6 steps to reduce radiologist burnout

By Kate Madden Yee, AuntMinnie.com staff writer

May 5, 2016 -- That stress you're feeling isn't all in your head. Diagnostic radiologists are vulnerable to burnout, with nearly half showing symptoms in a recent study. Fortunately, there are six steps you can take to fight burnout, according to a new report from the American College of Radiology's Commission on Human Resources.

A 2015 survey showed that burnout of radiologists was seventh highest among all physicians, compared with being 18th highest just two years earlier. What's more, a 2014 survey found that just slightly more than one-third of radiologists (37%) said they were happy at work.

Dr. Jay Harolds
Dr. Jay Harolds of Michigan State University.

Burnout is a problem for individuals, but it can also have significant negative consequences for radiology practices and their patients, wrote a team led by Dr. Jay Harolds of Michigan State University in an article published in the Journal of the American College of Radiology (April 2016, Vol. 13:4, pp. 411-416).

"Burnout can have adverse effects on professionalism, academic and clinical performance, patient safety, interpersonal relationships, personnel retention, and patient satisfaction," the group wrote.

What is burnout?

Burnout is a mix of emotional exhaustion, a decreasing sense of accomplishment, and depersonalization -- that is, a negative and detached attitude toward oneself and others, Harolds and colleagues wrote. It can be caused by many factors:

  • Declining income
  • Inadequate training/skills for the job
  • Isolation in the workplace
  • Long hours
  • Poor intellectual stimulation
  • Poor relationships with colleagues and patients
  • Severe time constraints for work output
  • Too much night call
  • Unfair supervisors
  • Work overload

Other risk factors include making medical errors, having struggles between work and home, poor work and lifestyle balance, and not taking care of one's physical and emotional needs. Personality traits such as being perfectionistic, self-critical, or idealistic don't help either, the group wrote.

"Decreasing reimbursements mean that in order to make the same amount of income, radiologists need to read more studies," Harolds told AuntMinnie.com. "Some do this to maintain a particular lifestyle, but others do it because medical school put them into $200,000 worth of debt. As well, technology like PACS has led to greater efficiency, but also to more isolation, since interactions with referring physicians are rare."

Avoiding burnout

Harolds and colleagues listed six potential risk factors for burnout and ranked them by order of importance. The team then offered suggestions for ways to reduce burnout risk:

  1. Hire adequate staff. Not having enough radiologists to do the work of a practice is a key factor in burnout. "It may be helpful to offer to pay one or more members of the radiology group to work one or multiple additional hours as a volunteer rather than routinely requiring all the radiologists to work longer," the authors wrote.
  2. Mitigate stress. High-stress environments make doctors 15 times more likely to develop burnout. "Appropriate scheduling, time for adequate rest, a reasonable pace of work, and fairness in the workplace are important for preventing burnout," they wrote.
  3. Establish a sense of control. Burnout arises when radiologists aren't involved in their practice's decision-making, when there's poor communication, and when staff achievements aren't acknowledged. "Satisfaction in the workplace is high in organizations that emphasize teamwork, empower healthcare professionals by involving them in decision-making, recognize good work ... and have excellent communication," according to the authors. They suggested that practices give their radiologists credit for contributions beyond clinical duties, offer mentoring programs, and provide a way for them to identify areas of dissatisfaction -- and then address them.
  4. Reduce night and weekend call duties. Some practices hire full- or part-time radiologists to handle night and weekend shifts, establish a reading station in another time zone, or make shifts shorter to mitigate this problem.
  5. Encourage a balanced lifestyle. Studies have found that one of the best ways to prevent and treat physician burnout is to seek a balanced lifestyle, including physical, emotional and spiritual balance; taking care of oneself; and getting adequate time off. "A radiologist should seek to maximize time spent in various activities that he or she finds important," the authors wrote.
  6. Improve efficiency. Ideas for improving radiologist efficiency include hiring staff for dictation; using radiologist assistants, nurse practitioners, or physician assistants; and decreasing the amount of administrative work radiologists do.

Practices should also help their radiologists set reasonable financial expectations and goals, reduce their isolation, and even hire professional help if needed, such as an organizational psychologist, Harolds and colleagues wrote. Another resource is the American Medical Association, which has an online module specifically about preventing physician burnout. The module includes the "Mini Zero Burnout Survey," a free tool that helps track workplace stress among practice members.

Awareness is key

The Commission on Human Resources would like the radiology community to become more aware of the problem of burnout -- and take action to address it, Harolds said.

"We've got to help radiologists with their lifestyle balance," he said. "If you're constantly under tremendous work pressure, and you don't have time for your family, for exercise, for activities you enjoy, that's not a good recipe for health or happiness. The radiology community as a whole really needs to acknowledge this problem."

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Last Updated np 5/5/2016 11:19:59 AM

36 comments so far ...
5/5/2016 4:01:06 PM
Little H
Most important, realize that burn out can only be addressed if the entire department is on board.  As an individual, you will be at the mercy of the group's work ethic.  Try to join a group which tries to balance work load, stress and income for the benefit of all.

5/5/2016 4:03:40 PM
+1 above comment. 
Alignment of one's work/life/professional priorities with the dominant culture of the group is key to avoiding burnout, IMO.

5/5/2016 4:20:35 PM
In a tight job market most people don't have many choices. 

5/5/2016 6:38:37 PM
Interview2017 is correct.
Physician burnout lectures and articles irritate me, because as a Resident you hear the Compliance Required "burnout spiel", but are powerless to enact any burnout precautions. Try working less hours in residency and getting more rest, yeah right. Try working at a slower pace while On-Call so you are less stressed and make less mistakes and you'll soon be looking for another line of work.
Those habits and values carry over into Attendingship. Witness how much grumbling occurs when a physician colleague is off ill for a day or is taking maternity leave, especially in a private practice sort of group.
Our attending physicians are killing themselves, making good money, but killing themselves caught between exponential increases in volume versus threats of losing the practice to a tele radiology group, or becoming employees at about half their current pay. Sure, the simple cure is to hire more radiologists, but that means each group member taking anywhere between a 5% to 20% pay cut to bring on new people. Unfortunately, Radiologists are already working harder, faster and/or longer to offset a 5-20% pay/reimbursement cut. Hence we have more utilization of imaging resources with less radiologists; thus current radiologists are trying to work faster, which increases throughput, increases stress and increases errors.
In order to eliminate physician burnout, physicians have to realize they are not gods and that mortals need rest. Having rest is not only good for the doctor (attending and resident physicians) it is good for the patients (less errors).
Then, physicians have to stop the mad rush to increase throughput, which is an erroneous assumption throughput equals productivity. Productivity also implies a functional quality of the product and not simply a number of units passing down a conveyer in a given time.
More importantly is that in many industries, increasing productivity may increase profit or increase income. In medicine, every increase in productivity has led to a decrease in reimbursement. In other words, physicians do not reap the benefits of being more productive, because their service is constantly de-valued as throughput increases. Hence, physicians trying to work faster are only devaluing their services and will get paid less per unit of production. 
Eventually physicians just need to say "Enough, I'm not going faster just to feed malpractice lawyers with my mistakes and get libeled and slandered in the media for being a leading cause of deaths". 

5/6/2016 4:14:44 AM
Burnout as a resident??????

Wow wait until you are 50