Monday, September 10, 2012

Physician Burnout: It's Inevitable, But Not Unavoidable

If you have given any consideration to a career in medicine, you have heard about physician burnout. But never fret: Dr. Jewell offers some advice on how to deal with the stresses of a medical career in this guest post:

Doctors are in some way or the other responsible for maintaining the balance of the yin and yang of the universe - well at least that is what they are trained to believe throughout their tenure at medical school. The practice of medicine manages to portray itself as attractive and “fun” during the first couple of years after college, but the fun aspect gradually takes a backseat and eight or 10 years down the line they get engulfed in the burnout pedantic. Experts believe that this is because of the medical training that the physicians receive (or lack of it actually) and also because how people generally define “success”. The problem is there is only one parameter to measure success - busy practice. More often than not the success of a physician is defined by his workplace pressure and his ability (or inability) to continue performing on the trapeze wire that losing balance. Here are the few reasons of physician burnout and how it can be avoided:

  • The job is “stressful”: Well, how would you define that? Some of the more demanding professions such as that of a physician or a lawyer are characterized as having a heap of responsibility with very little control on the final outcome. Like it or not, the job is one of the most demanding ones and needs one to keep performing under pressure without succumbing to it. It definitely saps all energy every day, day by day.
  • Physicians are taught to solve problems - not to bask in them! A typical physician encounters hundreds of physically and mentally sick patients throughout the day and he is always expected to be the problem solving machine and hardly a human being (with a whole bunch of emotions affecting performance). Here, the problem does not lie with the profession - the training provided to medical students does not adequately equip them to handle emotional pressure.
  • The balance is always tipped! Throughout medical school a medical student is taught to shove aside all priorities of life and focus only on medicine and its charismatic capabilities of transforming others' lives. The problem is medical school does not last a lifetime but the training continues to dominate the students and somewhere down the line family responsibilities start qualifying as “other priorities”. Here also, it's the training mythology that is to be blamed when some elemental changes would definitely make things better.
  • A physician is always expected to have leadership skills but is never taught the same. Military and medicine are two different professions their leaders are only expected to give the orders, but in the latter the so-called leaders are never made to attend even a single lecture on leadership. The dysfunctional top-down leadership system not only leaves a health care delivery team confused but also puts more stress on the “leader” himself.
  • A doctor is almost always considered as a machine. A physician is supposed to be able to keep performing under pressure and never succumb to it. He is always expected to be the perfect decision maker and service provider in front of his teammates, customers and hospital governing bodies. That definitely saps emotional and mental strength.
  • So much work and you still have to deal with the money part! More on healthcare system might be a blessing for patients because they can choose to remain blissfully unaware of the twisted proceedings of medical insurance companies, but the physician is never spared. He is expected to have all knowledge about all kinds of insurance companies and also be able to make sure that his cut comes to him without bothering his patient.
  • There is always an uncertainty about what's going to happen next. No marketing guru can perfectly predict the career course of a physician. So, the subconscious is always worried about what plans the future has for the physician. That is definitely emotionally taxing.
  • Medical practice is like a ticking bomb. Medical science has evolved tremendously over the last couple of years, but so has the legal noose that almost always is concerned only about patient benefits and rights. A physician is always silently waiting for the bad stuff to happen and that is emotionally taxing.
  • Too much pressure and you eventually get hurled into a lifelong emotional trauma. That is exactly what happens with physicians. All of a sudden nothing seems to make sense and the volatile love for medicine disappears suddenly. That is the end state of a burnout.

Word of advice
Burnout is inevitable under the circumstances and in most cases physicians seem to accept it as a way of life. The good news is this can be avoided. Solution on this is quite apparent! Stick to your reason or purpose of becoming a doctor! After spending quite a lengthy span of your life in medical studies, it's obvious to get bewildered when you see the purpose behind your endeavor is lost for some reason. Now, you have to jump in and establish the connection back, for it’s a source of your motivation and endurance.

Some of the important signs of a burnout include exhaustion, questioning your own ability and cynicism. You need to make something very clear to yourself - you have a talent that can benefit your fellow men, but that does not make you a machine. You have every right to feel sick, feel stuck and feel bored. Just indulge in activities that make you happy, get help from family and stop categorizing everything related to your profession is important and everything else “other priorities”.

Dr. Jewell is a board certified Oregon plastic surgeon who has served as President of the American Society for Aesthetic Plastic Surgery (ASAPS) in 2005-06.

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