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It’s time to advocate for a new culture in medicine

Dianne Ansari-Winn, MD, MPH
Physician
October 6, 2018
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The National Taskforce of Humanity in Healthcare recently published research showing physician burnout is impacting quality safety, and health care system performance — estimating that “costs for burnout-related turnover may be as high as $1.7B annually among hospital-employed physicians, and $17 billion across all U.S. physicians.” At Stanford Medicine, physician burnout costs at least $7.75M yearly.

These numbers are staggering. Growing numbers of physicians are leaving medicine (surely impacting the physician shortage) and over half of U.S. physicians are experiencing burnout.

Meditation rooms and yoga will not cut it.

Experiencing burnout first-hand as a practicing anesthesiologist caused me to leave clinical practice after 15 years but led me down another path advocating for a new culture in medicine that respects and invests in physician wellness.

For the majority of doctors, myself included, practicing medicine is not just a job, it’s a whole lifestyle. Because of this, physicians often feel they shouldn’t need help doing their job, so they suffer in silence. The lack of conversation between physicians makes burnout very isolating, despite the number of doctors experiencing it. This isolation, on top of a culture in medicine that glorifies burnout as a sort of rite of passage, further compounds the problem.

For physician burnout and the stigma around it to end, health care organizations need to make changes to create a more supportive culture in medicine for physicians and, therefore, patients.

First, when scheduling physician shifts, it’s imperative to take into account each physician’s needs, so they feel seen and valued as an individual, versus a cog in a money-driven, seven-on-seven-off machine. When physicians are enabled to have greater flexibility and work-life balance and are included in the process of setting their own work schedules, a large portion of factors that contribute to burnout are eliminated.

The next thing health care organizations can do to create a more wellness-focused culture for physicians is to foster conversation and education around burnout. When I first began to experience burnout in practice, I didn’t know what to do or who to talk to. It’s important for doctors to be able to recognize physician burnout, seek help from colleagues or a professional, and get better at practicing self-care. I hear from residents and physicians who express their frustration with lectures about implementing these strategies without any real tools to do so. Physicians who experience burnout need to know where to turn and have both colleagues and coaches who know how to support them without judgment.

Last, but perhaps most desperately needed, is a shift in the systemic culture of medicine. Medicine is really hard. Yet, doctors devote their entire lives and hundreds of thousands of dollars in student loans to being able to do it because they truly want to help people. When physicians are healthy in mind, body, and spirit, the work they do is amazing. If they aren’t taking a holistic approach to their own wellness, they aren’t able to do as much for others. I liken this to the familiar airplane metaphor. Doctors need to put their own oxygen mask on first, so they can help their patients.

At the same time that the health care industry has become, in large part, about making money, doctors have gotten lost in the shuffle. There’s a stigma that, following the metaphor, sounds a lot like: “Why do doctors need oxygen in the first place? Why are they not able to breathe?” Physicians aren’t just the hours they work or the dollars they generate; they aren’t superhuman.

For burnout to end, the culture around medicine has to change. This requires digging deep and shifting to more realistic expectations of physicians, reinvigorating medicine with the human element (for both patients and providers), and utilizing technology, such as AI, that can alleviate an immense amount of pressure by allowing more complex and flexible schedules. We’ve already identified the problem. It’s time to actively work to implement these solutions, for the sake of physicians, their families, and, of course, their patients.

Dianne Ansari-Winn is an anesthesiologist and founder, Physician Vitality Institute, and a member of the medical advisory board, Lightning Bolt Solutions.

Image credit: Shutterstock.com

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It’s time to advocate for a new culture in medicine
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