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Physician Stress & Burnout

By Michelle Mudge-Riley DO MHA

Have you wondered about the impact stress and burnout might be having on you? 

Most physicians enter the medical field believing that hard work and dedication will lead to a happy, successful and satisfying career in the practice of medicine. The sacrifices made through the added years of education and training required to develop medical expertise seem to be well worth it in the journey that culminates in a successful career with wealth, stability and a sense of personal accomplishment and altruistic satisfaction. 

Over the past few decades, amidst growing worries about health care costs and quality, the era of external surveillance and accountability grew. Managed care was born and the large number of preventable medical deaths that occur each year as an unintended outcome of medical interventions was highlighted through media and other channels. This was followed by pay for performance and now new legislation with emphasis on Medicare reimbursement rates and prevention. In short, there has been an increase on the external monitoring and interference on doctors, telling us what we can and cannot do and paying us less for doing it.

A recent article in The Annals of Surgery reported that 40 percent of surgeons reported being burned out and 30 percent screened positive for symptoms of depression. Several other peer-reviewed articles suggest that many of these problems may actually begin during medical school and residency training.  One study reported a 50 percent burnout rate in medical students with 10 percent experiencing suicidal thoughts. 

Last year, a survey conducted by The Physician’s Foundation found that 78 percent of physicians think medicine is either “no longer rewarding” or “less rewarding” and 49 percent of primary care physicians say they will reduce the number of patients they see over the next three years.

Physician burnout is more common than it should be. There are a number of steps you can take if you suspect stress and burnout may be affecting you.

Recognize The Symptoms

Many times, physicians don’t perceive that they’re working under any undue stress, and even if they do, they look at stress as being part of the job. You may recognize the more obvious physical symptoms of stress such as chest pain, palpitations, headaches, muscle pains, panic/anxiety attacks, and gastrointestinal distress, but you may not recognize the more subtle symptoms such as anger, irritability, mood swings, apathy, loss of focus, sleep disturbance, isolation, and an overall sense of frustration and dissatisfaction with what you are doing. Understanding, acknowledging and accepting the fact that you are stressed and that the stress is affecting your moods and behaviors opens the door for the next steps.

Remind Yourself This Is Not A Character Weakness

Remind yourself that you are not invincible, that reacting to stress is not a character weakness, and that you can take steps on your own to help adjust to the pressures of the surrounding environment.  Introspection is often involved and includes re-visiting the question of why you became a doctor, what the you enjoy about the profession and what you could do to reenergize the passion in your medical career.

Reach Out To A Mentor Or Physician Coach

Taking advantage of a physician coach or mentor will help provide the needed expertise to move forward. An external “big picture view” from a knowledgeable person with experience in doing this with physicians can help you put things into perspective and create an action plan to move forward.  This can culminate in a desire to change or offer a new perspective on the current situation.  A recent study concluded that physicians who are dissatisfied might greatly benefit from a personal coach or mentor to decrease the chance that the process of burnout will get out of hand.

Diversify Yourself & Your Career

You may want to take steps to innovate and diversify your current model of practice. You could explore opportunities in a field that is complementary to your current field and interests such as informational technology, public health, genomics, or aging. You could pursue more of an administrative role as a medical director.

Some of the options for a physician who wants to use his or her medical knowledge and skills to do more than practice direct clinical care include medical communications and writing, consulting, teaching, starting a business, working in the medical device or pharmaceutical industry, the wellness and health promotion industry, marketing and sales, business development, finance or grant writing.

A physician is uniquely qualified to pursue any of these options but you must take specific steps to move from the clinical to the non-clinical realm. Although physicians make excellent managers, organizational leaders or entrepreneurs, for a physician to step out of the clinical world into any other job requires a shift in focus and some new skills.  In addition, all of these options carry a particular set of job and lifestyle considerations—for example, what is the salary? Are there opportunities to move up the career ladder? What is lifestyle like? Will travel be involved?

It’s important to realize there are options and there is hope.   Exploring sites like this one, finding others and reaching out to those who have been there or who may be doing what you want to do can be an important and empowering first step.

From the following peer-reviewed article:  Rosenstein, Alan and Mudge-Riley, Michelle.  “The Impact of Stress and Burnout on Physician Satisfaction and Behaviors”.  Physician Executive Journal Vol. 36 No.6, Nov-Dec 2010, p.16-23.

About: Michelle Mudge-Riley DO MHA successfully made the transition from clinical practice to non-direct clinical work and now works for a brokerage firm in Richmond, Virginia as Director of Wellness and Health Promotion.

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