Merriam-Webster defines burnout as "exhaustion of physical or emotional strength or motivation usually as a result of prolonged stress or frustration." Google's dictionary gives a sobering example: "high levels of professionalism that may result in burnout."
The Medscape National Physician Burnout & Depression Report 2018 states that overall, about 42% of physicians are experiencing symptoms of burnout. 12% of us are "feeling down," or "colloquially depressed." 3% of us meet criteria for clinical depression.
High-acuity specialties such as Critical Care Medicine top the list with burnout rates of 48%. However, Emergency Medicine ranks 6th, at 45%. Primary care specialties like Internal Medicine and Family Medicine are at 46% and 47%, respectively. While Plastic Surgery seems the "happy specialty," 23% of its practitioners report burnout. Immediately above, Dermatology and Pathology are tied at 32% each, and Ophthalmology at 33%. None of us are immune.
The worst case - physician suicide - is about 400 practitioners a year. But depression, divorce, and substance abuse are common. Perhaps even more common - and mostly unmeasured - is the number of people who are "getting by." No crisis yet, but unhappy in their job, experiencing dissatisfaction, and not sure what to do, or ways in which they can make a change.
Too many bureaucratic tasks, too many hours at work, too little respect from colleagues, staff, and administration, and electronic health records were top cited concerns.
Angels of Hippocrates has noted that burnout may be a personal issue, but it's mostly due to workplace problems. That's why our programs take a three-pronged approach. Our Happy Doc Summer Camp 2018 curriculum includes both personal wellness and workplace wellness tracks.
Personal wellness can accompany a variety of philosophical frameworks, modalities, and evidence-based behavioral interventions. The common element in the Happy Doc curriculum is that personal wellness is about helping the person adapt to the stresses of their environment.
Workplace wellness is finding ways in which we can adapt the workplace to be more hospitable to those who inhabit it. Physicians list job dissatisfaction as their main contributor to burnout, and identify many specific factors leading to it. However, when the Medscape survey asked practitioners how to to address burnout, the #1 response was "increased pay," though pay dissatisfaction ranked low as a cause of burnout. This disconnect seems to imply that physicians do not feel empowered to change their environment, despite being able to articulate that the environment is a source of burnout and stress.
Resilience is defined as: 1. the capability of a strained body to recover its size and shape after deformation caused especially by compressive stress; 2. an ability to recover from or adjust easily to misfortune or change. Resilience is an excellent quality. But the second definition overlooks something the first does not - in order to experience resiliency the stress must end.
There are doubtless things that might be easy to change personally, and battles that seem not worth fighting. However, focusing only on changing the individual without any attention toward changing the workplace may increase feelings of burnout, powerlessness, and frustration. For this reason, Angels of Hippocrates has included a Workplace Wellness Track.
We start with identifying systems and institutional issues that contribute to burnout and frustration. Next, we examine interpersonal skills and relationships and examine workplace initiatives to support personal wellness. Ultimately, armed with new tools we will help people create workplace action plans in which they identify goals for change in their own workplace and begin to develop solutions.
Happy Doc's curriculum is designed for adult learners. There are no requirements. We are happy to talk with you, but in the end you choose the path that gives you the knowledge you need to solve the problems you face. If you want to experience the ropes course or the climbing wall or play volleyball, it's because these things make you happy - not because it's some team-building exercise. Choose as much or as little as you need, but have fun doing it. Having fun, getting information that's useful to you, and coming up with your own plan - that's what Happy Doc is about.
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