Testing for Burnout

Patricia Lindholm, MD,
2010-2011 MMA President

In this blog, it has been my goal to provide useful resources to those of you who are interested in physician well-being. I hope to continue to do so in the remaining six months of my presidential term. I wish I could give you a feeling for the many connections that I have made with physicians across the country who are also interested in physician wellness. We have been sharing our work with each other in order to highlight studies and programs that exist or are being developed in the U.S. and elsewhere.

One such connection I’ve made is with Heather Fork, M.D., of Austin, Texas, who writes a blog called “Doctor’s Crossing” (DoctorsCrossing.com). She consults with physicians who face decisions about whether to make a career change or who are battling burnout. I warned her that I would shamelessly borrow some of her material for my blog.

One of the resources Dr. Fork discovered is a simple self test for burnout. It www.mindtools.com/stress/Brn/BurnoutSelfTest.htm. This nonvalidated tool assesses the three dimensions of burnout:

• Emotional exhaustion;
• Depersonalization – viewing others as objects, developing cynicism, separating ourselves from the people we serve; and
• Decreased personal accomplishment – less satisfaction in our work, joyless striving (what I think of as loss of a sense of purpose).

The prevalence of burnout is staggering, and it starts as early as medical school. Tait Shanafelt and Liselotte Dyrbe, two Mayo Clinic colleagues, have published an expanding volume of work documenting how burnout influences professionalism and the degree to which medical students, residents, and practicing physicians are affected by it.

If you think you might be experiencing burnout, take the self-test. If you get a high rating on the burnout scale, I encourage you to find a trusted advisor or therapist to help you refresh your spirit and your view on your work. It is possible to recover from burnout, as I can say that from my own-experience. Do yourself a favor and keep your flame alive!

Finding Balance

Patricia Lindholm, MD,
2010-2011 MMA President

Recently I became aware of the work of Lee Lipsenthal, M.D., an internist who developed a program called “Finding Balance in a Medical Life.”  He has written a book by the same name that I suspect will be on my reference shelf and used for many years into the future.

The first half of the book summarizes what is known about the physician personality, the state of physician health and the prevalence of burnout.  My readings in the area of physician wellbeing over the last two years confirm his analysis.

The second half of the book contains a panoply of tools which can help us find our way out of burnout and back to a life of balance.  Many of these are familiar to those of us who have studied psychology and neuroscience in the last couple of decades, such as cognitive therapy and emotional shifting.  Mindfulness meditation is discussed in some detail with exercises that can easily be done over 5-10 minute periods.  There is an interesting chapter on “Psychosynthesis” which discusses how to identify our personality and sub-personalities and how to use them to respond to a variety of situations.

By serendipity, I also came across the keynote lecture that Lipsenthal delivered to the annual Scientific Assembly of the American Academy of Family Physicians in 2010 in Denver.  The AAFP shared a video of his presentation on their web site for those of us who were unable to attend the meeting.  During that talk, Lipsenthal revealed that he was undergoing treatment for metastatic adenocarcinoma of the gastroesophageal junction.  Thus far he has survived about 18 months from diagnosis and looks pretty good but is well aware of the poor five-year prognosis.  By already having established a habit of meditation and daily expressions of gratitude, he was prepared to face the illness with calm. 

The book and the talk both ended with the following words of wisdom:  Balance is knowing that today is a good day to die; that you have lived fully, lovingly and without remorse. 

May we have many good days.