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Burnout

Maxed Out Doctors: The High Cost of Burnout in Medicine

Why managing stress & building resilience have direct impacts to your healthcare

When was the last time you went to the doctor? Did it feel like a sprint trying to get all of your questions answered? And, what’s the deal with those awful gowns? Practicing medicine has always been a stressful profession, but for the thousands of doctors and medical students on the verge of burnout each year, the exhaustion can directly impact the quality of healthcare you receive.

The Medical College of Wisconsin recently created a new pathway in its medical school curriculum focused on ways to improve patient safety. As part of that curriculum, the Medical College is also teaching resilience to its students. Happily, I was asked to present a resilience and burnout prevention workshop to second and third year medical students last week. Having experienced burnout firsthand, I am mindful of the effects burnout can have and how quietly it can creep into your life.

As I listened to a presentation by one of the doctors prior to my workshop, I was stunned by what I heard. She talked about the difficulties many medical students face (or will face) as part of their training and a culture that hasn’t changed much in decades. According to statistics she recited from a study of 2682 medical students, 53% were burned out; 14% were depressed; and 4.4% had seriously considered suicide. Further, a full 100% of the students reported feeling disrespected or humiliated at some point and stated that being demeaned led to confusion, frustration, poor performance, and cloudy judgment. More importantly, and from a patient safety standpoint, 76% of students reported that they had observed an error by one of the senior physicians, yet only 50% reported it.

Unfortunately, the medical culture hasn’t changed much and disruptive behavior by residents and attending physicians is often tolerated, teamwork isn’t a focus, and doctors and medical students simply have to deal with the stress, pressure, and extremely long hours in combination with a lack of sleep.

One predictive factor for those doctors who were at a higher risk for burnout was being on the front line of providing health care access—practicing in a specialty like emergency or family medicine. According to one survey of 7288 doctors, 45.8% reported having at least one symptom of burnout. Another study looking at resilience in the third year of medical school found that exposure to stressful events like unprofessional behavior by residents and attending physicians was more predictive of endpoint levels of depression and other stress symptoms than actual trauma exposure. Poor role modeling by more senior doctors also increased medical student cynicism and decreased empathy.

With this background, it makes it all the more important to teach both doctors and doctors-in-training about resilience—how to handle and manage stress, adversity, and the challenges that come with practicing in a tough profession. I told my medical student class that during my own year-long struggle with burnout, not one of the over half dozen doctors I saw asked me how I was doing or asked me about my stress levels. I reminded them that there is a human being underneath that flimsy medical gown. Burnout is all about lost energy, enthusiasm, and confidence. I don’t know about you, but I want my doctor to have an abundance of all three.

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Paula Davis-Laack, JD, MAPP, is a stress and resilience expert and the Founder and CEO of the Davis Laack Stress and Resilience Institute, a company dedicated to helping professionals and professionals-in-training manage stress, prevent burnout and build resilience. Paula regularly appears in a variety of media outlets and has been featured in and on The Steve Harvey TV Show, Working Mother magazine and Women’s Health magazine. Her new e-book is called 10 Things Happy People Do Differently. She is available for workshops, training, and speaking opportunities. Please visit her website for more information.

Connect with Paula on Twitter, Facebook and LinkedIn.

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