By now, this is not news to you: burnout among physicians is common. A 2017 Medscape survey indicated that 55% of internists experienced burnout, defined in this context as a loss of enthusiasm for work, feelings of cynicism, and a low sense of personal accomplishment. ACP recognizes burnout as a significant threat and in response has developed an initiative to enhance physician well-being and professional satisfaction. In their statement of commitment, the College talks about “identifying strategies and necessary infrastructure to improve the efficiency of practice, reduce administrative burden, promote an organizational culture of wellness and enhance individual resilience.” In her recent column on the topic, Susan Thompson Hingle, MD, MACP, Chair of the ACP Board of Regents, writes: “ACP has long identified reducing administrative complexities or burdens as a priority, and the Patients Before Paperwork Initiative addresses systems challenges and seeks to reinvigorate the patient-physician relationship by challenging unnecessary practice tasks.” This is one step towards addressing dissatisfaction with the weight of administrative burdens. Regarding organizational culture, ACP offers “Top 10 Culture Change Interventions to Reduce Burnout and Improve Physician Well-being”, including identifying a wellness champion, focusing on leadership development, and establishing a culture that emphasizes teamwork and relationships; I highly recommend reviewing this.
Many of us have teaching and leadership roles. At the residency level, the ACGME also recognizes a need for change; they updated the common program requirements in response. In this context, they relate self-care to professionalism and describe it as a skill to be learned and developed along with other aspects of residency training. Promoting resilience is an important part of the approach to reducing burnout, particularly among trainees and junior colleagues. In a recent commentary in Academic Medicine, Abaza and Nelson speak to the issue of role modeling and resilience: “More than just being understanding and supportive of our learners’ self-care needs, this means providing the role modeling they need to see to understand the relevance of self-care. […] We need to openly talk about the dilemmas we face in making choices between our needs, our family’s needs, and our patients’ needs. […] Balance does not mean forgoing responsibility for obligations but finding ways, to the best of one’s ability that day, to accomplish them within a reasonable framework.” [Acad Med. 2018;93:157–158.]
The solutions aren’t easy, but there is no question we need to continue to focus attention on burnout and resilience for the good of our patients and our profession. I urge you to review ACP’s resources at https://www.acponline.org/practice-resources/physician-well-being-and-professional-satisfaction.
-Rob Nardino, MD, FACP