Ready, Set, Go: Burnout

When I was a child I was in love with the book Go Dog Go, which disturbingly enough has become an accurate reflection of society.  The dogs in the book are always on the move from the moment they get up until they fall into bed at the end of the day.  Americans are constantly on the move.  We never stop, and slowing down is not an option either.  As it becomes harder and harder to get to the next level, stress levels rise and trickle down.  Students can now take high school classes in middle school and if they don’t take these classes they are already behind.  This pressure continues to build especially among overachievers.  Doctors go through a lot of fierce competition to get into college, medical school, and residency, then have to get a job.  This leads to physician burnout.

What are the implications of this highly stressful lifestyle?  And how can a person avoid burnout or recover from burnout?

The Surprising (and Bad) Effects of Stress

A Dutch study found a correlation between stress and cardiovascular disease and diabetes.  The study measured cortisol (a stress hormone) content in hair samples for a three month period of time from 283 older men and women.  They found that those people in the highest quarter for cortisol had about three times the risk for diabetes and cardiovascular disease.  However, there seemed to be no correlation between cortisol levels and the risk for lung disease, cancer, and osteoporosis.

Stress can also lead to people abusing prescription drugs, drugs, and alcohol.  Doctors abuse alcohol and drugs at the same rate as everyone else; however, studies show that doctors abuse prescription drugs more often than the average person.  Lisa Merlo, an assistant professor of psychiatry at the University of Florida, studied 55 doctors who were being monitored by their state physician health program (PHP) because of problems with alcohol and drug abuse.  69% of these doctors had abused prescription drugs, most commonly narcotic painkillers and sedatives.  When asked why they turned to these prescription drugs most of them said “they were self-medicating for physical pain, depression, anxiety or stress in their personal or professional lives.”

Research has also found that unrelenting job pressures have caused 66% of doctors to experience emotional, mental, and physical exhaustion that leads to physician burnout.  Health care workers who experience burnout are at higher risk for substance abuse, lying, cheating, and suicide.  In addition, burned out health care workers are more likely to make errors in regards to patient health and lose a sense of empathy.

How Can Doctors Fight Stress?

Very little is known about how to overcome burnout; however, a possible solution is adopting an attitude of “mindfulness”.  Mindfulness is the ability to be fully present and attentive in the moment.  But how effective is mindfulness is helping people overcome burnout?

Two studies in The Annals of Family Medicine attempted to answer this problem.  The first study asked 45 doctors, nurses, and physician assistants to respond to statements such as “I tend to walk quickly to where I am going without paying attention to what I experience along the way. I find myself listening to someone with one ear, doing something else at the same time.  And I forget a person’s name almost as soon as I’ve been told it for the first time.”  After getting a response the study recorded clinical interactions with more than 400 patients and interviewed the patients to gauge their reactions.  They found that the most mindful doctors were the most efficient and patients were more satisfied.

A second study found that even a short abbreviated mindfulness course was more effective at reducing physician burnout than having no course at all.  According to Dr. Beech, “Mindfulness gives doctors permission to attend to their own health and well-being, but it also allows doctors to help patients by listening more, talking less, and seeing what the patients need.”

Here are some other tips for addressing and preventing physician burnout.

Why Does This Matter?

Besides the fact that stress can contribute to serious health problems, by helping themselves doctors can better help their patients.  Not paying enough attention to a patient’s problems can lead to serious health issues for the patient.  My mom’s doctors didn’t pay enough attention to her and as a result she is always in pain and now it isn’t fixable.  I have seen friends burn out and not reach their potential because nobody taught them how to manage stress.  According to a recent American Psychological Association poll, nearly a quarter of Americans report feeling extreme stress.  If doctors can figure out a way to fight stress than they can help everyone else fight it.