Physician well-being is essential to optimal patient care

I chose to leave clinical medicine in 1996 after just three years as a general internist. At the time, I was certain that it was the right decision and necessary for my overall health, but could not have articulated all the reasons why I needed to leave. I loved both the intellectual challenge and the art of medicine. I thoroughly enjoyed my connections with patients. I regarded my professional life as a privilege.

And yet I felt emotionally drained. The struggle to provide safe care in an environment that seemed ill-equipped to mitigate human errors felt unending. I found it difficult to leave work at work. I suffered from sleep disturbances. I tried different practice environments, but was unable to find a situation that worked for me.

Becoming a freelance writer gave me the freedom to focus my attention on understanding the problems that frustrated and worried me in training and practice. In my second career I apply my clinical experience every day to communicate knowledgably about the flaws in our health care system — and the solutions that innovative individuals and organizations are using to solve these complex problems. I feel gratified to have a clear mission today that aligns with the reasons I chose medicine in the first place: to improve patient care.

It’s my belief that physician well-being is essential to optimal patient care, especially in the face of recent changes in the health care arena, such as value-based contracting and the patient-centered medical home model. Burned out physicians cannot take on the additional requirements inherent in these initiatives, such as embracing the EMR, enhancing patient engagement, leading effective teams, and ensuring care continuity. With additional stress, they may experience more severe symptoms of burnout, hindering their ability to provide ideal care, or they may leave practice, as I did. I was fortunate enough to land on my feet. Others do not.

I heard a statistic last fall at the Massachusetts Medical Society conference on physician well-being that prompted me to action: Female physicians have a suicide rate that is 130 percent higher than women in the general population (for male physicians the rate is 40 percent higher). Although the data do not draw a direct correlation between physician stress and suicide, I did. I decided to share my story — to put a face on physician burnout and to highlight the importance of the problem.

In October 2013 I wrote a guest blog for WBUR. The response — 20,000 hits through Facebook, more than 300 comments, and many emails — suggests that the post hit a nerve. Since the posting I’ve had many conversations with physicians who have reached out to share their stories of burnout and exhaustion. Their frustrations with the current practice environment. Their desire to spend more time with patients. Their sense of hopelessness.

I wanted to find ways to support physicians who are experiencing stress and burnout. Editing the submissions for the “What Works 4 Me” blog is one step I’m taking to lend support. By offering suggestions about what works, the blog underscores both the scope of physician stress and the importance of physician wellness. And it offers hope. Stress is inherent in the practice of medicine. Burnout doesn’t need to be.

Diane Shannon is an internal medicine physician.  This article originally appeared in What Works For Me, a joint project by the Massachusetts Medical Society and the Institute of Lifestyle Medicine.

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