Career

Don’t assume work is sole burnout determinant


 

Physician burnout is almost always linked to issues at work. Blame is placed on added duties piled onto a to-do list that barely makes enough time for prolonged patient interaction in the first place. Fault is laid upon the hours and hours per week – or even per day – wasted on cumbersome data entry into bulky electronic health record (EHR) systems.

But Dike Drummond, MD, a family physician and burnout coach/consultant, says burnout should not be viewed as job specific. “To say that burnout is always about work is absolutely an error,” said Dr. Drummond, whose website is www.thehappymd.com. “You can have people flame out spectacularly at work and nothing has changed about work at all. It’s because something’s going on at home that’s made it impossible to recharge on their time off. And, that list of recharge-blocking issues is huge.”

Money problems, marital problems, family problems: Dr. Drummond says any and all of those issues can eliminate the doctor’s ability to recharge at home.

“The strain of your practice continues, but now without the ability to balance your energy with some recovery when you’re away from the hospital, burnout can come on very rapidly,” he said. “So when you see a colleague flaming out at work, one of the questions you must ask is, “How is it going at home?” You may be the first to learn their spouse left them 2 weeks ago.”

Dr. Drummond’s advice is: Don’t always blame the stresses of work. Build your recharge strategy (rest, hobbies, date nights) and make sure you maintain your recharge capabilities.

“Ideally, with a hospitalist-type schedule, when you’re on you’re on and when you’re off you’re off,” he said. “It should be easier to create that boundary for hospitalists than other specialists who chart from home or are on call.

The “off switch” on your doctor programming is called a boundary ritual. Pick some activity you do on the way home from work, saying to yourself ‘with this action, I am coming all the way home.’ It can be as simple as a deep releasing breath as you step out of your car at home. Make sure you take that breath and let it all go before you walk into the house after each shift.”

Colin West, MD, PhD, FACP, of the departments of internal medicine and health sciences research at the Mayo Clinic in Rochester, Minn., and a leading researcher on the topic of burnout, refers to this phenomenon as “work-home interference.” On the bright side for hospitalists, he says, is that aspects of HM work schedules may help mitigate burnout; some work can be left at the hospital when shifts end, rather than following physicians into their home lives.

But Dr. West acknowledged that the rigors of the traditional 7-on/7-off schedule come with their own unique burnout challenges for hospitalists as well.

“A hospitalist can say ‘Well, jeez, I’m on nights for the next week, and that means during the day I’m sleeping and recovering,’” Dr. West explained. “Well, how do you maintain a family life for that period of time when you’re basically off-cycle with your family? There are those kinds of stressors. It’s a mixed bag for hospitalists there.”

Richard Quinn is a freelance writer in New Jersey.

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