Culture of medicine blamed for physician burnout epidemic.
By Chelsea Nichols
The Mayo Clinic defines burnout as a three pillar syndrome. A low sense of personal accomplishment, emotional exhaustion and depersonalization—treating people as an object instead of human—create what we know as burnout. Virtually every physician experiences burnout at some point in their career, the Mayo Clinic reports, sometimes as early as an intern.
Burnout not only affects physicians, but patients. The Mayo Clinic lists “quality of care, patient safety, medical errors, malpractice claims, patient satisfaction and compliance” all as results of burnout.
Ironically, physicians turned down this interview for reasons related to burnout, most blaming emotional exhaustion. Kentucky physicians are not alone. The medical research group reports nearly 38 percent of physicians surveyed experience emotional exhaustion.
The following are excerpts from interviews with Dr. Eli Pendleton, assistant professor and family medical director for University of Louisville Healthcare, Louisville, and Dr. Kay Corpus, an integrative medicine physician at Owensboro Medical Health System, Owensboro, Ky.
Dr. Eli Pendleton assistant professor and family medical director under University of Louisville Healthcare
Root of the problem
My wife is also a physician so balancing the two positions and family between our work obligations and family obligations is probably the largest source of my burnout. How do you have a successful professional life and a successful home life at the same time?
Combating burnout
I’m still working on it! I try and make time for those activities outside of work that fill my cup – making sure I have time to exercise, making sure that I have time for my wife and I, making sure that we take vacations. I’m being more conscious of the type of projects I sign up for within work. I think with less available time or less available energy it’s important that I stick with projects I’m really passionate about otherwise it’s just work.
I had a kid right when I was trying to learn to say “no” to things. That was tough. I really had to take a step back, reassess how much time and energy I was putting into things and make sure I wasn’t spending a lot of time on things that weren’t important to my career or weren’t really necessary.
Dr. Kay Corpus board certified in family medicine, integrative medicine physician, Owensboro Medical Health System
Culture of medicine
I think the biggest thing is awareness. What has helped me is the actual recognition of burnout. In medical school, residency and fellowship, you don’t get an option to be burned out; it doesn’t matter if you’re burned out. You just go. It’s sort of the culture of medicine to be, “I know you’re tired, but you still have to care for people.” You can’t just take a healing day. It’s not accepted in this culture, traditionally. That culture has to change to be sustainable and happy as a physician.
Not being grounded
I’ll do my yoga practices in the morning and then I’ll meditate. I’ll make my green smoothie and prepare for the day. Of course there are times where I just jump up and rush out and those are my worst days. I’m not grounded before I walk into the office. Now I’m on my way to work and
You have to be in that space if you’re going to see this many patients a day or do a complicated procedure. I wouldn’t want any doctor to work on me who wasn’t grounded who is stressed out and doesn’t care and is just done. That’s where we make mistakes.
In between patients, washing hands is a ritual that I like. Just breathing, just getting set, letting go of the last patient and then have my full attention for my next patient.
Peers and practice
I have family members that are physicians. I have tons of friends who are physicians [who] are done and they’re young. They’re planning their retirement right out of college because they’re so tired. That’s really sad because we need more doctors. We need good doctors. I really love the ones who know how to take care of themselves, who can be an example to their patients.
This is a reflection of what happens everywhere and it has to change. Often times it gets to the point where you hit a wall and you want out. You just want out.
Schwartz Center Rounds strengthens patient-caregiver relationship, remind caregivers why they entered the healthcare profession.
Norton Cancer Institute now offers a regular forum for its employees to openly and honestly discuss the most challenging emotional and social issues that arise in caring for cancer patients and their families.
The program, called Schwartz Center Rounds®, has been found to increase compassionate care, improve teamwork, and reduce caregiver stress. Norton Cancer Institute is the only program in Kentucky to be approved for hosting Schwartz Center Rounds. Schwartz Center Rounds are a program of The Schwartz Center for Compassionate Healthcare, a Boston-based nonprofit dedicated to strengthening the relationship between patients and caregivers.
Unlike traditional medical rounds, the focus is on the human dimension of healthcare. Caregivers share their experiences, thoughts, and feelings on topics drawn from actual patient cases. The principle is that caregivers are better able to make personal connections with patients, families, and colleagues when they have greater insight into their own feelings.
“Schwartz Rounds are an opportunity for dialogue that doesn’t happen anywhere else in the hospital,” said Sarah Parsons, D.O., Louisville Oncology. “We can talk about the heart of the work we do in caring for patients.”
According to a comprehensive evaluation of the program published in 2010 in Academic Medicine, the journal of the Association of American Medical Colleges (AAMC), Schwartz Center Rounds strengthen the patient-caregiver relationship and remind caregivers why they entered the healthcare profession in the first place.
Schwartz Center Rounds allows caregivers at Norton Cancer Institute to express their experiences to others. In turn, caregivers will better understand each patient experience and further the mission to blend comprehensive healing, passion and hope for patients and their families.
