Physician Heal Thyself

Physician Heal Thyself

Pediatricians are burning out. Are you one of them?
How to recognize, diagnose, and treat burnout in ourselves.“I was so tired; I didn’t realize how disconnected I was from my husband and children. I was not mentally present for them even when I was home because I was always thinking of the charts I have to finish or my day in the office. I didn’t even know I was burned out.”
– A. R. (Pediatrician in Virginia)

Physicians in Virginia, just like many around the country and for that matter around the world, are exhausted. We are trained to go, go and then go some more. We are always looking for the next goal. Just get into medical school, get through medical school, get through residency, and get through your fellowship. Physicians are trained to work all hours, suck it up, and never complain. This is the status quo. This is the way it has always been. Taking care of others is what we do. However, taking care of ourselves is not always a priority. The system is broken and we can and must fix it. Many of us do not recognize that we are burned out until it is pointed out to us by a friend, mentor, counselor or coach.
What is burnout?

In 1982, Dr. Christina Maslach defined burnout as a psychological syndrome involving emotional exhaustion, depersonalization, and a diminished sense of personal accomplishment that occurred among various professionals who work with other people in challenging situations.
The symptoms and feelings of burnout include:

• Emotional exhaustion- this feels like you are depleted of emotional and physical energy. You distance yourself emotionally and cognitively from work.
• Depersonalization or cynicism- this feels like you are detached from your job.
• Inefficacy- this feels like, not achieving what you want at work and feeling incompetent.

Dr. Maslach created a validated tool for measuring burnout called the Maslach Burnout Inventory (MBI). The advantages of the MBI are that it documents the range of burnout symptoms and can measure prevalence of symptoms. The disadvantages are that it does not identify the underlying causes of burnout and there is a cost to taking the MBI.

Do you need to take the MBI to recognize burnout in yourself? No, you need to pause, do some self-reflection and check in with yourself.
Ask yourself a few simple questions:

• How am I feeling, now? Get a journal, write down the answers or dictate it in the notes section of your phone. Take time to think about your feelings, reflect on the last week, reflect on the upcoming week. How does that make you feel? Excited or exhausted. Write that down. Over time, you will see patterns.
• Are you feeling cynical toward your patients? Do you resent going to work? Are you scared of going to work?
• Is my current job working for me? What would my ideal life look like? Am I achieving what I want at work? Am I working towards what I want?

What can you do once you recognize burnout in yourself?
Take some of these next steps:

• Take time away from work. Taking some time away from work and reflecting on your current situation can bring you self-awareness.
• Counseling – Find a licensed counselor who can talk with you privately about issues
• Coaching – Find a good physician coach. A coach will help you look at your thought processes and can get you to produce the results that you want in your life.
• Take some time for self-care. Shut off your devices, pick up a non-medical book that you want to read. Spend 15 minutes doing things that bring you joy.
• Prioritize sleep. Go to sleep at a good time.
• Take some time to alleviate your stress. Mindfulness is a great way to quiet your mind. Basic guided mediations are available on www.youtube.com
• Take your vacation. Many of us have not used our CME or vacation hours due to the pandemic. Taking time away from work is important for your mental health.
• Find peer support. Talk to others who understand what you are going through and have been trained as peer supporters.

The Virginia AAP cares about our pediatricians and wants to support you. The Virginia AAP Provider Wellness committee will be holding workshops that can help combat burnout. These interactive discussions will focus on topics such as finishing your charting in the office, imposter syndrome and how to achieve a work-life balance. Work-shops will include group coaching with certified physician coaches. We will be posting information on workshops during the summer of 2021. Stay tuned for more information. Learn more about Lotus Physician Coaching services.
Riva Kamat MD, FAAP
Founder and Co-Chair of the Virginia AAP Provider Wellness Committee
Pediatric Hospitalist at Inova Children’s Hospital in Falls Church, Virginia
Physician Coach and Founder of Lotus Physician Coaching, LLC
www.lotusclinicianwellbeing.com
Twitter: @rivakamat