, complex cases, and gender disparity can potentially help you to find a buoyancy where there once was fatigue (4,5).
For both male and female physicians, although studies show that they led healthier lifestyles, physician overall mortality was higher than other professional groups. Understanding on a scientific level, what may contribute to this fact, and how to potentially prevent lower well being due to specific stresses, can be useful.
DO YOU NEED TO PREVENT BURNOUT?
Do you relate to any of the above descriptions of aspects of burnout?
You may not be a doctor, but you may have similar pressures in your job. Increased responsibilities, an increased pace, higher workload expectations, high acuity or the problems presenting themselves, greater degrees of complexity, and more administrative duties may be some of the elements you are facing in your current job.
Despite the massive increase in data and technology, many professionals are using technology to work even harder. In addition, working from home, losing sleep, neglecting exercise and relationships, and self care, are all too familiar results of burnout where the person starts to lose the joie de vivre, the life force energy and spark, the spring in their step, that they used to have.
Maybe this is you, maybe this is a colleague.
SUCCESS + WELLNESS
So the next question is, how do you prevent burnout? There are a variety of approaches. the more you understand the science of wellness, and the importance of self care, the better. The more you take time to reflect, and accept, and commit to living aligned with your values, the better. The more you can accept and come to terms with, and even honour, your very human strengths and vulnerabilities, and your realistic capacity, the better.
Often the development of resilience is a more customized approach. In addition to putting into action the lifestyle approaches, there are unique strengths that you can ignite with individual or group wellness and resiliency sessions. Your personal strengths in terms of motivation, perspectives on your self and the world, your understanding of your values and gifts, and the practical aspects of the building blocks to create a resilient brain and heart and body all play into your prevention of burnout.
Consider taking care of yourself, and dedicating time to learning more about ways in which you can become more resilient. A few key tips are:
create a sleep schedule that works for you and stick to it
enjoy time in a natural setting to decompress at least once a week
learn how to deepen relaxation through activities, mindfulness, meditation, and proactive rest
take more breaks during the day
decrease your screen time
learn more about how to build a resilient nervous system
Wishing you the best always,
Dr. M. ~
References
2019 Editorial Physician Burnout: A Global Crisis. The Lancet. VOLUME 394, ISSUE 10193, P93.
2020 Perspective. Authours: Pamela Hartzband, M.D., and Jerome Groopman, M.D. Physician Burnout, Interrupted. NEJM. 382:2485-2487
Medscape National Physician Burnout & Suicide Report 2020: The Generational Divide
2000 Article. Authours: Julia McMurray et al. The Work Lives of Women Physicians. J Gen Intern Med. 15(6): 372–380.
2007 Book. Authour: Lee Lipsenthal. Finding Balance in a Medical Life.