Session 47

In this episode, I talk with Dr. Dike Drummond about a common and serious issue in the medical world today—physician burnout.

In fact, burnout is found to happen to one in three physicians. Not only do physicians experience burnout but medical students do as well. And don’t blame it on the electronic medical records (EMRs). Surveys on the prevalence of physician burnout have actually been down in the last 20 years.

Although we have the intention to heal other people as physicians, sometimes we forget to take care of ourselves. This is something that needs to be discussed. Physician burnout seems to be invisible, but it 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 power of mindfulness. Lastly, learn about the squeegee breathing technique to help you get through the day with more awareness and less stress.

Listen to this podcast episode with the player above, or keep reading for the highlights and takeaway points.

What is Physician 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)
• And Scale 3 – Lack of efficacy (Self-doubt about the work they do)

Looking at Burnout Through the “Disease” Paradigm

• Stress as the cause of burnout
• Burnout as the disease

[Related post: Avoiding the Burn: 7 Tips for Premeds and Medical Students.]

The Prevalence of Physician Burnout

• Physician burnout 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).

Factors that Contribute to Physician Burnout

• American health care environment
• Acceleration of change in the health care system
  • Big data and EMR getting in between the physician and the patient

Subconscious Programming Physicians Tend to Take on During Training

• “The patient comes first.”
• “Never show weakness.”

The “Patient Comes First” Mindset

• Programming we receive in training
• The difficulty of recognizing our needs like rest, sleep, emotional, and personal self-care
• Self-care as a blind spot that underlies everything else
• Multifactorial aspect to burnout: 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.

[Related episode: A Burnout Story and What You Can Do to Avoid It.]

Burnout in Male vs. Female Physicians

These details are based on the Maslach Burnout Inventory.

How men experience burnout:

1. Cynicism and sarcasm
2. Exhaustion

Men don’t often go to “self-doubt.” So these doctors get tired, cynical, and sarcastic, but they still believe they’re doing good work.

How women experience burnout:

1. Exhaustion
2. Cynicism and sarcasm
3. Questioning the quality of their work
4. They ask for help or tell somebody they’re not doing well

Women comprise 85% of Dr. Drummond’s clients.

Medical Error Rates Associated with Physician Burnout

• The 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 are affected by physician burnout:
  • Patient satisfaction rate
  • Turnover rates for physician and the staff members
  • Malpractice risk
  • Divorce
  • Alcohol addiction
  • Suicide

Common Coping Mechanisms for Burned Out Physicians

• Workaholic
• Superhero
• Emotion-free
• Lone ranger
• Perfectionist

How to Avoid Burnout as a Premed, Med Student, or Physician

1. Acknowledge your self-care needs.
2. Balance your life as you go through your training.
3. Acknowledge your humanity, and reach out to others who seem to be struggling.
4. Be okay with asking for help.

Balancing Medicine and Family Life

There is no such thing as “balance in the moment.” In each moment, you’re either studying 100% or you’re with your family 100%. But over time you find balance.

You have to take care of your needs first.

[Related episode: How to Protect Your Relationships as a Premed and Med Student.]

The Powerful of Mindfulness for Avoiding Burnout

• Having awareness in the moment
• Noticing the way you breath
• Noticing the way stress makes you hold your shoulders
• Releasing stress in the moment and being present with your breathing

[Related episode: How Can I Learn to Relax and Destress for the MCAT?]

How to Be Burnout-Proof

• Acknowledge the end of your humanity and the need to perform.
• Recognize whenever you’re using unhealthy coping mechanisms, and learn how to put them away.
• Develop a mindfulness practice through meditation or yoga.
• Dr. Drummond shares the squeegee breathing technique.

Advice for Premeds, Medical Students, and Physicians

You are not a doctor. You’re a human being who’s chosen to practice the craft of medicine as a way to make a difference in the world. But it’s not who you are. There is more to you and your life. Shut off medicine when it’s time to, and relax into the rest of you.

Links and Other Resources

• Follow Dr. Drummond on Twitter / blog /Facebook.
• Article: Burnout and Satisfaction With Work-Life Balance Among US Physicians…
• Article: Burnout and Suicidal Ideation among U.S. Medical Students
• Related episode: The Dark Side of Medical Education: Premed Through Residency.
• Need MCAT Prep? Save on tutoring, classes, and full-length practice tests by using promo code “MSHQ” for 10% off Next Step full-length practice tests or “MSHQTOC” for $50 off MCAT tutoring or the Next Step MCAT Course at Blueprint MCAT (formerly Next Step Test Prep)!