More than 45 percent of physicians are experiencing at least one symptom of burnout, according to the first national study on the topic, and that concerns noted physician and professor of medicine emeritus Dr. Paul Griner, (www.DrPaulGriner.com), author of “The Power of Patient Stories: Learning Moments in Medicine.” “Burnout can lead to misdiagnoses,” Griner says. “As I emphasize in my book, it’s vital to spend time talking to and listening to patients – thorough patient histories and observation and a good physical exam are often the difference between an accurate diagnosis and a wasted battery of unnecessary diagnostic tests.”
Burnout can be characterized by, detachment, diminishing empathy and emotional exhaustion – all of which can impede a physician’s ability to thoroughly and accurately assess patients, Griner says.
The Archives of Internal Medicine study, published in August, surveyed 7,288 physicians, and assessed them using the Maslach Burnout Inventory. Nearly half, 46 percent, reported at least one symptom of burnout. Specialties that were most at-risk were family medicine, general internal medicine and emergency medicine — those that benefit most from taking time to listen to patients because they are often the first point of patient contact, Griner says.
He notes that strategies to address this problem must recognize that burnout begins early in one’s medical career, during medical school and throughout residency training.With 59 years in medicine, as a practicing hematologist and internist, professor of medicine at the University of Rochester School of Medicine, and senior lecturer at Harvard Medical School, Griner offers these suggestions for overwhelmed physicians:
• First, take care of yourself. It sounds simple, but it’s something doctors repeat so often to patients, they’ve often ceased hearing the words: Eat well, get adequate rest and exercise regularly. Taking care of yourself physically is fundamental for coping with stress and the negative emotions, such as frustration and anger, that can come with working in any field.
• Take time to nurture relationships. Having meaningful relationships with colleagues and co-workers can make your work more gratifying. Take some time – even a few minutes a day – to get to know them. They can provide a sounding board, a sympathetic ear, or ideas for solving problems. And you can do the same for them. Devote more time (at meetings and lunch) to the rewarding aspects of medicine, sharing patient stories and humorous anecdotes, and less time on frustrations.
• Actively listen to your patients and pay attention to what’s going on in their lives. It will not only help you give them better care, you’ll find it makes your work more interesting and satisfying.
• Do what’s necessary to achieve a work-life balance. If you are not spending relaxed time with your loved ones, having some fun outside of work, or enjoying interpersonal relationships, you are at a greater risk for burnout. Just as taking care of yourself physically is vital, so is taking care of yourself emotionally. If necessary, identify a colleague who seems to have achieved this balance and spend some time with him or her.
• Participate actively in health reforms that will return a greater level of control to physicians and their patients. These include payment for value and greater patient participation in decision-making about care. Reorganizing primary care practices to allow more time for complex patients and recognition by insurers that excessive hassle is bad for patients and physician are also vital. These changes should lead to more satisfied patients and physicians and less burnout.
Preventing burnout needs to start early, Griner says. Teachers must give medical students and residents the tools to cope with and reduce the stresses that cause it.
“This is not the first survey that’s found a heightened level of burnout among physicians. We know it’s a problem,” Griner says.
“Doctors need to be in tune with their patients, asking, listening and connecting the dots. They can’t do that effectively if they’re burned out.”
About Paul Griner, M.D.
Hematologist/internist Paul Griner has had a 59-year career in medicine. He is a professor of medicine emeritus at the University of Rochester School of Medicine and Dentistry and was a consultant at the Massachusetts General Hospital, senior lecturer at Harvard Medical School, and consultant to the Institute for Healthcare Improvement (IHI) in Cambridge, MA. He has written or co-written 130 journal articles, book chapters, and books on clinical medicine, medical education, and health policy. He is a member of the Institute of Medicine of the National Academy of Sciences and was president of a number of national medical organizations, including the American College of Physicians.