Burnout

I have a friend who is a successful and acclaimed doctor who practices medicine in another state. He has been recognized by his peers as an outstanding physician and has received many honors. Her was recently named the chief wellness officer for a university health care and school of medicine. He explained his role this way:

“Unfortunately, physicians across the nation are increasingly suffering from symptoms of burnout, which can negatively impact patient care. This initiative will work to optimize the practice environments of our physicians, provide resilience education and create a safety net for physicians who require resources to treat or prevent burnout.”

I’m glad that doctors are working to treat and prevent professional burnout, but I suspect that the next time that I speak with my friend, if the subject come up, he will find that I have a few things to say about it. It seems to me that doctors should have been dealing with burnout a long time ago. They are highly compensated, have a lot of options for dealing with stress and are in a field where they have access to information and resources to take proactive action.

I am not unfamiliar with professional burnout. It is a phenomenon in my profession. However, in my field, preventing burnout is seen as an individual’s responsibility. The professional code of ethics for United Church of Christ ministers says, in part: “I will honor my ned for time for physical and spiritual renewal, recreation and vacation.” Self care is one of the expectations of those in my profession. You’d think it would be a basic responsibility of physicians.

I admit that I have a bias about physicians. I’m well compensated for the work I do. My salary and benefits are over three times the wages of a full-time minimum wage earner. It is also less than one tenth of the wages of a starting physician in practice in our community. There is a shortage of physicians in our country that is self-induced. Medical schools limit admissions to assure that the shortage is maintained. Thousands of extremely well-qualified students are turned away from medical schools each year. The shortage means that high wages for physicians are guaranteed for years to come. Physicians can afford to take vacations. They can afford to take time for professional development and continuing education. They can afford to schedule their work in a manner that allows for family commitments. It is hard for me to feel sorry for physicians who are experiencing burn out because they haven’t managed the stress of their profession.

I know that my attitude is not fair. Those who are experiencing burn out deserve effective treatment and physician burn out is a serious problem because it affects patient care as well as the life of the suffering physician.

Consider, however, the single mother in our community who is working two different jobs to provide for her children. When she isn’t working for wages, which she does 60 hours a week, she is responsible for childcare, laundry, shopping, cooking and cleaning. When her washing machine broke down there was no money for repairs so she used a laundromat for nearly six months while she saved to purchase a used machine for their home. She purchases her closing and much of the clothing for her children at thrift stores. Because her two jobs are not full time, she has no paid vacation. Even if she could find time for a vacation, there would be no extra money for travel. She leaned on relatives for childcare just to make it through the average work day and so cannot ask them to give here additional coverage when she has a day that isn’t scheduled for work at one of her jobs. She is tired all of the time, stressed because of financial pressures, worried about her children, and struggling to keep here head above water.

She doesn’t have anyone studying her stress levels or a well-funded university initiative with professional staff studying ways to treat and prevent her burnout.

Consider the elderly couple in our community who worked long and hard and prudently saved for their retirement only to have a major illness consume a great deal of their savings. They downsized to an apartment and returned to the workforce part time to make ends meet. Then another illness struck and even with medicare and a supplemental policy the expenses continue to outpace the income. Technically they qualify for section 8 housing assistance, but the waiting list for such an apartment is more than two years in our community and, frankly, they have no desire to accept more assistance. They have always been able to pay their own bills. They are well aware that they are just one more illness away from needing a nursing home which would completely wipe out their remaining resources.

There aren’t any university studies seeking solutions to the burned out feelings they have. There don’t seem to be any programs to prevent the stresses they feel.

I don’t mean to detract from the meaningful work that my friend does. I hope that his program is successful and that they learn a lot about treating and preventing burnout. But I also hope that they learn some things that can be applied to people in other professions and situations. Because the physicians who are becoming burned out are probably seeing patients in their practices like the overstressed single mother and the couple who are outliving their savings due, in no small part, to the high cost of health care. I hope they learn things that can be applied to preventing and treating burn out for those whose burnout goes undiagnosed and untreated simply because they can’t afford to see a doctor when they feel burned out.

And I hope, perhaps selfishly, that my colleagues in other professions, who are highly educated and well-compensated for their work, will begin to understand that preventing burnout is a professional ethical responsibility and they rather than blame others, or the nature of their job, or the limits of human endurance for the stress they experience will honor their “need for time for physical and spiritual renewal, recreation and vacation.”

The first step to preventing burnout may well be for individuals to take responsibility for its prevention.

Copyright (c) 2018 by Ted E. Huffman. I wrote this. If you would like to share it, please direct your friends to my web site. If you'd like permission to copy, please send me an email. Thanks!