Toronto – Canada




Photography By James T. Rutka, MD



On Being Mindful




In the medical profession, we often wear multiple hats:  physician, scientist, educator, advocate, committee participant, administrator, parent, sibling, and friend are just a few! Thus it is no wonder that the topic of physician burnout is on the rise in nearly every medical journal, blog or Twitter feed.  Physicians spend a significant amount of time caring for others but this should not preclude them from caring for themselves.


Dr. Charles Balch (surgical oncologist, Johns Hopkins) is credited for pioneering research inquiry into surgeon burnout.  He categorized burnout as a clinical syndrome which is evidenced by emotional exhaustion, a decreased sense of personal accomplishment, and a detached or negative response to patient care.


Results from subsequent national studies led by the American College of Surgeons suggest that burnout rates among surgeons range from 30 to 38%.  The implications are far-reaching; every one-point increase in burnout is associated with a 5 to 11% increased risk of having made a major medical error within the past three months.  Burnout is strongly associated with decreasing job satisfaction; interestingly, career satisfaction is at times specialty specific, and highest among paediatric, orthopaedic, and endocrine surgeons (80-90% satisfaction) and lowest among vascular surgeons (36% satisfaction).  6.4% of physicians report suicide ideation; burnout compromises decision-making and compassion; burnout leads to disruptive behaviours such as alcohol and drug abuse, broken personal relationships, and workplace conflicts.  Burnout is largely a systems-level issue, not an individual choice.


Of course, job burnout is common in numerous occupations and professions.  It may be caused by having unclear job expectations or not knowing what others expect from you in the workplace.  Your job may be a poor fit for your interests and skills, causing increased stress over time. You may find yourself in the midst of strained workplace dynamics, and may feel undermined by colleagues at every turn.  You may find that your work-life balance ratio is out of balance and you are spending less time with your friends or family.  To recognize job burnout, you may wish to ask yourself the following questions:  Am I inpatient with my colleagues at work?  Do I find going to work a challenge and a struggle each day?  Have my sleeping or eating habits changed while at this job?  Or are my achievements at work not important to me anymore?


Juggling multiple interests is part and parcel of the lives we lead, and I daresay that this does enhance our productivity.  And yet a great paradox occurs in that the traits that drive many of us to excellence are the same traits that drive us to exhaustion.  Though we are used to making certain personal sacrifices for our patients and our careers, our mental wellbeing should not be one of them.







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