The flame that is so strongly lit when applying to medical school commonly dwindles into a slow fade of burnout for many attending physicians. The impact is real and so are the consequences. It affects depression and suicide rates; it worsens patient care; and it has a costly impact. We have discussed that before, though. What I want to discuss today is what I see as five of the most common causes of burnout that happen in the medical field.Burnout: physical or mental collapse caused by overwork or stress.
WorkloadIt is not uncommon for health care providers of all kinds to be asked to see more patients in less time all while trying to adequately document everything in an inept electronic medical record (EMR) system. However, most people go into the medical field to help others. This premise assumes that you’ll actually be allowed to spend an adequate amount of time with your patients. Particularly in primary care specialties, this no longer exists or, at best, it is rare. Balancing the desire to spend enough time with patients with the efficiency required by your employer can be tough. When your expectations (to spend time with patients) do not meet reality (spending time with a computer), disappointment will occur.
Stressful WorkI explain the stress of doing my job to my wife like this: In being an anesthesiologist I have the same work stress other jobs do (you don’t agree with leadership decisions, some of your colleagues are selfish and tough to work with, or someone didn’t like the way you did something). On top of that, I also have other stress related to patient outcomes. When I make mistakes, my patients can literally die. Seeing two pediatric hangings in one week while in residency was tough. I have a bad memory, and I won’t forget that. Ever. I also won’t forget my first intraoperative death when my patient threw a massive pulmonary embolism two weeks into my first month of anesthesia residency. I remember her name, her kids, when it happened. In medicine, we have the normal stress of work, but we also have the stress of taking care of other people and the outcomes these people sometimes face.
Life outside of WorkSpeaking of talking to my wife, we all have lives outside of work. Or, well, we should. I have a wife and three kids. There are friends outside of work. What about our hobbies and interests outside of work? All of these things place demands on our lives. All of them are likely good things, but when these demands are met with the ever increasing demands of work brought home, this can add to the stress and burnout health care providers feel. I have to finish charting at home pretty regularly to make sure all of my charts are closed. Additionally, for two years I had to call possible research participants at home prior to their day of surgery so that they would have time to think about the proposal. When work creeps into what should be a protected space (your home life), this can be dangerous and lead to burnout. I encourage you to set boundaries. Being available 24/7 can cost you at home and lead to worse burnout.
Financial StressStudent loan debt is at an all time high. Remember that for the averages below, there are just as many people above these averages as their are below. I have many friends who have >400,000 in med school debt (not including what their spouse carries). In fact, a resident of mine recently told me he has $500,000 that he anticipates to turn into $700,000 by the time he graduates. If you weren’t aware, here are the current rates of debt for various fields:
- Medical School: $189,000
- PA School: $89,000
- CRNA school: Wide ranging (50k – 150k)
- dental school: $261,149 (this one surprised me, too!)
BureaucracyAdditional work placed on physicians by administration can add to the cumbersome jobs. This includes maintenance of certification exams. It includes paperwork to show your hours. The hassle of EMR’s that sometimes make work harder and less efficient. All of these demands that are placed on top of our time with patients increase the demands on our lives and, thus, lead to burnout. Sometimes scribes, nurses, and other support staff can help decrease this demand. However, these resources are not available to everyone!
Take homeAs with anything, you can’t fix a problem if you don’t first recognize what is causing it. I hope this list encourages you to think about potential sources of burnout in your life so that you can snuff them out. Make a plan to attack these and prevent them where you can.
What are the causes of burnout where you work? Any tips for dealing with them? What are some of the other major causes that I didn’t mention? Leave a comment below.TPP