Burnout is described as a syndrome of “emotional exhaustion, depersonalization, and feelings of low personal accomplishment,” and is an increasingly problematic condition among physicians for a multitude of reasons. The job of a physician can be a physical and mental strain, particularly for those in oncology, where the demands of routine excellence and long hours are commonplace.
At The University of Texas MD Anderson Cancer Center in Houston, the burdens that physicians and other oncology specialists face receive special attention through the Faculty Health & Well-Being Program. Henry M. Kuerer, MD, PhD, a surgery professor at MD Anderson who helped launch the program, described the signs and treatment of physician burnout in an abstract as part of the MBCC mini-symposium Thursday.
Kuerer discussed the variables that go into achieving a proper work-life balance, such as attitudes and beliefs related to relationships, habits, skills, and personality traits.“We all know what burnout looks like in our colleagues, but it is often hard to identify it in ourselves,” Kuerer said in an e-mail interview. “Burnout is a real-life, everyday thing. As with most things in life, the recognition of a problem is the first step in prevention and recovery from the problem.”
Doctors who are more experienced may have greater difficulty in acknowledging burnout. “For those who trained before resident work-hour restrictions were instituted, there is an unwritten code of rules and expectations,” Kuerer said. “There is a mentality that the harder we work, the more patients we have, and that the more tired we are, the better physicians we are.”
MD Anderson launched its well-being program approximately 10 years ago as a result of a tragedy. “We initially had buy-in for a faculty health program at MD Anderson after the suicide of one of our beloved surgery professors. It took a devastating event for us to get momentum and resources to make this happen,” explained Kuerer.
Warren L. Holleman, PhD, a professor of Behavioral Science who serves as director of the Faculty Health & Well-Being Program, described in an e-mail how he went about structuring the program. “I visited with every individual and group that would see me, and asked them to tell me their needs and challenges in terms of maintaining personal health and job satisfaction,” he said. “Many said this was the first time anyone ever asked them their views on how to improve our work culture.”
Although some of the concerns reflected individual health needs, Holleman said “there was also a need to change institutional culture” so that faculty members spent less time on administrative tasks, had a greater impact on decisions affecting their daily work lives and career prospects, and had avenues for building stronger social support networks with colleagues.
Both Kuerer and Holleman noted that administration backing is vital. “One essential component is to have the appropriate support and buy-in from the leadership of an institution,” Kuerer said.
Although a medical institution’s leaders may want to provide wellness programs, financial pressures present challenges. “Executives have this bad habit of setting revenue targets that are unsustainable in the long run,” said Holleman. “So what gets sacrificed, of course, is the health and happiness of their employees. Health organizations need to stop judging success in terms of quarterly reports and set their eyes on sustainable, long-range targets. Health, happiness, and job satisfaction may be inversely proportional to short-term productivity, but they are directly proportional to long-term productivity.” Although physician burnout oftentimes flies under the radar, the fact is that this condition is prevalent among providers and must be addressed accordingly by both individuals and organizations. “There is extensive evidence that burnout is associated with medical error and therefore decreased quality of care, increased lawsuits, and ultimately costs,” Kuerer said. “At this pivotal time as the nation’s reforms its healthcare system, it is of paramount importance that physicians develop their own personal methods to prevent burnout and maintain resilience. Without this renewed effort and support, the public at large is also at risk.”