Preventing Physician Burnout

In a cross-sectional survey ("Predictors of physician career satisfaction, work-life balance, and burnout," Obstetrics & Gynecology) of randomly selected physicians from across the country just under half of all respondents indicated that they were satisfied with their work-life balance, and half of respondents indicated that they felt some level of emotional "resilience." It turns out that the lack of these two factors plays a significant role in the development of physician burnout; a syndrome that occurs when a person is under constant pressure, and is marked by emotional exhaustion, cynicism, feeling ineffective in one's work, and experiencing interpersonal difficulties. Burnout in physicians, which has been on the rise, has been linked to impaired job performance, poor health, marital difficulties, and alcohol or substance abuse.

The good news is that there are strategies that can be taken to significantly reduce the incidence and negative effects of burnout. Factors that are critical to combating burnout are havingcontrol over one's schedule, thenumber of hours worked, and emotional resilience. Unfortunately, in this current era of healthcare reform, controlling the first two factors can be quite challenging, but not impossible, if one takes a conscious and deliberate approach to managing priorities and time. Many physicians find that they spend a significant amount of time on activities that do not provide enough value - one way to think about this is to determine your "time ROI" (return on investment).

Follow these five steps to significantly improve your work-life imbalance:

1. Identify the five to eight most important aspects of your life (what you value most).

2. Now determine how much time you devote to those areas (and how much time is spent in areas not on your list).

3. If there is a disconnect between what you value and how you spend your time, this is a signal to you to make changes in your life.

4. Plan your time so that you are focused on what you value most.

5. Determine what can be delegated to others.

Preventing burnout also involves developing emotional resilience - the ability to manage stressful situations effectively and prevent stress from building up. For this we turn to some interesting research from the field of neuroscience that explores the link between stress, sleep, and positivity. These three factors have an interdependent relationship with one another - cause a change in one, and the other two are impacted.

So for example, the more stress in your life, the worse your sleep and mood. If you get too little sleep, then you will experience more stress and a lowered mood. In general, it can be difficult to derive meaningful change in the first two factors, sleep and stress, but much easier to have an impact on the latter one - positivity. If you are able to increase positivity, you will experience a significant improvement in sleep and a significant reduction in stress (negative emotional state).

Follow these simple brain-training steps to increase your positivity:

1. Practice positive "self-talk" by cultivating self-encouragement optimism, recognizing accomplishments, and appreciating good fortune.

2. Challenge your negative (typically distorted) thinking, the most common of which are:

• Catastrophic thinking. Identify a more realistic assessment of the situation. Usually, things are not as bad as we think they are. And often, our greatest learning comes from adversity.

• Black and white thinking. Challenge all-or-nothing thinking. Usually there is some gray area to work with. It is very seldom absolute.

• Jumping to conclusions. Avoid leaping to a foregone conclusion, such as thinking you know what others must be thinking. Learn to get curious, ask questions, and look for alternative explanations.

• Over generalizing. Look for a more accurate appraisal of the situation. When we look more closely at situations, we often find that negative or stressful outcomes are limited to that event, not generalizable across all situations.

• Excessive criticism. Whenever you hear yourself thinking, "should," substitute "it would be nice." This allows you to avoid excessive self-criticism or the belief that there is only one solution.

Changing thinking leads to changes in behaviors which leads to changes in results. So the easiest and most efficient method to change the results you are getting is to engage in positive and constructive thought patterns. As you transform your thoughts, you actually create an alteration in the neural connections in your brain. This in turn, leads to the development of new habits, ensuring that the changes you create are lasting ones.