Burnout in Physicians _ _______________________________________________________________________
STRATEGIES FOR MANAGING STRESS AND AVOIDING BURNOUT
Strategy Classification
Specific Strategies
Personal lifestyle
Obtain adequate sleep Ensure proper nutrition Participate in regular physical activity
Identify and maintain priorities Schedule adequate vacation time Participate in hobbies and/or volunteer activities Maintain sense of humor Recognize limitations Seek emotional support and practical assistance from family Maintain network of friends
Professional lifestyle
Eliminate chaos in the office or practice Review and redesign workflow Make documentation a team effort Take time away (short breaks) Seek support from colleagues Promote a healthy work environment Become an advocate
Organizational level
Create a healthy work environment Encourage and maintain strong leadership style Engage in participatory decision making, especially with respect to direct patient care Foster good interpersonal relationships among all healthcare professionals Encourage and provide access to training targeted to physician well-being
Source: Compiled by Author
Table 8
Explore Other Interventions Cognitive-behavioral training, physical relaxation (e.g., massage), and mental relaxation (e.g., mediation) may have limited benefit, according to a meta-analysis of interventions to reduce work-related stress in healthcare workers. The study demonstrated low-quality evidence that cognitive-behavioral training, with or without relaxation, reduced stress compared with no intervention, but only after the more than one month of follow-up [105]. Similarly, physical relaxation was most effec- tive one to six months after the intervention. Little evidence supported mental relaxation as a way to reduce work-related stress after up to six months [105]. Develop Efficient Practice Habits As discussed, use of EHRs is a leading source of physicians’ stress and dissatisfaction, and approximately 61% of physi- cians have reported that other staff could perform functions in EHRs [37]. Thus, making documentation a team effort can help alleviate physicians’ electronic burden. In addition, experts recommend that physicians ask colleagues for help in using EHRs more efficiently and that they create templates as a way to semiautomate documentation [98; 106]. Given that a chaotic work environment is associated with high rates of stress, job dissatisfaction, and burnout, eliminating chaos can help prevent stress and burnout [65]. Redesigning work flow can also help; this strategy was associated with sig- nificant reductions in the burnout rate in a study of primary care clinicians working at 34 clinics [107].
Physicians can work more efficiently by standardizing workflows and processes whenever possible, minimizing interruptions by batching nonurgent tasks, and creating patient resources or delegating patient education [98]. Taking mini-breaks during the day gives physicians time to recharge and refocus [108]. Promote a Healthy Work Environment Physicians can take steps in their practice to promote a healthy work environment, and physicians in hospitals or managed care settings should work with leaders to ensure that all physicians and staff have a healthy work environment [19]. Flexible scheduling is an important element of a healthy work environment, as it gives physicians better control over their time and helps them achieve greater satisfaction with work-life balance [52; 108]. Participate in Support Groups Support from colleagues can help to increase job satisfaction and reduce the likelihood of burnout [44; 80; 109]. In one study, professional relationships were the second most com- mon strategy for preventing burnout, reported by 57% of physicians [94]. Physicians are often hesitant to seek help, but such support groups are not designed to be solely for physi- cians with mental health or substance abuse issues. Instead, support groups offer an opportunity for healthy but stressed physicians to discuss professional and personal problems [90]. Two randomized trials have demonstrated that programs offering physicians an opportunity to meet with colleagues in a structured format substantially reduced the rate of burnout and enhanced physician engagement [104; 110].
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