LAS VEGAS – A growing body of medical literature suggests that physicians are increasingly feeling burned out and dissatisfied with their profession.
In a 2009 survey of 7,905 surgeons, 40% described themselves as burned out, 30% screened positive for symptoms of depression, and 28% had a mental quality of life score that was greater than one-half of a standard deviation below the population norm (Annals Surg. 2009;250:463-71).
Dr. Stephen H. Mandy
"In addition, 49% said they would not want their children to be physicians," Dr. Stephen H. Mandy reported at SDEF Las Vegas Dermatology Seminar.
In a more recent survey of 16,394 internal medicine residents, 52% reported burnout, 46% reported high levels of emotional exhaustion, and 29% reported high levels of depersonalization (JAMA 2011;306: 952-60). Level of debt was correlated with a sense of burnout.
Common causes of burnout range from personal and professional financial debt to health problems and increased regulatory demands, but other reasons "are mostly due to boredom, which usually starts around age 45," said Dr. Mandy, a dermatologist who practices in Miami Beach. "Most people affected by burnout are very good at their job but they’re not learning anything new, they’re not challenged, and they’re not deriving satisfaction form their work."
A long list of potentially dire consequences face burned out dermatologists, he said, including loss of staff, divorce, alcoholism, medical errors that may translate into lawsuits, and other personal problems, as well as loss of patient confidence, trust, and satisfaction.
In a 2006 article, Dr. Mandy suggested that dermatologists and great culinary chefs share a certain kinship, including a thirst for knowledge, an artistic eye and sensitivity, and attention to detail (Clin. Dermatol. 2006;24:543-4). Both professions embrace "rigorous consistency and methodology, respect for tradition of the trade, service, and long years of training," he said.
Despite the parallels of the professions, he cautioned that success in dermatology comes with a price, including increased public exposure that may result in less privacy. "And if you’re expanding your business empire, expect to spend more time with management issues and personnel problems and less time doing what you like to do," he said.
Dr. Mandy offered the following tips for dermatologists on the verge of burnout:
• Reflect on why you chose medicine as a profession. "It is not only about the money; it’s about the service of others," Dr. Mandy emphasized. "If you forget why you went to medical school, volunteer for a month in a third-world country or inner-city clinic to remember."
• Be mindful of your lifestyle choices. "Practice in a peaceful place," he advised. "Engage and enjoy your patients – it’s fun and good business; and run your office in a manner that is fun."
Setting aside time for "the things you love" – be it family, pets, sports, hobbies, or other interests outside of work – is also key, as is a willingness to seek professional help in getting your life on track. In one recent study, primary care physicians who participated in an intensive educational program in mindfulness, communication, and self-awareness experienced short-term and sustained improvements in well being and attitudes associated with patient-centered care (JAMA 2009;302:1284-93).
• Know your capabilities. "You cannot build satisfaction on your weaknesses," he said. Build your body of knowledge, perfect your skills, and demonstrate your mastery by publishing and mentoring.
• Tune in to how your practice delivers service. "This means treating your patients well and your employees better," he said. "Easier is better than faster and cheaper."
• Manage your patient load. "Don’t overschedule," Dr. Mandy cautioned. "Keep a small, integrated, mutually dependent staff, and strive for excellence and service. Your receptionist is your biggest asset."
• Lead by example. "Be prompt and dress well, in a manner that reflects your style," he said. "Be professional."
Dr. Mandy said that he had no relevant financial conflicts to disclose.
SDEF and this news organization are owned by Elsevier.