The burnout bags health care professionals carry are enough to tip the scales of any airline. And just like the fees airlines slap on oversized suitcases, the costs for health care workers are at an all-time high. Staffing shortages, increased patient loads (both their own and those they supervise), medicine costs, resource shortfalls, and everyone’s favorite bag- the never-ending administrative burdens all add to the weight.
The cost? While a distinct difference between burnout and depression exists, it is hard to deny that individuals with unaddressed burnout are at risk for developing clinical illness. An estimated 300-400 physicians die by suicide each year, with the rate for men 1.42 times higher than the national average and 2.27 times higher for women. Additionally, resident physicians are at a much higher risk for a major depressive episode compared to nonphysicians in the same age group, 28 percent vs. 8 percent. The cost also includes an increased risk of major medical errors as well as physicians leaving clinical practice altogether.
The weight of burnout for physicians is undeniable. For those looking to unload some of the baggage and enable themselves to stay in clinical medicine longer, a career they worked so hard to attain, you can do a few things to keep the scales in their favor.
1. Rest. I can see you rolling your eyes through the computer screen, thinking, “If one more person tells me I just need to sleep more so I am not burnout, I may murder them.” Honestly, I have felt the same way a time or five. However, rest is that important, so I am braving the eye-rolling and bringing it up anyway.
I won’t bore you with the benefits of sleep. They are well known. These benefits, combined with giving yourself uncommitted downtime, allow you to reset and provide you with the energy needed to take on a busy week.
2. Exercise. This is tough, and I’ve used all the excuses myself. As we all know, exercise is extremely beneficial to our physical health. It also decreases stress and negative mood while improving sleep, mood, cognitive functioning, and self-esteem.
And the best news? You don’t need to slay yourself in the gym for hours a week to reap these benefits and reduce the weight of your burnout baggage. You can find them in as little as three 10-minute walks four days a week. Not bad, right?
3. Nutrition. Studies have shown that chronic stress influences the types of foods individuals consume, often compounding the effects stress has on your physical health. In a study among 1,383 trauma surgeons, those who consumed a healthy diet were 2.6 times more likely to achieve work-life balance. Although the study was observational with questionable methods for assessing diet, it is reasonable to say a perceived healthy diet plays a protective role of sorts against burnout in trauma surgeons.
Additional studies have shown an inverse relationship between consuming healthy foods and burnout symptoms. More strongly powered studies will be required to establish a definitive relationship between diet and burnout.
4. Outdoors. While current research directly linking burnout reduction and time spent outdoors or in nature is lacking, the benefits of nature on well-being are hard to deny. In studies in multiple European countries and cities across the U.S., improved attention and reduced stress have been linked to nature exposure.
Furthermore, the American Journal of Critical Care published a small study in 2018 on burnout in nurses. They compared the burnout of nurses who took daily work breaks outside vs. those who did not use the Maslach Burnout Inventory Scale and found a statistically significant improvement in the sub-scales for emotional exhaustion and depersonalization in those who took daily breaks outdoors. More research should be extended to all health care professionals, but this is a simple intervention health care providers can implement and safely experiment with immediately.
5. Remoralization. “Demoralize” is defined by Merriam-Webster as to cause to turn aside or away from what is good or true or morally right; to corrupt the morals of; to weaken the morale of; discourage. Many health care providers experience demoralization working in a health care system where they cannot care for patients correctly due to staffing, resource limitations, and organizational constraints. The suitcase that demoralization fills on the burnout journey is heavy, hence the need for remoralization.
The process of remoralization involves renewing one’s commitment and energy toward one’s values. This can be a difficult feat in the face of a system where health care providers feel they have very little control. One way to do this is to advocate with clinical administrators or on a larger scale for the resources and staffing required to care for patients, fair productivity targets, better pay, positive recognition systems, and duty hour limits. Additional ways include advocating for patient needs that are not being met, taking time away from work, pursuing new hobbies, and talking with others. These allow health care providers to recharge, reflect on what makes their work meaningful, and reinforce their commitment to making a positive impact.
6. Community. A 2022 cross-sectional study of 218 participants published in The Journal of Surgical Research noted a connection between higher burnout among individuals struggling to find a mentor or social community outside of work. This highlights an additional pathway in reducing the weight of burnout carried by health care professionals. Physicians need to be able to plug into communities where people understand what they are going through and have a sense of belonging, decreasing the burden of isolation.
7. Advocacy. The final key to reducing the weight of burnout is advocacy. When health care providers become involved in community advocacy, it instills hope and gives them direct access to those who can make the change. Advocacy allows them to align with ethics and values, reducing the moral injury that makes burnout heavy.
To my colleagues: I, too, am sick of hearing that building resilience is key to beating burnout. Our resiliency is not the problem. We are not the problem; we are the solution!
Marie Livesey is a family physician.