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STRESS, BURNOUT AND REFUELING

Learn about the prevalence of burnout among physicians, its consequences, and coping strategies to prevent and alleviate burnout. Explore the importance of physician wellbeing for quality patient care.

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STRESS, BURNOUT AND REFUELING

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  1. RUNNING ON EMPTY: STRESS, BURNOUT AND REFUELING Sandra L. Frazier, MD Assistant Dean of Professional Development

  2. You might be burned-out if: • You consider a 60 hour work week as part-time • You are jealous of the Walmart greeter • You think about how relaxing it would be if you were in jail right now

  3. Why is this topic so important? Quality Cost Patient Experience/ Outcome Wellbeing of clinicians

  4. OBJECTIVES • Define burnout and explore its prevalence among physicians • Identify possible consequences of burnout • Learn coping strategies

  5. 44 year old surgical subspecialist cc: “wrong site surgery” Career Background – AMC, Teacher of the Year, PD, highest producer, Section Chair, significant increase in administrative duties Social Background – married with 2 children ages 7 and 9. Felt so bad about complaining to his wife that now he sits at home in silence CASE EXAMPLE

  6. “How could this happen? Patients used to always be forefront in my mind. Now, I am so distracted with all I have to do. Should I just quit? I am so unhappy. But I can’t go back in time. I can’t tell my Chairman that I don’t want to be PD or chief. He’ll think I’m weak and he’ll be so disappointed. I just want to teach and take care of my patients. I don’t enjoy coming to work anymore.” CASE EXAMPLE (CONTINUED)

  7. A state of emotional, mental, and physical exhaustion caused by excessive and prolonged stress ICD-10 Burnout Z73.0 – “a state of vital exhaustion”

  8. STRESS CONTINUUM Eustress Distress Burnout o o o (too much) Burnout - a. Emotional exhaustion b. Depersonalization c. Decreased sense of accomplishment

  9. STRESS

  10. Common Signs and Symptoms of STRESS

  11. Over engagement Over reactive emotions Urgency, hyper-activity Physical exhaustion Anxiety disorders Physical damage Stress may kill you prematurely, and you won’t have enough time to finish what you started Disengagement Blunted emotions Helplessness, hopelessness Mental exhaustion Detachment, depression Emotional damage Burnout may never kill you, but your life may not seem worth living STRESS VS. BURNOUT Dr. Arch Hart – Professor of Psychology

  12. RECENT STATISTICS MAYO • 2011 45.8% at least 1 symptom • 2014 54.4% at least 1 symptom Medscape Lifestyles Report • Percentages of physicians reporting burnout - increased in nearly all specialties 2014-2015 • Top 5 – critical care, urology, EM, FM, IM

  13. Medscape 2016

  14. BURNOUT BY GENDER Medscape 2016

  15. Too many bureaucratic tasks Spending too many hours at work Increasing computerization of practice Inability to provide patients with the quality of care they deserve Feeling like just a cog in a wheel Too many appointments in a day Differences with colleagues, staff, or employer Compassion fatigue (overexposed to death, loss of patients) what are common work causes? Medscape 2016

  16. Erosion of professionalism More medical errors Absenteeism Decreased quality of care Relationship difficulties Depression/suicide Substance abuse Physical illness CONSEQUENCES OF BURNOUT

  17. COPING STRATEGIES/PREVENTION

  18. PROACTIVE STRATEGIES • stress and energy drain • ability to recharge

  19. YOU - ↓ STRESS • Increase self awareness • Practice mindfulness • Ask what went well/why? • Learn to delegate • Learn relaxation techniques • Express gratitude • Journal • Learn to say “no” • Develop your spirituality • Seek help

  20. YOU - RECHARGE • Perform a random act of kindness • Keep a life schedule • Focus on healthy lifestyle • Pursue a hobby • The “walk through” • Take your vacation time • Reflect on your “Pt. Hall of Fame” • Try some “me” activities

  21. OTHERS • Invest in healthy relationships • Agree to neighborhood watch • Identify peer/faculty mentor • Reflect regularly with at least one person • Give others benefit of the doubt/seek first to understand • Add variety to work activities

  22. COMMUNITY/ORGANIZATION • Have team retreats • Provide on site child care • Develop wellness committee • Develop a peer support program • Establish float pool coverage • Identify a group charity • Volunteer • Support community events • Join a non work group • Take a “service” trip

  23. PROFESSIONAL DEVELOPMENT OFFICE

  24. PROFESSIONAL DEVELOPMENT OFFICE • Sandra L. Frazier, MD Assistant Dean of Professional Development sfrazier@uabmc.edu • Phone (205)731-9799 • Website: www.uabhealth.org/physicianhealth

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