Physician burnout during COVID: Bringing ancient practices to modern medicine

Back in January of 2020, the average physician burnout rate was a staggering 42 percent.  However, as COVID cases continue to surge, that statistic is now undoubtedly larger.  Physicians are exhausted, both physically and mentally.  They’ve watched colleagues suffer extensively or even die as a result of contracting COVID from infected patients.  There is not enough staffing to support the needs of the increasing patient load. Resources like basic equipment and beds are scarce, and the death toll keeps rising. And it’s not just doctors carrying the burden.  It’s every single health care worker, be they be midlevel providers, nursing, therapy, or janitorial/housekeeping staff.

Burnout is a multifactorial problem characterized by exhaustion, inability to make decisions, difficulty concentrating/memory issues, increased friction among co-workers, and reduced initiative/performance, among other things.  Though burnout affects men and women, there are factors that specifically affect women only, causing burnout to be higher amongst them.  Personal factors, such as quality of relationships, sleep, diet, and exercise, also play a role.  All of the stresses associated with work-related burnout (and its causalities) are things that lead to hypertension, anxiety, depression, insomnia, and weight gain.

Physician burnout also has a significant role in affecting patient care.  Physicians and staff who are experiencing burnout symptoms have a higher incidence of miscommunication and medical errors, leading to poor and mismanaged patient care, and in some cases, patient mortality.  Patients who are under the care of a doctor who is burned out may feel unheard and unimportant to their provider—never a desired feeling when on the exam table or before heading to the OR.  They are less likely to be invested in their own path to healing; if their own doctor doesn’t seem to care, why should they?  Physician burnout is quite seriously a hidden health care crisis.

Thankfully, there is a powerful tool available to address physician burnout. It is grossly underutilized in modern medicine, though used by ancient medical practitioners routinely.  It requires no medications, special equipment, or significant time investment.  It can be used literally anywhere at any time.  No one even has to know you’re using it, though using it in groups allows a synergy that can be life-alteringly positive:  mindfulness.  Mindfulness is described as the ability to be completely present at the moment, from a place of curiosity rather than judgment.

Doctors who practice some form of mindfulness can serve patients more effectively than those who do not.  They respond instead of reacting to stressful or emergent situations.  They remain motivated to excel because they see these situations objectively without inserting a personally-imposed narrative.  Therefore, they can tap into their knowledge and experience to see the real issues at hand and address them effectively.  They can foresee problems before they happen and can address them with a sense of calm preparedness or take steps to avoid them altogether.  Doctors who are mindful have better communication skills and can listen to the message, rather than the words of a conversation, allowing them to really hear what the patient or coworker is telling them, even if they aren’t saying it with the “right” words.  This leads to a better rapport and an increase in trust. Coworkers are more willing to participate and be flexible with other ways of doing things.  The patient has greater buy-in to take an active role in healing themselves.  The mindful doctor can even facilitate better communication between others and lead to better teamwork and problem-solving.  These successes drive the provider to uncover an untapped potential to do their jobs well and wholly serve their patients.

Importantly, the doctor who takes it upon themselves to be mindful can have a massive ripple-effect as a leader in the health care team.  They can inspire others around them to tap into their own innate abilities and strengths by modeling mindful behaviors and practices—a powerful mode of leadership, indeed, effectively banishing burnout for good.

What are doctors who bring mindfulness to their practices saying?  How has it affected them? Dr. George Adesina, an adult cardiologist in Houston, has begun implementing mindfulness during his day, and this is what he shared with me: “Working on the front lines has taken a major toll on my mental wellness.  But now, taking just a few minutes a day to recenter myself has improved every aspect of my day.  It’s helped me become not only a better provider, but a better person.”  Says Dr. Deep Shah, a pediatric dentist in Philadelphia, “Practicing mindfulness has helped me be unbreakable mentally and not worry about things beyond my control.  It’s allowed me to stay grounded and not be phased by the highs and lows that come with medicine and patient care.”

Easy ways to bring mindfulness to medicine

Enjoy a mindful drive/commute in. Notice the sounds of the road, the feel of the steering wheel against your hands, the support of the seat against your body.  Look for something new every day on your route to work, even if you take the same one every single day.

Practice resonance breathing or other breathing exercises on your walk into the building. There is a great app for resonance breathing, called The Breathing App, or you can simply make your exhales slightly longer than your inhales by counting.  For example, inhale to a count of four, and exhale to a count of six.

Set an intention for your shift. This can look different for each person.  The biggest thing I tell my clients is to know your “why.” When things get heavy or before you start your work, taking a moment to remember what drives you allows you to be present and give wholly.

Hold a (short) group breathing/meditation session at huddles or before a procedure. The doctor can do this as the team leader or use apps like Calm, Balance, or Insight Timer.

Why mindfulness works

Spiritually, employing mindfulness works on an energetic level, shifting it to a productive and purposeful state.  Physiologically, meditation and mindfulness effectively tone the parasympathetic system (primarily the vagal nerve) to remain stimulated, even when the going gets rough.  This keeps the heart and respiratory rate in check, cortisol levels down, and allows for decision-making to be executed out of true knowledge of the moment rather than illusion driven by fear, ego, or fatigue.

Intentions and affirmations, as corny as they may seem, work because of neurolinguistic programming.  Essentially, words carry energy.  By choosing words that carry positivity, the brain is re-wired to receive information in a different way, allowing for response instead of reaction.

The physician’s job is to lead a team of health care workers in a common mission—to serve the patient to the best of their collective and individual abilities.  Performing the job mindfully leads to maximized job fulfillment, optimized overall health, increased patient satisfaction, improved patient outcome, and has the power to transform health care as we know it.  It is time to bring the ancient model of medicine’s knowledge and practices into the modern one.

Seema Desai is a dentist and life coach. She can be reached on Instagram @dr.seemadesai and at Seema Says Namaste.

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