Wellness Can’t Wait
Burnout syndrome (BOS) is a serious epidemic that is adversely affecting between 40 to 75% of our healthcare trainees and professionals. Up to 12% of doctors with BOS express thoughts of suicide, and the rate of completed suicide in medical trainees is double that of the general population. In fact, we are losing almost 400 healthcare providers a year to suicide. This is comparable to losing the number of students in an average size medical school every year. We must address the issues of BOS now, before we lose anymore healthcare providers to suicide.
BOS is defined as the prolonged, psychological response to job-related, interpersonal stressors. BOS occurs when occupational demands exceed one’s ability to cope, and is characterized by three measurable domains:
- Emotional Exhaustion: feelings of emotional and physical depletion.
- Depersonalization: a sense of indifference, detachment, or negative, cynical feelings toward patients and/or co-workers.
- Lack of Personal Efficacy: a decreased sense of personal accomplishment.
Occupational stressors leading to BOS accumulate during the preclinical training years, finally reaching a critical point during the later years of medical school or shortly after starting residency. Without improved coping ability during the first months of internship, as the workday becomes longer and patient responsibility increases, those more susceptible to BOS struggle to put present-day challenges in perspective. They may lose sight of the greater goal of graduating residency and going into practice.
Burnout may seem to be a purely personal issue, but in medicine that is not the case. The enormous burden that residents and medical students on rotation undertake to maintain patient quality-of-care could result in BOS with detrimental effects on the trainees’ personal lives and professional development. However, burnout also leads to negative ramifications for patients.
- gaps in professionalism, including callous attitudes or overt hostility toward patients and co-workers
- lack of career satisfaction
- early retirement or leaving the profession
- strained relationships, marital separation, or divorce
- depression and anxiety
- suicidal ideation/completed suicides
- increased medical errors
- less patient satisfaction with quality of care
I am presently at the AAIM meeting in Philadelphia and have had the opportunity to meet with dozens of residency program directors and discuss their departmental wellness initiatives. During those discussions five program directors confided in me that their programs have been devastated by recent resident suicides. Three out of five stated they did not see it coming. In contrast, other program directors told me that their residents were doing just fine and did not really need a wellness initiative. But how do they know? How do they be assured that they won’t be the next program director devastated by a resident suicide and dealing with the guilt that they did not do enough?
So when I say, “Wellness can’t wait!” – I mean it literally.
Jeffrey Levy, MD
Author of CoreWellness: A Physician Wellness program
CaseNetwork is a technology enhanced medical education company and the developer of CoreWellness: A Physician Wellness program – a 24 module online program that provides the tools needed for residents and medical students to overcome adversities, build resilience, improve wellness, and thrive. CaseNetwork also delivers competency-focused, case-based education that enables learners to improve their knowledge and comprehension of critical patient situations and disease states. CaseNetwork’s simulated patient encounters integrate evidence-based clinical information with required proficiencies and skills. CaseNetwork’s proprietary platforms include interactive decision making and peer-to-peer problem solving that is conveniently delivered in a browser or on a mobile device for anytime, anywhere learning. The CaseNetwork solution helps healthcare professionals advance their skills and improve competency with the ultimate goal of enhancing patient outcomes. For more information, visit www.casenetwork.com.