The Healthy Radiologist: Am I burned-out?

2016 10 12 15 35 01 841 Funt Stacy 400

Are you feeling tired and cynical, as if your job is sucking the life out of you? If you answered yes, you're not alone!

Some 50% of all physicians reported at least one symptom of burnout, with radiology ranking the fourth-highest among all medical fields sampled, according to a survey from Shanafelt et al published in Mayo Clinic Proceedings in December 2015. And it's getting worse: The overall burnout rate increased 10% from 2011 to 2014. For radiology, the burnout rate went from 47.7% to 61.4%.1

Dr. Stacey Funt.Dr. Stacey Funt.

Burnout is different from job-related stress. With stress, you can bounce back to your old self after a nice weekend off or a vacation. Burnout, on the other hand, is not so easily remedied.

Burnout is defined as chronic, debilitating stress that depletes all of your energy reserves. University of California, Berkeley psychologist Christina Maslach, PhD, known for her pioneering research on occupational burnout,2 defines it as a "prolonged response to chronic emotional and interpersonal stressors on the job, and is defined by the three dimensions of exhaustion, cynicism, and inefficacy." You feel like you can't recharge your battery and are going through the motions just to survive. The Maslach Burnout Inventory (MBI) is the standard questionnaire used to determine its presence; you can find an abbreviated version here.

The consequences of burnout are pervasive and go way beyond the loss of joy and meaning at work. Burnout can destroy relationships and lead to addiction, worsening health, depression, and even suicide. It can affect professional performance, resulting in decreased concentration and lower productivity and accuracy, as well as cause personality changes, including increased anger. If a physician who has clinical contact is suffering from burnout, it can lead to poor patient interaction and lower patient satisfaction.

While there is certainly a continuum of burnout and symptoms can vary greatly, it is important to recognize early signs of burnout in yourself or a colleague before it progresses.

What causes burnout?

The causes of burnout are usually multifactorial. The list of external factors that can contribute to burnout in the current climate of healthcare is extensive: loss of autonomy, corporate takeovers, job insecurity, workflow demands and inefficiencies, scheduling, isolation, reimbursements, strained administrative relationships, etc.

Many of these issues are addressed at the organization or system level, and getting involved with finding solutions can be empowering. But for many of us, this feels beyond our sphere of influence. You could also be managing a tough work environment well enough, but a crisis in your personal life such as a failing relationship, ill health, or financial strain could send you over the edge.

If you are in an abusive or unhealthy work environment, finding new employment or reducing your hours may be your best bet, and taking even the first step in that process can bring some relief. However, if that is not an option for you and you can't affect any of the external factors, there is still good news: There are many things within your internal domain that you can control to reduce burnout.

Building your own resilience, focusing on self-care, reframing your thoughts, connecting to your values, prioritizing, managing your emotions, and making changes to how you practice can all help restore your emotional health. There is a plethora of resources for help, including books, websites, articles, groups, coaches, courses, counselors, select peers, and employee programs.

If you are concerned that someone you work with is experiencing burnout, talk with him or her. Ask how the person is, follow up, and provide support. If you feel burned-out or are on your way to it, start by taking one action step. Below are just a few ideas to consider. See if any resonate with you, or create your own robust self-care plan:

  • Take care of your body. Exercising, eating well, and getting enough sleep can help replenish your energy reserve, increase your self-esteem, and reduce depression.
  • Spend time with people you love and/or enjoy. Nurture your relationships and develop support outside of work.
  • Develop interests outside of work. Have other sources for self-esteem, joy, meaning, and satisfaction.
  • Make a list of what "feeds you," and make time for those things. Make "appointments" for self-care and put them on your calendar. Then keep them.
  • Take a class in mindfulness or stress management. Develop a practice that suits your interests and beliefs.
  • Work on tolerating imperfection (in yourself and life around you). Many of us are perfectionists by nature, and that can greatly compound an already stressful life. Be open to self-compassion.
  • Make a list of your top five priorities in life and see if you are living in alignment with them. Let your values be your compass in your decisions.
  • Get outside help if your situation is not improving with your own efforts.

If your current life story is not what you had in mind, then make some changes.

As Albert Einstein said, "If you always do what you've always done, you will always get what you've always got."

References

  1. Shanafelt TD, Hasan O, Dyrbye LN, et al. Changes in burnout and satisfaction with work-life balance in physicians and the general U.S. working population between 2011 and 2014. Mayo Clin Proc. 2015;90(12):1600-1613. Erratum in: Mayo Clin Proc. 2016;91(2):276.
  2. Maslach C, Schaufeli WB, Leiter MP. Job burnout. Annu Rev Psychol. 2001;52:397-422.

Dr. Stacey Funt is a board-certified radiologist, coach, and clinical instructor in lifestyle medicine. She is the founder of Lifestyle Health, a health coaching and consulting company, focusing on self-care for busy professionals with private coaching, interactive workshops, and lectures. Dr. Funt also teaches burnout prevention for physicians in training at multiple residency programs, in addition to her work as a part-time radiologist in New York. Her website can be viewed at Lifestyle-health.net.

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