The Final Word: Be aware of burnout, acknowledge stress and pursue a healthy work-life balance
There is a terrible epidemic in medicine today. It’s called burnout. JAMA recently published a review of all the papers on the incidence of burnout in physicians and concluded that it is 72 percent! Burnout is a state of emotional and mental exhaustion caused by excessive and prolonged stress. Burnout in physicians is a disaster. It results in poor judgment, hostility toward patients, medical errors and difficult relations with co-workers. It produces depression, anxiety, sleep disturbance, fatigue, broken relationships and early retirement. It costs each hospital in America $1.3 million per year.
What’s causing this? Physicians are faced with too many bureaucratic tasks, too many hours at work, lack of respect, increased computerization and insufficient compensation. Being a doctor is stressful. There is great responsibility with little control over outcomes. We work with sick people all day. We have a hard time maintaining boundaries between work and life. We may not have asked to be leaders but we’re the ones giving orders.
It is no wonder that we are exhausted! It’s no wonder that we fail to connect to others. It is very easy to become calloused and cynical. At times the work is overwhelming and seems without value or meaning. We can’t always be all things to all people. We know that our careers are supposed to produce feelings of fulfillment and satisfaction. How do we achieve true meaning for our lives?
I now spend my time teaching medical students. I promise them that being a physician can be the most wonderfully rewarding way to spend their lives but that they need to be aware of making it an all-consuming full-time job. They must be aware that it is easy to ignore the possible problems of stress. Burnout is even a problem for medical students and residents.
We all need to acknowledge and assess the problems of this evil. Everyone needs to develop a community of support. We are not in this alone. Everyone needs a system of dealing with stress. There have to be organizational practices and policies that help us develop a balance between life and work. We have to control the number of work hours. It is imperative that we control work. There has to be a focus on work activities that provide the most meaning. We all need to work on leadership ability. We can’t always have others telling us what we must do. It is possible to reduce clerical work and improve efficiency. We must learn to delegate.
But the most important factor to prevent burnout and have a successful life is to have a balance. Our lives must have more than just work. There must be a physical aspect, a spiritual aspect and a relational aspect. My friend and fellow neurosurgeon, Joseph Maroon, has written a wonderful book: Square One: A Simple Guide to a Balanced Life. In this book we have the answer to burnout.
The physical side of our lives must include exercise and a proper diet. We must think about what we are putting into our bodies. We should keep track of the number of hours that we are sleeping. We should never use elevators unless we are pushing a stretcher. Make time for vigorous workouts.
The spiritual side of our lives must provide time for meditation. Keep a gratitude journal. We must never lose sight of the purpose of our lives. Be mindful.
Then the relationship side of our lives is absolutely critical. We must know the language of love: words of affirmation, quality time, gifts, acts of service and physical touch. Have you told anyone that you love them today? And it is not just your spouse. We must all have a cadre of colleagues that support us. The practice of medicine demands that we must have people that we can tell about our difficult patients, our frustrating tasks, and our conflicts. We all need friends. Cultivate community in the work place. Health care is a team sport.
Burnout is not inevitable, but be aware that we are in an epidemic. So stop for a moment and make sure that it will never happen to you and that you will never let it happen to your friends!