An Uncommon Cure for Physician Burnout

A recent Mayo clinic study concluded that almost 50% of physicians are experiencing at least one symptom of burnout. I actually think it's much higher.

Inevitably we're told to cope with burnout using a variety of methods. I take that to mean "Shut up and put up." Well, I've got a different solution for physician burnout. Watch my video where I explain my alternative solution:

Understanding Your Online Reputation As A Physician

By Jeffrey Segal, M.D., J.D. and Michael J. Sacopulos, J.D.

The observation that social media is experiencing explosive growth is hardly novel. Moreover, social media is significantly influencing the medical profession. 

CNN Money.com reported that Facebook passed the milestone of half a billion signed on users half a year into 2010.  The professional and legal ramifications from the rapid growth of social media touch almost every aspect of physicians practicing today.  One of the most challenging of these ramifications is a physician’s online reputation.

Pew Internet and American Life Project recently released numbers that document just how important the source of information regarding medicine and physicians the internet has become.  Sixty-one percent (61%) of American adults look on-line for health information. Forty-nine percent (49%) of Internet users report researching a specific disease or medical problem on the Internet.  Forty-seven percent (47%) report seeking information about their physician or other healthcare professionals from on-line sources. 

Finally, five percent (5%) of “E-Patients” have posted a review online of a doctor. It is these very reviews from a small subset which form the basis of a physician’s reputation on-line.

Most physicians equate a tainted online reputation with a direct loss of business.  The analysis is simple; the worse the online reputation, the fewer the patients.  There are certainly many examples to support this reasoning. 

Dr. Linda Morrison, a physician practicing in Indiana, experienced first hand the harm that arises from an online reputational attack. In July of 2000, Dr. Morrison noticed that an anonymous individual was posting defamatory statements about her via the internet. Dr. Morrison received e-mails from this individual under a pseudonym “Surfycity45” that, among other things, made threats against her medical license.  The attacks continued into the fall of 2000. Dr. Morrison ultimately learned that “Surfycity45” had been circulating defamatory comments about her while simultaneously encouraging others to do the same. “Surfycity45” worked hard to organize a cyber mob with Dr. Morrison as its target.  

Dr. Morrison, via counsel, attempted to enjoin Defendant American Online, Inc. from the continued posting of the defamatory statements about her by the anonymous subscriber.  For a variety of legal reasons, the United States Northern District Court of Indiana ruled against the injunction.  Although Dr. Morrison alleged that “Surfycity45” statements were false, defamatory, and had resulted in damage to her professional reputation as a physician, she was unable to have these remarks removed from the Internet in a timely fashion. The damage was done.  

The implications of a physician's online reputation now extends beyond patients. At least twenty seven (27) states have a recognized cause of action for negligently credentialing a physician. Given this liability, credentialing committees will likely perform detailed background checks using all available search tools, including social network sites.

It is not just patients and credentialing committees which are scrutinizing physicians’ online reputations.  In any  medical malpractice action, physicians should assume that the plaintiff’s attorney will checking the doctor’s online reputation. Geoffrey Vance, a thirty eight (38) year old partner at McDermott, Will and Emry, makes use of social networking sites to gather facts about the opposing side for trials.  “I make it a practice to use as many sources as I can to come up with and to find information about the other side” Vance said.  “We used to run Lexus Nexus; we still do that.  We always look at cases, and now we use the internet – Google, and social networking sites.”

Mr. Vance is not alone.  Paul Kiesel, a lawyer in Los Angeles County, admits to using social media not only to investigate the opposing side, but also to help select jurors.  “Last month I had fifty (50) jurors, and as the Court Clerk read out the names, I had two (2) people in the courtroom and the third person back at the office, with all three (3) of them doing research.”

Lawyers are not the only actors in a courtroom who are using social media at trial.  Courts across the country are grappling with the serious problem of “Internet-tainted” jurors.  In case after case, judges and lawyers have discovered that jurors are doing independent research via cell phone during trials.  Last year in Arkansas, a state court judge allowed a 12.6 million dollar verdict to stand even though a juror sent eight (8) messages via Twitter from his cell phone.

Physicians’ online reputations are being examined with increasing frequency at crucial moments in their professional career.  It is no longer  prudent for a physician to fail to monitor his or her online reputation. “Physicians should carefully monitor their online reputation. I have seen examples of ex-spouses, past employees, and competitors all posing as disgruntled patients in an online effort to damage a physician’s reputation. This is a real threat that is not going away,” says Rivera.

Whether physicians work through organizations such as Medical Justice or Search Engine Optimization companies or go it alone, they need to guard their online reputations. In the words of Benjamin Franklin “It takes many good deeds to build a good reputation, and only one bad one to lose it.”

About: Jeffrey Segal, MD, JD, is a neurosurgeon, is the founder and CEO of Medical Justice Services and has been a speaker at the Medical Fusion Conference.

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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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