Wellbeing: A Team Sport

About four years ago I found myself in an ironic dichotomy: I had achieved significant professional success, and at the same time I was suffering from significant burnout.

On one hand I was feeling success, but on the other hand, I was completely empty.

Physician burnout is an epidemic. For the last several years, 50% of physicians surveyed in the United States report feeling clinical burnout, which entails emotional exhaustion, lack of personal accomplishment, and depersonalization.

I think while the awareness of burnout is everywhere, we often find ourselves plugging away, not changing, and not sure how to get off the rat race of medicine and life, until something snaps.

For me, I have found two things that are the main culprits of burnout:

1.     Increasing work demands

2.     Lack of recovery days

Part of the reason for burnout is work compression – the reality that we are all doing more in the same amount of time than we did last year or the year before. Our work demands are increasing and not associated with any increase in ‘recovery’ time.

It’s like you went from running a 5K to a 8K to a 10K, but you are required to run in the same amount of time you run the 5K, and there is no longer recovery.

Because of work compression, we need work recovery.

One of the things we should reassess is our work versus recovery in medicine.  A day away from the hospital is GOLD. As our compression increases, we need to think of ways to work in recovery days. When I feel myself spirally toward burnout, the best thing is for me to be off the grid for a day here and there.

For us to do this as a profession, it is going to take a team effort.

Based on statistics, if I walked into any clinic, any operating room, or any hospital ward, I would find half of my colleagues NEED a recovery day.

I wonder, what if we built those into our schedules?

What if we had built in recharge days, where doctors could sign up?

Yes, I know what you are thinking, it’s called vacation.  

Many physicians have enormous stress both before and after vacation. Most physicians must achieve the same metrics each month: such as RVUs or call assignments, or face a cut in pay. Hence they must do the same amount of work in a fewer amount of days. Clinical demands pile up, administrative work remains, and it’s very hard to actually take a vacation and not be overwhelmed on the bookends.

Vacation is important, and we all need to unplug. What I am suggesting is that we take a hard look at how medicine has changed with regards to work compression, and schedule in work recovery. We should consider – as teams – how we can build in days of recovery for ourselves and for each other.

If you think about it – we as physicians heal. It’s our number one job. Everything we do, whether research, administrative duties, or education is all to improve the clinical care of our patients – to heal.

Shouldn’t we be smart enough to say enough is enough and heal ourselves?

Shouldn’t we be able to figure out how to make access to sure we have access to exercise, healthy foods in the doctor’s lounge, recovery/recharge days, and mental breaks?

Can’t we figure out how to allocate duties that someone with less education can do and allow us to focus on the care of patients and training the next generation of doctors?

And shouldn’t we be able to build in recovery days – where we allow staff to take a break from overloaded work schedules to PREVENT errors and workplace culture declines due to burnout?

I know people will criticize my idealism, but I’m a realist. I know how smart we are as healers. I know how hard we work – all of us. From physicians to nurses to pharmacists.

We should be able to look at work hours, work shifts, call hours, and build in mandatory away time, breaks, a day here and there where recovery is required.

Airline staff do this…don’t you think there is a reason?

We are smart. We can figure this out. And we need our leaders to equip us to do so.

For the most part, the schedule of medicine has not changed. We still spend 24 hours in the hospital and take weekend calls that can be brutal. But its compression and pace has changed, with added technology, and the result – clinical burnout, is of no surprise.

We must change in response.

We must.

Let’s focus on prevention. And recovery.

It’s time.