Physician burnout is an ongoing discussion in healthcare. Characterized by emotional exhaustion and depersonalization, burnout is a syndrome, accompanied by a feeling of reduced personal accomplishment, loss of work fulfillment, and reduced effectiveness. Since physicians are so integral to the healthcare system, the effects of their fatigue have a global impact often leading to potential losses in productivity, increases in health care costs, and risks to patient safety.
There are numerous factors contributing to burnout; increased IT demands, added documentation, and constant change and increased complexity of the healthcare ecosystem to name a few. Undoubtedly, these issues can lead to depersonalization, but the base cause is without a doubt much deeper. With healthcare treatments progressing and our abilities expanding, so too, do our expectations for our providers. Trained to diagnose and treat, success in these areas defines our persona. However, precisely what is our definition of success?
Arguably, most would stipulate that success is the prevention of death, but if this is the case, we fail 100% of the time. In our endeavor to succeed, we strive to create the opposite of death, which most would proclaim is life. But the reality is the exact opposite of death is actually non-death. Life is much broader and more encompassing than just your physiologic health status. Hence, we must adjust our definition of success. Aiding those we serve in living their lives in a manner they desire within their psychosocial dimensions, should be a higher aspiration. Shifting our focus to deliver value to those we serve by understanding their definition, undoubtedly, will bring significant satisfaction to our vocation. Not only will we enhance our care, but we will be in stronger communion with those we serve.
Physicians strive for human interactions with both our patients and each other. With the progression of technology, our engagement with both groups has decreased. No longer do we congregate in the doctor’s lounge. Furthermore, our “curbside” consults are occurring electronically or by interacting with on the internet which is impacting opportunities for peer education and discussion. Communication with our patients has shifted as well.
Additionally, the market is also demanding greater transparency and value. Therefore, we must consider our patient’s desires and input. The accountability is much higher with a broader focus and increased scrutiny by those we serve. No longer can we dictate what to do, now we must work with you, and foster shared decisions. Undoubtedly, all these issues will improve the care we deliver. However, they also create more stress to our lives and consequently require us to think differently.
If we continue to remain stagnant in our current paradigm of delivery and yet have expectations of ourselves to act differently, burnout will continue to ensue. Sure, we need to decrease the burden of items that are better performed by others, such as data entry and certain “paperwork.” However, focusing on the underlying factors contributing to dissatisfaction with our profession is paramount. The social anthropology of physicians is an area of focus needing examination. If we genuinely wish to lessen burnout, we must focus on the underlying behavioral drivers of why we do what we do. We need to change our frame of reference and redefine what will keep us engaged and feeling fulfilled. We must remember that doctors need hope too.