Page 9 - Delaware Medical Journal - August, 2016
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PRESIDENT’S PAGE
DOROTHY M. MOORE, MD
MSD President Dorothy M. Moore, MD is an Ophthalmologist who practices at Delaware Eye MD Associates in Wilmington.
Physician Burnout: Caring for the Caregiver
Last month’s President’s Page discussed the prevalence of physician
emerging and getting the consideration
it needs. It should be considered not just for the sake of the individual physician dealing with it in the trenches, but also in the grand scheme of things, how it affects our hospital organizations, and in terms of its effect on health care reform.1
Health care reform is likely contributing to this, with increased numbers of insured, decreasing reimbursement in relation
to increasing practice expenses, EMRs, ever changing regulations, and reporting requirements, to name a few. Many
of these changes have contributed to increasing our workloads with decreased autonomy. We want to care for patients rather than spending time on regulatory paperwork, insurance preauthorizations, reimbursement issues, and charting to meet coding requirements, all allegedly in the name of quality patient care.
Physician burnout is characterized by2,3 loss of enthusiasm for work (emotional exhaustion); feeling of cynicism (depersonalization), and a low sense of personal accomplishment. Any of these sound familiar? For many of you reading this, it just may sound familiar given the grim statistic that as many as 50 percent of us experience burnout at some point in our work life.
So how do we assess this and, more importantly, address this to save one
of the key elements in our health care system – our physician workforce – from destruction? The classic assessment
tool for physician burnout is the Maslach Burnout Inventory (MBI).4 There are
other assessment tools, some of which are similar to the MBI, such as: the “Burnout Self-Test: Checking Yourself for Burnout” at mindtools.com; the “MiniZ Burnout Survey” part of the Steps Forward online program of the AMA at stepsforward.
org; “Doctor for Doctors - Burnout Questionnaire” from the British Medical Association at web2.bma.org.uk; or the abbreviated MBI at aap.org. You can answer.com. The questions relate to the areas of the symptoms of burnout with nine related to emotional exhaustion, accomplishment.4 Burnouttoolbox.com lists others. No doubt many of us will score high on any of these questionnaires.
So, how did we get here? Some blame our training. We are conditioned to work long hours and to continue to do so even after we are exhausted – the survivor mentality.2 Our profession requires long hours at peak performance, usually under chaotic, stressful conditions. We have been trained to put ourselves last ignoring our own stress levels. Our
jobs frequently interfere with our work- life balance with poor control over our schedules and the demands continually escalate. We frequently do not practice what we preach – wellness – by taking care of ourselves. Let’s not forget about the physician personality, our sense of personal responsibility that is desirable in a good physician but which can 2 Top that off with the new health care environment that is evolving and the increased physician
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