In this episode, Ryan talks with Dr. Dike Drummond as they talk about a common serious issue in the medical world today – physician burnout. In fact, burnout is found to happen to one in three physicians. Not only physicians experience burnout but even medical students as well. And don't blame it on the EMRs. Surveys on the prevalence of physician burnout have actually been done in the last 20 years.
As physicians, we have the intention to heal other people that sometimes we tend to forget to take care of ourselves. This is something that needs to be discussed because physician burnout seems to be invisible and no one is noticing. However, physician burnout can take its toll on your practice and your life in general.
Listen in to learn more about what burnout is, how it’s measured, how to avoid it, and the powerful for mindfulness. Lastly, learn about the squeegee breathing technique to help you get through the day with more awareness and less stress.
Here are the highlights of the conversation with Dr. Drummond:
What is burnout?
A cluster of symptoms measured by the Maslach Burnout Inventory
Scale 1 – Measurement of Exhaustion (downward spiral trajectory)
Scale 2 – Deep personalization (compassion fatigue)
Scale 3 – Lack of efficacy (Self-doubt about the work they do)
Looking into the “disease” paradigm:
Stress as the cause of burnout
Burnout as the disease
The popularity of physician burnout:
Physician burnout prevalence surveys have been done for 20 years
One in three practicing doctors is suffering from symptomatic burnout on any given office day (regardless of country, delivery systems, and specialty)
“It takes happy doctors to have happy patients.”
Factors that contribute to physician burnout:
American healthcare environment
Acceleration of change in healthcare system (big data and EMR getting in between the physician and the patient)
Subconscious programming physicians tend to take on during training:
“Patient comes first.”
“Never show weakness.”
The “Patient comes first” mindset:
A programming we receive in training
The difficulty of recognizing our needs like rest, sleep, emotional, and personal self-care
Creates the blind spot that underlies everything else
Multifactorial aspect of it – stressed patients come to you plus you still have to take care of the EMR plus you're supposed to be available for your kids and your spouse
Burnout rates in men vs. women (based on Maslach Burnout Inventory):
How men experience burnout:
- Cynicism and sarcasm
*They don't get to “self-doubt.” So doctors get tired, cynical, and sarcastic but still believe they're doing good work.
How women experience burnout:
- Cynicism and sarcasm
- Questioning the quality of their work
- They ask for help or tell somebody they're not doing well
*Women comprise 85% of Dr. Drummond's clients.
Medical error rates associated to burnout:
- Medical error rate is higher the more burned out you are
- Variation in the standard of care is wider in the burned out population
- What other rates go up:
- Patient satisfaction rate
- Turnover rates for physician and the staff members
- Malpractice risk
- Alcohol addiction
Coping mechanisms that turn into survival strategies for burned out physicians:
- Lone ranger
How to avoid burnout:
- Acknowledge your self-care needs.
- Balance your life as you go through your training.
- Acknowledge your humanity and reach out to people who seem to be struggling.
- Be okay to ask for help.
Balancing career and family life:
There is no such thing as “balance in the moment”
It's either you're studying 100% or you're with your family 100%
You have to take care of your needs first
The powerful of mindfulness:
Having awareness in the moment
Notice the way you breath.
Notice the way stress you hold your shoulders.
Learn how to release stress in the moment and be present with your breathing.
How to be burnout-proof:
Acknowledge the end of your humanity and the need to perform.
Recognize whenever you're using those coping mechanism tools and notice how to put them away.
Develop a mindfulness practice through meditation or yoga.
Dr. Drummond shares the squeegee breathing technique!
Some pieces of advice for premed students:
You are not a doctor. You are a human being with a larger life who's chosen to practice the craft of medicine as the way to make a difference in the world. However, it's not who you are. Shut it off when it's time to and relax into the rest of you.
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