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By Sofia Olsson, MS-I, and Anand Singh, MS-I

This article was originally published in the July/August 2022 issue of the Tarrant County Physician. You can read find the full magazine here.

Burnout is not a new term for physicians. In fact, prior to the pandemic, an online survey conducted by the American Medical Association in January 2020 found that there was an overall physician burnout rate of 46 percent.¹ Unfortunately, the pandemic has exacerbated burnout for physicians due to a multitude of unprecedented factors. Burnout can be defined by three main symptoms: exhaustion, depersonalization, and lack of efficacy.² Physicians may exhibit harmful behaviors as coping methods in response to burnout, so it is important to acknowledge behavioral health as it addresses how individuals’ daily habits and actions impact their mental and physical health. As two medical students, we founded Behaviors Supporting Mental Health (BSMH) to raise awareness surrounding behavioral health for all individuals. For our current campaign, we are focusing on physicians’ response to burnout. Through BSMH, we hope to provide resources for physicians to address their behavioral health and reduce or prevent burnout.

Continuous refinement of our daily habits, actions, and behaviors leads to better
mental and physical health. 

First, though, we want to acknowledge the prevalence of burnout and what factors are contributing to this phenomenon. According to research conducted by the Agency for Healthcare Research and Quality, the cause of physician burnout is multifactorial.³ The study found that some of the main causes of physician burnout are tied to physicians having to balance family responsibilities, work under time pressure, deal with a chaotic work environment, have a low control of pace, and implement electronic health records.³ Unfortunately, physician burnout has been linked to consequences such as lower quality of patient satisfaction and care, physician alcohol and drug abuse, and even physician suicide.² Therefore, addressing physician burnout and combatting unhealthy behaviors are critical for physicians themselves as well as for the patients they serve.

The activities physicians partake in can impact their risk for burnout, so assessment of one’s behavioral health is important regardless of current mental health. Several coping strategies, such as making an action plan, taking a time out, or having discussions with colleagues, have been correlated with a lower frequency of emotional exhaustion in physicians.⁴ On the other hand, keeping stress to oneself has been associated with a greater frequency of emotional exhaustion.⁴ After making note of behaviors and identifying their purpose, one can decide whether these actions should be eliminated, continued, or supplemented.⁵ Changing behaviors, however, is easier said than done. Since useful coping skills are not “one size fits all,” BSMH aims to provide resources that help physicians build a toolkit of ways to improve their behavioral health. For example, the app Provider Resilience, designed by the Defense Health Agency, functions as a method to keep physicians motivated and hold them accountable in their behavioral health.⁶ The QR code shown is a link to the BSMH website (https://tinyurl.com/bsmhproject), which includes further resources tailored to prevent or relieve burnout in physicians. Our contact information can also be found here for anyone with questions or a desire to collaborate.

Continuous refinement of our daily habits, actions, and behaviors leads to better mental and physical health. Regardless of the extent of a physician’s burnout, addressing behavioral health is always a necessity. Intentional actions impact one’s identity as a physician and any other role they have outside the clinic. Transitioning one’s behavioral health from passive to intentional can improve one’s ability to balance familial responsibilities, work under pressure, and deal with a chaotic work environment.² This puts physicians in control of their behaviors and decreases their risk for substance abuse and suicide while improving the quality of patient care.^7,8 Meaningful reflection and continuous behavioral health improvement creates a healthier mindset that allows physicians to better care for their patients and themselves.  

References

1. Berg S. Physician burnout: Which medical specialties feel the most stress. American Medical Association. https://www.ama-assn.org/practice-management/physician-health/physician-burnout-which-medical-specialties-feel-most-stress. Published January 21, 2020. Accessed May 18, 2022. 

2. Drummond D. Physician Burnout: Its Origin, Symptoms, and Five Main Causes. Fam Pract Manag. 2015;22(5):42-47.

3. Physician Burnout. Content last reviewed July 2017. Agency for Healthcare Research and Quality, Rockville, MD. https://www.ahrq.gov/prevention/clinician/ahrq-works/burnout/index.html      

4. Lemaire JB, Wallace JE. Not all coping strategies are created equal: a mixed methods study exploring physicians’ self reported coping strategies. BMC Health Serv Res. 2010;10:208. Published 2010 Jul 14. doi:10.1186/1472-6963-10-208

5. Hem, Marit Helene, et al. “The Significance of Ethics Reflection Groups in Mental Health Care: A FOCUS Group Study among Health Care Professionals.” BMC Medical Ethics, vol. 19, no. 1, 2018, https://doi.org/10.1186/s12910-018-0297-y. 

6. Provider Resilience. Version 2.0.1. National Center for Telehealth & Technology. 2021.

7. Harvey, Samuel B, et al. “Mental Illness and Suicide among Physicians.” The Lancet, vol. 398, no. 10303, 2021, pp. 920–930., https://doi.org/10.1016/s0140-6736(21)01596-8. 

8. Panagioti M, Geraghty K, Johnson J, et al. Association Between Physician Burnout and Patient Safety, Professionalism, and Patient Satisfaction: A Systematic Review and Meta-analysis. JAMA Intern Med. 2018;178(10):1317–1331. doi:10.1001/jamainternmed.2018.3713