PRSonally Speaking

Tuesday, September 24, 2013

Am I Burned Out?
by Stephanie Rowen, MD
As the mother of a 10-month-old daughter, I’m still trying to figure out how to balance my work and home life.  I feel pressure to be everything in both arenas.  At work I hear about efficiency, doing more with the same or less, patient-driven access, service.  At home I want to be a supportive involved parent and a loving, caring spouse.  I feel pulled in many directions and feel like I need Botox just to keep my brows from furrowing all day long.  Am I burned out?
Physician burnout seems to be a buzzword as we face the imminent squeeze on the healthcare system when many more Americans will have access to health insurance next year.  I was struck by a New York Times article last month, “The Widespread Problem of Physician Burnout” about a recent study published in Archives of Internal Medicine.  The medical journal article, “Burnout and Satisfaction with Work-Life Balance Among US Physicians Relative to the General US Population” by TD Shanafelt, MD, et al, states that almost half of the more than 7000 physicians surveyed reported at least one symptom of burnout.  Compared to other Americans in the workforce, we as physicians have a statistically significant greater risk of burnout.  Another article, “An Interactive Individualized Intervention to Promote Behavioral Change to Increase Personal Well-Being in US Surgeons” from the same lead author in Annals of Surgery, looks specifically at surgeons.  Surgeons were found to be poor judges of their well-being as almost 90% rated their well-being as at or above average while over 70% had scores on the Mayo Clinic Physician Well-Being Index that were in the bottom 30%.
What does this mean for plastic surgeons?  I think we suffer from burnout as much as our other surgeon colleagues, though we probably do not even know it. Knowing is only the beginning. What can we do about it?
We all struggle with work-life balance.  What IS work-life balance?  Is there ever balance?  It seems to be more of a teeter-totter than a balance.  We feel torn between work, families, hobbies, exercise, friends….  As a “caring” profession, we tend to put our patients first and ourselves second.  We want to do the best we can for our patients, even if it means staying up all night, skipping that outing with friends, missing Thanksgiving dinner. 
In 2014 it is estimated that 30 million or more Americans will have access to health insurance who do not have it today.  What will these newly insured people mean for us?  More work, less compensation, less time for ourselves.  “Efficiency” is another buzzword, along with “technology”. I would argue that “physician well-being” should be as important a buzzword as those.  We cannot provide quality medical care to anyone, let alone 30 million more people, if we do not take care of ourselves.
Large HMOs realize this. They have been putting a lot of emphasis on physician health and well-being.  I am on the “Physician Health and Well-Being Council” at my facility.  There is a lot of effort and money being put toward programs to help physicians fight burnout.  Programs are offered to physicians to encourage camaraderie between specialties, to encourage healthy eating, to encourage physical exercise and to encourage mindfulness based stress reduction.  For those physicians who do not have access to these opportunities through work, it is important to find ways to address these issues in their own lives.  We encourage wellness in our patients, but we need to remind ourselves that we are patients as well.  It is becoming more and more important as we become busier and face even more patients in the coming year.  The numbers from the studies above are sobering.  We need to address burnout together and as individuals more so now than ever.
For me, I am definitely going to take the mindfulness based stress reduction seminar, exercise as much as I can and spend quality time with my family as I watch my daughter grow up.  Botox wouldn’t hurt either.