Acknowledging burnout is important first step

By Brooks Jackson / Health Care Column

For many of us, the arrival of spring means graduation – a memorable moment for students and families. As dean of the University of Iowa Carver College of Medicine, I have the privilege of participating in our commencement ceremony, and it’s always gratifying to see our fourth-year medical students’ faces as they celebrate what they’ve accomplished and look forward to their careers as physicians.

To share in our students’ pride in reaching this next step on the journey to becoming a doctor is humbling and reinvigorating. It makes me think back to when I was a medical student, and how eager I was to enter the next phase of my career.

I also recognize that our soon-to-be doctors are entering medicine at a time when many of their colleagues are questioning their desire to continue in the profession.

Physician burnout is a hot topic these days, with news stories or journal articles stating that at least a third, and perhaps as many as half, of doctors have experienced professional burnout, which can be described as displaying one or more of these characteristics or behaviors:

  • Detachment and depersonalization, which can include any combination of anger, cynicism, sarcasm and a general lack of empathy or understanding to clients and colleagues
  • Exhaustion, both physical and mental, that cannot be remedied with normal rest or time away from work
  • Increased inability to perform one’s day-to-day responsibilities professionally, consistently and satisfactorily
  • A feeling of “loss of control” related to workload, time and decision-making

Burnout is more than an occasional “bad day.” It’s a prolonged period of the challenges outlined above. And it affects employees from all industries and at all levels of experience and expertise.

Its consequences can be serious and wide-ranging: substandard service and diminished productivity, lack of communication and collaboration, loss of trust, higher turnover and a greater risk of alcohol or drug abuse and suicide.

For many professionals, what makes burnout difficult to prevent or overcome is the ongoing cultural belief that “work always comes first.” Compounding the issue is the reluctance of some employees to admit experiencing burnout out of concern that doing so may signify weakness, or even incompetence, to their employers, clients and customers.

In medicine, the implementation of electronic health records is often cited as a major source of frustration (and loss of control, as already noted) and subsequent cause of burnout. Navigating EHRs is indeed one aspect of administrative work that’s become the bane of busy doctors. Other burnout factors may include too many hours in the clinic or hospital, lack of respect from administrators, leaders and colleagues, compensation and reimbursement issues, governmental oversight and regulations, too great an emphasis on finances and serving in a profession that sometimes seems to prioritize process over people.

These are not new challenges, and they are not unique to the health care profession. Companies and employees have struggled with paperwork, technology, regulation and bureaucracy for generations. This is not to minimize the issue of burnout but to suggest that perhaps today’s workforce is becoming more cognizant of work-life balance and less reluctant in acknowledging burnout.

As the old saying goes, the first step toward fixing a problem is admitting it exists. In this respect, the health care profession is making progress, as reflected in the medical literature and the popular press.

A key next step is to get informed and take advantage of professional services and resources when burnout starts – for yourself and for your colleagues.

Brooks Jackson is University of Iowa vice president for medical affairs and dean of the UI Carver College of Medicine.