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Recommendations and Resources for Coping with Burnout

  • Mariam AbdurrahmanEmail author
  • Heather Hrobsky
Chapter
  • 25 Downloads

Abstract

Physician burnout is prevalent across the profession, with prevalence rates ranging from a third to over half of North American physicians and trainees. Burnout is associated with depression, suicidal ideation, and substance abuse. Burnout can also be associated with unprofessional behavior, reduction in productivity, and medical errors. The elevated rates of burnout, the associated comorbidities, and the health systems impact constitute a public health crisis. Physician burnout is a personal, organizational, and health systems crisis that requires urgent attention. The purpose of this chapter is to provide recommendations and resources aimed at the recognition and management of burnout.

Keywords

Physician burnout Detachment Depletion Disengagement Physician engagement Occupational stress Wellness Work stress 

References

  1. 1.
    World Health Organization. Burnout. https://icd.who.int/browse11/l-m/en#/http://id.who.int/icd/entity/129180281. Accessed 1 Oct 2019.
  2. 2.
    Shanafelt TD, Hasan O, Dyrbye LN, Sinsky C, Satele D, Sloan J, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general US working population between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600–13.CrossRefGoogle Scholar
  3. 3.
    Puffer JC, Knight HC, O’Neill TR, et al. Prevalence of burnout in board certified family physicians. J Am Board Fam Med. 2017;30(2):125–6.CrossRefGoogle Scholar
  4. 4.
    Peckam C. Medscape national physician burnout & depression report 2018. 12 Jan 2018. https://www.medscape.com/slideshow/2018-lifestyle-burnout-depression-6009235?faf=1. Accessed 1 Oct 2019.
  5. 5.
    West CP, Dyrbye LN, Shanafelt TD. Physician burnout: contributors, consequences and solutions. J Intern Med. 2018;283(6):516–29.CrossRefGoogle Scholar
  6. 6.
    Rotenstein LS, Torre M, Ramos MA, Rosales RC, Guille C, Sen S, Mata DA. Prevalence of burnout among physicians: a systematic review. JAMA. 2018;320:1131–50.CrossRefGoogle Scholar
  7. 7.
    Mata DA, Ramos MA, Bansal N, et al. Prevalence of depression and depressive symptoms among resident physicians: a systematic review and meta-analysis. JAMA. 2015;314(22):2373–83.CrossRefGoogle Scholar
  8. 8.
    Rotenstein LS, Ramos MA, Torre M, et al. Prevalence of depression, depressive symptoms, and suicidal ideation among medical students: a systematic review and meta-analysis. JAMA. 2016;316(21):2214–36.CrossRefGoogle Scholar
  9. 9.
    Patel RS, Sekhri S, Bhimanadham N, et al. A review on strategies to manage physician burnout. Cureus. 2019;11(6):e4805.PubMedPubMedCentralGoogle Scholar
  10. 10.
    Dyrbye LN, Thomas MR, Shanafelt TD. Systematic review of depression, anxiety, and other indicators of psychological distress among U.S. and Canadian medical students. Acad Med. 2006;81:354–73.CrossRefGoogle Scholar
  11. 11.
    Wallace JE, Lemaire JB, Ghali WA. Physician wellness: a missing quality indicator. Lancet. 2009;374:1714–21.CrossRefGoogle Scholar
  12. 12.
    Dyrbye L, Shanafelt T. A narrative review on burnout experienced by medical students and residents. Med Educ. 2016;50:132–49.CrossRefGoogle Scholar
  13. 13.
    West CP, Dyrbye LN, Erwin PJ, et al. Interventions to prevent and reduce physician burnout: a systematic review and meta-analysis. Lancet. 2016;388:2272–81.CrossRefGoogle Scholar
  14. 14.
    Panagioti M, Panagopoulou E, Bower P, et al. Controlled interventions to reduce burnout in physicians: a systematic review and meta-analysis. JAMA Intern Med. 2017;177:195–205.CrossRefGoogle Scholar
  15. 15.
    Shanafelt TD. Noseworthy JH[]. Executive leadership and physician well-being: nine organizational strategies to promote engagement and reduce burnout. Mayo Clin Proc. 2016;92:129–46.CrossRefGoogle Scholar
  16. 16.
    Ruzycki SM, Lemaire JB. CMAJ. 2017;189:E1236–7.CrossRefGoogle Scholar
  17. 17.
    Halbesleben JRB, Rathert C. Linking physician burnout and patient outcomes: exploring the dyadic relationship between physicians and patients. Health Care Manag Rev. 2008;33(1):29–39.CrossRefGoogle Scholar
  18. 18.
    West CP, Tan AD, Habermann TM, Sloan JA, Shanafelt TD. Association of resident fatigue and distress with perceived medical errors. JAMA. 2009;302(12):1294–300.CrossRefGoogle Scholar
  19. 19.
    Shanafelt TD, Mungo M, Schmitgen J, et al. Longitudinal study evaluating the association between physician burnout and changes in professional work effort. Mayo Clin Proc. 2016;91(4):422–31.CrossRefGoogle Scholar
  20. 20.
    Pearl R. The unspoken causes of physician Burnout. https://www.forbes.com/sites/robertpearl/2019/07/08/physician-burnout-1/#1a93d568119e. Accessed 20 Sept 2019.
  21. 21.
    Ecleberry-Hunt J, Van Dyke A, Lick D, Tucciarone J. Changing the conversation from burnout to wellness: physician well-being in residency training programs. J Grad Med Educ. 2009;1(2):225–30.CrossRefGoogle Scholar
  22. 22.
    Accreditation Council for Graduate Medical Education. Common program requirements (residency) 2019. https://www.acgme.org/Portals/0/PFAssets/ProgramRequirements/CPRResidency2019.pdf. Accessed 17 Oct 2019.
  23. 23.
    Gazelle G, Liebschutz JM, Riess H. Physician burnout: coaching a way out. J Gen Intern Med. 2015;30(4):508–13.CrossRefGoogle Scholar
  24. 24.
    Mahood SC. Medical education: Beware the hidden curriculum. Can Fam Physician. 2011;57(9):983–5.PubMedPubMedCentralGoogle Scholar
  25. 25.
    Devi S. Doctors in distress. Lancet. 2011;377:454–5.CrossRefGoogle Scholar
  26. 26.
    Mohanty D, Prabhu A, Lippmann S. Physician burnout: signs and solutions. J Fam Pract. 2019;68(8):442–6.PubMedGoogle Scholar
  27. 27.
    Gaiser RR. The teaching of professionalism during residency: why it is failing and a suggestion to improve its success. Anesth Analg. 2009;108(3):948–54.CrossRefGoogle Scholar
  28. 28.
    Gofton W, Regehr G. What we don’t know we are teaching: unveiling the hidden curriculum. Clin Orthop Relat Res. 2006;449:20–7.PubMedGoogle Scholar
  29. 29.
    Lyons B, Gibson M, Dolezal L. Stories of shame. Lancet. 2018;391(10130):1568–9.CrossRefGoogle Scholar
  30. 30.
    Boehm KS, McGuire C, Boudreau C, Jenkins D, Samargandi OA, Al-Youha S, Tang D. The shame-blame game: is it still necessary? A National survey of shame-based teaching practice in canadian plastic surgery programs. Plast Reconstr Surg Glob Open. 2019;7(2):e2152.CrossRefGoogle Scholar
  31. 31.
    Stehman CR, Testo Z, Gershaw RS, Kellogg AR. Burnout, drop out, suicide: physician loss in emergency medicine, Part 1. West J Emerg Med. 2019;20(3):485–94.CrossRefGoogle Scholar
  32. 32.
    Dyrbye LN, Eacker A, Durning SJ, et al. The impact of stigma and personal experiences on the help-seeking behaviors of medical students with burnout. Acad Med. 2015;90:961–9.CrossRefGoogle Scholar
  33. 33.
    Vogel L. Medical education needs reform to improve student well-being and reduce burnout, say experts. CMAJ. 2018;190:E1426–7.CrossRefGoogle Scholar
  34. 34.
    Zivanovic R, McMillan J, Lovato C, et al. Death by suicide among Canadian medical students: a national survey-based study. Can J Psychiatr. 2018;63:178–81.CrossRefGoogle Scholar
  35. 35.
    Schernhammer ES, Colditz GA. Suicide rates among physicians: a quantitative and gender assessment [meta-analysis]. Am J Psychiatry. 2004;161(12):2295–302.CrossRefGoogle Scholar
  36. 36.
    Kulkarni A. Navigating loneliness in the era of virtual care. N Engl J Med. 2019;380:307–9.CrossRefGoogle Scholar
  37. 37.
    Brown S. Bringing back the doctors’ lounge to help fight burnout. CMAJ. 2019;4(191):E268–9.CrossRefGoogle Scholar
  38. 38.
    Klevos GA, Ezuddin NS. In search of the most effective interventions for physician Burnout. https://www.physicianleaders.org/news/discussion-burning-brightly-burning-out. Accessed 13 Oct 2019.
  39. 39.
    Verweij H, van Ravesteijn H, van Hooff MLM, et al. Mindfulness-based stress reduction for residents: a randomized controlled trial. J Gen Intern Med. 2018;33:429–36.CrossRefGoogle Scholar
  40. 40.
    American Medical Association STEPS Forward. 2015. Resident and fellow burnout: create a holistic, supportive culture of wellness. https://edhub.ama-assn.org/steps-forward/module/2702511. Accessed 21 Sept 2019.
  41. 41.
    Shanafelt TD, Goh J, Sinsky C. The business case for investing in physician well-being. JAMA Intern Med. 2017;177:1826–32.CrossRefGoogle Scholar
  42. 42.
    George A. 2019. What's the true cause of physician burnout? https://www.medicaleconomics.com/news/whats-true-cause-physician-burnout. Accessed 21 Sept 2019.
  43. 43.
    Hengerer A, Kishore S. 2017. Breaking a culture of silence: the role of state medical boards. National Academy of Medicine, Washington. https://nam.edu/breaking-a-culture-of-silence-the-role-of-state-medical-boards/. Accessed 31 Oct 2019.
  44. 44.
    Jena AB, Prasad V. Duty hour reform in a shifting medical landscape. J Gen Intern Med. 2013;28(9):1238–40.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Department of PsychiatrySt. Joseph’s Health CentreTorontoCanada

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