First, a brief apology for my unplanned “break” the last couple of weeks.  Travel +  a wicked cold (which was at least thoughtful enough to not settle in until AFTER my half marathon last weekend) + life = no blogging.  Fortunately I have a backlog of topics so we’ll be good to go for a bit.

Last week Medscape released their annual report on Physician Burnout.  For those who don’t want to flip through the whole thing, the report indicates that burnout among physicians is at epidemic proportions. In one sentence, physicians are miserable.

Or are we?

I have many friends who are in medicine, most of us in academic medicine but not all. There are times when our work nearly brings us to our knees; I had one of those call weeks two weeks ago that was both physically and emotionally draining.  We share our tales of woe around EMRs and well-intended but poorly executed federal rules that actually impair the care of the patient (Meaningful Use, I’m looking at you). We talk about meeting requirements for MOC and how we’re a little intimidated by taking our recertification exam when we haven’t taken a night of general surgery call in several years.

And yet…I don’t think that most of us can imagine doing anything else because at the end of the day we love what we get to do and we love the people we do it with and for. While there are times when any of us would definitely acknowledge being burnt out, I’m also seeing many of us exhibiting wisdom about knowing when we must have time and space to put on our own oxygen masks first. That’s why I had a crazy-hard week of call nights with tons of administrative stuff to manage during the days…then promptly got on a plane to Louisiana and spent the weekend with friends eating great food and running.

Lest you think I am a paragon of self-care and burnout prevention, I’ll tell you I’m not.  I’ve been tremendously burnt out at a few points in my career (twice during residency, once early in my attendinghood), and I hope that I’ve learned from my mistakes. I’ve learned that I don’t like who I turn into when I’m in that place (I become mean- and if you know me personally you know I don’t care for mean people AT ALL).  I’ve also come to realize the simple joy in an early morning or late evening dog walk with Olivia; some days our adventures in the neighborhood provide the most effective therapy possible. I realize that time outdoors with a dog won’t help everyone in the same way it helps me, but I provide it as an example of a simple and high-yield intervention.

 

I have a few plausible theories behind the current epidemic of physician burnout, and I’m not sure which is correct- or if all are:

• Physician burnout really has increased (question, related but unrelated:  What about burnout rates in other high-stress, long-hour fields?)
• The stigma around physician burnout has gone away, so people are owning it (but the true incidence isn’t any different)
• Surveys are being worded in a way that if someone had a bad day last week they may be described as having burnout, when it’s really just a bad day
• We’re saying we’re burned out because we think we’re supposed to be burned out.  We’re busy!  We’re working hard! We’re supposed to be exhausted and maybe something is wrong if we’re not.

I suspect the truth lies somewhere in the spaces between these ideas; what I do know is that regardless of the actual incidence of burnout in medicine that a focus on wellness is both merited and deserved.  The pace that our world runs at simply isn’t sustainable and the demands placed upon us by our patients, our teams, and the healthcare system are huge- much less the demands of our “normal person” lives. We both need and deserve time and space to do those things that heal and restore us if we’re to sustain our roles as effective healers, team members, friends and family, and humans.  The challenge, of course, is prioritizing that time.  The reality is that if you don’t prioritize if for yourself, no one else will do that for you.

What’s your wellness today?  What do you need to sustain you? Sitting still with a cup of coffee? Yoga? A snowball fight? I challenge you to pick something, then revel in that- even briefly.