Physician Burnout. a Medical. Pandemic. John N. Evans, DPM, FACFAS. APMA National 2018 Conference July 13, 2018

Transcription

1 Physician Burnout a Medical John N. Evans, DPM, FACFAS APMA National 2018 Conference July 13, 2018 Pandemic

2 A loss of Emotional, Mental, or Physical energy due to continued Job-related Stress Physician Burnout definition

3 Physician Burnout % of physicians suffer burnout Physicians suffer burnout 2x more than other US professions Every medical specialty shows increased rates from 2011 to 2018

4 Physician Burnout by Specialty

5 Symptoms of Physician Burnout Exhaustion Lack of enthusiasm/motivation Frustration Cynicism Stress Passivity Detachment Reduced efficacy Behavioral extremes Mistakes Compassion fatigue Insomnia Depression Health issues

6 Poorer Quality of Life Increased stress-related disorders Consequences of Burnout Lower Quality of Care Errors, neglect, careless, inefficient, staff turnover, patient satisfaction Lower Sense of Personal Accomplishments Lack of Control & Meaning, desire for a different life

7 Why do Physicians burnout? Dike Drummond, MD 1. Actions of being a Doctor 2. Stress of being a Doctor 3. You are Human 4. Surviving being a Doctor

8 1. Actions of being a Doctor What we were trained to do All our Clinical activities

9 2. Stress of being a Doctor What we were not trained for Malpractice Billing/ coding/ EHR/ management/ politics/ changes in health care/ leadership Nasty patients

10 3. You are Human Dealing with Life Family, friends, Life, the Universe, and Everything -Douglas Adams

11 4. Surviving being a Doctor Workaholic Superhero Emotion-free Coping skills we learned in Medical school Lone Ranger Perfectionist

12 Medical School: Well-Being effects Medical students vs Age-related Peers Depression 27% v 7% Burnout 54% v 36% Alcohol abuse 34% v 9% Suicide 11% v 4%

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14 If you can sit quietly after difficult times, If in financial downturns you can remain perfectly calm, If you can see your neighbors travel to fantastic places without a twinge of jealousy, If you can happily eat whatever is on your plate and fall asleep after a day of running around without a drink or a pill, If you can always find contentment just where you are

15 You are probably a dog Jack Kornfield

16 Evolutional Psychology Our Minds did not Evolve to be Happy

17 Our Minds have Evolved to: Expect the Worst Pursue Pleasure and Avoid Pain Fear Threats Recall the Past Imagine the Future

18 Lion or Beige Rock Dilemma?

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20 Lion-Beige Rock Dilemma Is it a lion or a beige rock? Cost of one mistake: needless anxiety Cost of the other mistake: death Our minds evolved to make the first mistake 10,000 times to avoid making the second mistake once

21 Burnout Reduction Options What you do not have control of? Present Healthcare System Patients Modern Society issues. What you do have control of? You

22 Action Plan for Burnout (Prevention/Treatment) Sleep Exercise Nature Music Disconnect Ask for Help

23 So What Else Can We Do? Nothing Denial Leave Medicine Change

24 Burnout, at its core, is the impaired ability to experience Positive Emotion. J. Bryan Sexton, PhD

25 Positive Psychology

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27 Wealth

28 Age

29 Intelligence and Happiness Sometimes Metanalysis by Veenhoven & Choi 2012 Micro level Intelligence does not improve happiness, except within Self-Perceived Higher-Intelligent people Macro level Within Countries, Lower intelligence is related to Lower happiness Int. J. Happiness & Development 2012

30 The Pursuit of Happiness: Modern Solutions Acquisition Indulgence Food Shopping* Pleasure Sex Drugs or Alcohol Status-Seeking Power Achievement Avoidance Withdraw Isolation Passivity Drugs or Alcohol Television Smartphone addiction

31 The Hedonic Treadmill

32 Savoring Sources of Well-Being not subject to the Hedonic Treadmill Engagement Connection Rediscover Awe Gratitude Forgiveness Meaning and Purpose

33 Savoring

34 Engagement: Flow Mihaly Csikzentmihaly In the Zone Experience Gratification rather than Pleasure Strengths engage Challenges in an even balance Fully immersed in an energized focus in what is being done Experience a loss of space and time

35 Connection

36 Rediscover Awe

37 Gratitude

38 Forgiveness Holding onto anger is like drinking poison and expecting the other person to die Buddha The weak can never forgive. Forgiveness is the attribute of the strong Mahatma Ghandi

39 Meaning and Purpose

40 Three Good Things Martin Seligman, PhD Before bed, think of three good things that happened that day Write them down Reflect on them

41 Enhancing Resilience J. Bryan Sexton, PhD Duke University Three Good Things then label them: Joy, Gratitude, Serenity, Interest, Hope, Pride, Amusement, Inspiration, Awe, Love 10 day period Results: Internal Medicine Residents: 15% reduction in Burnout symptoms Patient Safety Officers: 19% reduction

42 One Conscious Breath Stop Thinking

43 In Conclusion Focus on the Positive Savor Thank You Engagement Connection Awe Gratitude Forgiveness Meaning and Connection John Evans, DPM Stop Thinking