What Happens After Physician Burnout?

Being a physician can be a rewarding profession, but it can also be challenging. It involves waging an invisible battle with the concealed forces of physician's burnout – cynicism, exhaustion, and doubt. The reality is that working in a fast-paced clinical setting, these forces conflict with physicians' engagement. With piles and piles of paperwork, the stress is likely to catch up with you. When this happens, symptoms of burnout present themselves. However, burnout does not only affect you, but it can affect your staff members, colleagues, and patients as well. Physicians who are burned out have a much more difficult time establishing solid and healthy relationships with patients. If stressors have you feeling cynical, exhausted or doubting yourself, then chances are that you are at an increased risk of making medical errors and providing decreased quality care. But what does physician burnout treatment entail? And what can you do to address this problem?

• Letting go of your negativity and establishing a sense of content within the clinical practice.
• Spending quality time with your family and friends.
• Scheduling some time away from work.
• Rediscovering your personal needs and what makes you happy.
• Prioritizing your responsibilities.
• Engaging teamwork to improve work well-being and productivity.
• Developing healthy habits and exercising on a regular basis.
• Performing relaxation techniques to keep stress levels under control.
• Finding an interest/hobby outside of the field of medicine.
• Reaching out to your family, friends, colleagues, or a support group in time of need.
• Striving to work towards/accomplish goals and milestones.
• Striving to balance your personal and professional life.

Yet, what happens after physician's burnout? No one seems to talk about physicians who have already been burned out.

“We want to understand how and why burnout happens; we are working hard to prevent it, but the conversation stops when the fire goes out. It’s like we disappear. There is no widely accepted mechanism for physician re-entry, just a few spotty programs that only accept physicians who left medicine in good standing, which most burned out doctors did not. Shadowing another physician to rebuild skills requires their commitment and their time, something most doctors are hesitant to give as it ultimately costs them money. Transitioning to non-clinical careers is also challenging because a burned-out doc starts with no referrals, lots of recently burned bridges, and little to no self-confidence with which to sell themselves. It’s a long slow, lonely climb” wrote anonymous on kevinmd.com.

Yet, is it entirely possible to bounce back from physician's burnout? But then what? How do you prevent it from happening again? If you have the same duties and requirements at your practice, how can you be expected to fulfill those without becoming burned out again?

Unfortunately, burned out physicians are on their own. In such instances, it is up to you to be your own advocate. A majority of health institutes do not care who fills your job position, as long as they are experienced and it is filled. For this reason, the best way to treat physician's burnout is to prevent it from occurring in the first place. You need to be able to recognize both the internal and external factors that are triggering high burnout rates. Streamlining workflow is an effective way to reduce chaos within the workplace that can contribute to burnout and allow you to focus on patients. How so?

Delegating Work Whenever Necessary

“Doctors don't need to deal with everything. There's an assumption that safety is promoted if the doctor does every task, signs every chart, processes every prescription renewal, and enters orders for every ear wash,” said Christine A. Sinsky, an internist at Medical Associates Clinic and Health Plans. Medical assistants can help free up your time by getting patients’ set up for their appointments, updating their medical histories, jotting down medication prescriptions, etc. If you feel that these tasks are beyond their abilities or training, you can always create protocols to be followed.

Lessen the Burden of Electronic Health Records (EHRs)

With the rise of computerization and modern technology, it is such work overflow that can lead to physician burnout. Most EHR-related tasks can be delegated to non-physicians/medical assistants and this can save you a great deal of time – time needed for assisting your patients. In fact, a recent survey found that a physician can save over 3 hours per day by delegating EHR-related tasks. “We find that the extra person actually improves the physician-patient relationship because the physician is able to provide his or her full attention to the patient and is not distracted by data entry,” revealed a source who participated in the study.

Making Your Work Schedule More Flexible

In order to maintain your professional well-being, it is necessary that you make your schedule more flexible. There are always overlaps between professional and personal tasks, so by addressing these issues, you can lower your stress levels. “You can change the schedule at the beginning or the end of the day. If some doctors have to come in a little later, you can stagger the schedules for their MAs so that they come in every half-hour. The earliest one would have to leave earlier. Of course, you can't shorten the schedule at both ends” said Dr. Mark Linzer, an internist.

Building Solid Relationships Among Staff Members

Medical practices are continuously making changes to improve workflow; however, ‘staff member’ changes should be made as well. This means getting staff members together for weekly or monthly meetings and openly discussing and addressing potential problems or issues that require improvement. The objective of these meetings is to diagnose the current ‘health state’ of the team and come up with strategies to engage teamwork and improve productivity. After all, communication and relationship building go hand in hand.

Working Together with Administration

As a physician, you should work closely with the administration to realize proposed changes within the workplace. In health institutes, physicians are responsible for ensuring the safety and well-being of themselves and their patients. So, if you suffer, then your patients suffer. Therefore, when proposed changes show the degree of a problem, the administration can take necessary steps towards resolving it. “Telling them that a majority of their doctors are burnt out and many of them are getting ready to leave has a powerful impact. You then present your improvement plan as a way to avoid this. You can explain that just a few small steps need to be taken to improve morale” said Dr. Linzer.

The sad reality is that burnout starts in medical school or during training, when physicians are given large volumes of information to cram for under tight deadlines. It becomes even more overwhelming as medical careers start to advance and those who make it past burnout need to find a way to push ahead. In order to prevent burnout from occurring or reoccurring, potential problems should be addressed head-on.

Consider asking yourself the following questions: Am I mentally and physically exhausted? Is my workplace chaotic? Are EHR-related tasks starting to pile up? Is my work schedule causing me overwhelming stress?

If you answered yes to these questions, it is time to take action. Try out 2-3 changes, such as hiring a medical assistant or taking some time off from work to recharge your batteries. Test out these changes and see if they make a difference. If you notice an improvement in your mood and satisfaction with your work, this will result in increased performance. “Healthcare is a giving industry. When you’re giving all day, you become depleted. A patient can never have a positive experience unless the physician is also having a positive experience,” said Steve Del Giudice, a retired dermatologist. In case of burnout, do something about the problem for yourself, for your family, and for your patients – before you find yourself in a situation that requires you to ‘rebuild’ your life, as well as your career.