6/29/2018. Chris Searles, MD. I have no financial conflicts of interest to disclose*

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1 Chris Searles, MD I have no financial conflicts of interest to disclose* 1

2 Engrossed late and soon in professional cares you may so lay waste that you may find, too late, with hearts given way, that there is no place in your habit stricken souls for those gentler influences that make life worth living. Sir William Osler What is Burnout? Burnout is a syndrome of emotional depletion and detachment that develops in response to chronic occupational stress It happens more when job stress is high, and personal autonomy is low 2

3 What is Resilience? Resilience is the ability to bounce back after being psychologically stressed or challenged It is easier to recognize burnout in your COLLEAGUES rather than YOURSELF. 3

4 60% increase of physicians in Stress related would change Disability Professions Claims if they since could 1990 How Do We Measure Burnout? Maslach Burnout Inventory (MBI) The 3 Domains of Burnout: Emotional exhaustion Depersonalization Low personal achievement Emotional Exhaustion Feeling emotionally overextended and exhausted by work Physicians are required to deal DAILY with the powerful emotions of human existence: pain, death, life, anger, abuse 4

5 Depersonalization An unfeeling and impersonal response toward patients, family, and friends Manifests as apathy and cynicism Low Personal Achievement Loss of feeling of competence and successful achievement in one s work Most ominous symptom. The Experience of Burnout It just isn t fun anymore Cynicism Going through the motions Anger Isolation from family, friends, and colleagues The Physical Side: HTN, weight, headaches, somatization Being late Negative thoughts and attitudes toward self, family, friends, and colleagues Declining quality of patient care Self medication 5

6 Where we are Health Work Recreation Partner Personal Family Household Spiritual Exercise Friends Recreation Health Work Personal Household Partner Spiritual Exercise Family Friends 6

Partner Family Friends Exercise Spiritual Household Personal Recreation Health OUR MEDICAL CAREER Burnout Among Physicians 7,288 MDs received the MBI.

7 Partner Family Friends Exercise Spiritual Household Personal Recreation Health OUR MEDICAL CAREER Burnout Among Physicians 7,288 MDs received the MBI. More burnout among docs than the general population Can you guess the top 3 specialties reporting the highest rates of burnout? Shanafelt, et al.. Burnout and satisfaction with work life balance among US physicians relative to the general US population. Arch Intern Med Oct 8;172(18): Burnout Among Physicians Shanafelt, et al.. Burnout and satisfaction with work life balance among US physicians relative to the general US population. Arch Intern Med Oct 8;172(18):

Burnout Among Physicians from 2011 to 2014 60 40 20 2011 2014 0 Mean Burnout Mean Satisfaction Shanafelt TD.

8 Burnout Among Physicians from 2011 to Mean Burnout Mean Satisfaction Shanafelt TD. Changes in Burnout and Satisfaction With Work Life Balance in Physicians and the General US Working Population Between 2011 and Mayo Clin Proc Dec;90(12): doi: /j.mayocp Burnout worldwide Gender differences Cultural background? 8

Our Increased Risk Perfectionism (Unrelenting Standards) Need for control High need for achievement Exaggerated sense of responsibility Need to please everyone How do I say no?

9 Our Increased Risk Perfectionism (Unrelenting Standards) Need for control High need for achievement Exaggerated sense of responsibility Need to please everyone How do I say no? Difficulty asking for help Difficulty taking time for oneself Meaning in Work Culture & Values Efficiency & Resources Control & Flexibility Workload Community & Support Work-Life Balance Clinician Self-care* 9

10 Happiness Circumstance 10% Set Point 50% Set Point 50% Lyubomirsky, S., Sheldon, K. M., & Schkade, D. (2005). Pursuing happiness: The architecture of sustainable change. Review of General Psychology Happiness is no accident it takes a lot of work! 10

10 Essential Tools to Enhance Resilience 1. Engage in Meaningful Relationships 2. Engage in Meaningful Pursuits 3. Accept Praise. You deserve it. 4. Take Care of Your Body and Mind Consistently 5.

11 10 Essential Tools to Enhance Resilience 1. Engage in Meaningful Relationships 2. Engage in Meaningful Pursuits 3. Accept Praise. You deserve it. 4. Take Care of Your Body and Mind Consistently 5. Learn to ACCEPT 6. Being Thankful for What You Have 7. Express Gratitude Toward Others and Engage in Acts of Kindness 8. Implementing Reflexive Optimism 9. Rediscover and Revisit 10. Practice Mindfulness MAKE to ENGAGE in meaningful relationships Who Are Your People? 11

12 MAKE to ENGAGE in meaningful pursuits 12

13 Rich Doc, Poor Doc 13

14 The Good Enough Physician 14

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Set limits with work and at work Learn how to say no sometimes Try to avoid sacrificing personal time

17 Making Time and Taking Time Yes No 1 Making Time and Taking Time Our problem with time Matching your goals with your time use means knowing your priorities and FINDING YOUR NO. Set limits with work and at work Learn how to say no sometimes Try to avoid sacrificing personal time for work Your schedule and time are important, too Health Recreation Personal Household Spiritual Work Partner Family Friends Exercise 17

18 Thank you! 18

Focus On Wellness: Fighting Provider Burnout

Focus On Wellness: Fighting Provider Burnout Part I: Recognizing The Risk 2017 Otsuka Pharmaceutical Development & Commercialization, Inc., Rockville, MD Lundbeck, LLC. December 2017 MRC2.CORP.D.00322