I recently read a study in JAMA entitled “Quality of Life, Burnout, Educational Debt, and Medical Knowledge among Internal Medicine Residents.”1 Over half (51.5%) of the 15,000 medical residents in the study cohort reported overall burnout and high levels of emotional exhaustion and depersonalization.
The residents were in various stages of training. They came from different backgrounds and were a mix of American and international graduates. Responses were gathered to questions about work/life balance and quality of life.
This study is just one in a long line of regularly published articles that detail burnout in both seasoned doctors and doctors-in-training.
What factors underlie burnout in doctors? According to the JAMA article, regulation limiting work hours that took effect in 2003 to help curb exhaustion and associated poor patient outcomes did not influence the survey’s outcome. In other words, lack of sleep doesn’t seem to be the main cause of the distress.
Is it possible to have some sort of work/life balance as a doctor? I certainly didn’t have one during my residency in family practice. For physicians, such a balance may be a fantasy . . . in part because of the culture of medicine, but also in part because we aren’t trained to create balance—and because we lack good role models.
What’s a physician to do?
Diversifying your skill set as a seasoned doctor (and even as a resident) may go a long way in helping to mitigate or reduce feelings of stress and burnout. In fact, the JAMA study reported that quality of life and satisfaction with work/life balance was highest among residents who worked a second job outside their regular residency training.
Diversification not only provides an outlet, but it can help you remember that there is more to life than just the hospital, the clinic, or being a doctor.
By diversification, I’m not suggesting having a family or running a marathon. Those are certainly good ways to help round out your life, but they won’t necessarily ignite your passion for serving others and they may not give you the sense of accomplishment that comes from using your clinical skills to achieve an outcome. You might, however, want to learn more about the business side of medicine; or take a course in real estate sales; or attend a non-clinical conference in health IT; or do some medical writing for a medical communications company.
Stress and burnout adversely affect patient care, decrease patient satisfaction, and increase the risk for medication errors. I’m surprised there aren’t more people out there trying to find a way to help doctors mitigate their distress. With a projected future shortage of doctors, such help is crucial.
It might have made a difference for me. I left my residency about 8 years ago because I didn’t have any sense of work/life balance and I didn’t know how to create it. I was afraid it didn’t exist. Many of the doctors I looked up to and even some of my peers were negative about it or muttered snide remarks whenever I broached the subject. Now that I have a business degree and experience in the nonclinical world, I wish I had known then what I know now.
It’s possible —even preferable—for doctors to have outside interests and to make time for those interests. Those who do will be the happy, successful, doctors who are needed for the future of health care. That’s part of the reason I now work to help doctors who feel trapped, burned out, or who just wonder if “this is all there is.”
I will soon begin a series of interviews with doctors who have found ways to diversify their skill sets. These physicians come from all parts of the country and are at various stages of their careers. It is my hope that you will be able to draw parallels from their lives and choices to help you in your everyday life and help you build a future in health care that you can look forward to.
Diversify, doctor . . . don’t give up!
1. West CP, Shahafelt TD, Kolars JC. Quality of life, burnout, educational debt, and medical knowledge among internal medicine residents. JAMA. 2011;306:952-960.