Dec 6, 2019
In this second part (part 2) of the "Joy, Empathy, and Provider Burnout" podcast, Dr. Laurie Drill-Mellum, an emergency medicine provider and a strong advocate for breaking down the communication barriers that are all too abundant today in medicine, continues her discussion around the challenging issue of "burnout" in healthcare.
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As Fred related, our journey between starting and finishing our practice matters. The "dash" in our practice, in our lives.
Firstly, mindfulness can help us begin to "own the dash", as it will help us to slow down, notice out thoughts and feelings. The second is acceptance. Accepting that things are not always going to go well. There will be pain. In our day to day and year to year existence. What will you recall and reflect on? What will others reflect on about you? Victor Frankel in "Man's Search for Meaning", astutely points out that how we react in our lives is one of the last "true freedoms". Self-awareness is a great first step in the road to recognizing and remedying burnout. Are we experiencing dread in going to work, moodiness, arriving late to work drinking more alcohol? The vast majority of burnout tends to be due to a systems problem, especially as it relates to workload and workflow. We are asking too much of people. Therefore, it is imperative that our systems also contribute in recognizing and treating burnout. Of course, there is always the possibility that continuing to work in medicine, despite addressing burnout symptoms, changing systems, etc., may just result in the practitioner moving on to a different field or even career in some cases. The triple aim in health care is going to depend on the wellbeing of those who are doing the work. And what exactly happens when we actually lose someone to burnout? The cost is significant, and in multiple layers. Cost to replace a physician, for instance, is approximately $1.5 million. Lost revenue, recruitment costs (which can be exorbitant nowadays due to the very competitive market that is out there), loss of clientele, etc. And as it turns out, the up and coming health care providers are looking for a healthy work-life blend. Even leading to less income in order to achieve a better work culture and atmosphere.
At the same time, limiting hours and training exposure, as well as the "hands-offs" that occur in patient care, do lead to concerns for patient safety and potentially care outcomes. Supporting our colleagues in the infancy of their career as well as the twilight is equally important. While focusing on our own individual professional well-being and work-life blend, offering support as a group in general is equally important; checking-in with our colleagues and making sure they feel supported, in other words.
Do you experience joy or do you experience happiness in your life and career? Maybe a bit of both? Joy is continued practice, while happiness is an on and off feeling. Shauna Shapiro, a mindfulness professor, compared two people: a lottery winner and an accident victim who is paralyzed. After a year out from their very disparate experiences, they were each at the baseline level of joy. Gratitude does in fact affect your happiness, and thereby contributes to a culture and ongoing experience of joy. For instance, the three daily gratitudes as advocated by the happiness guru, Seligman. Simple, but proven to be effective, and in a very short period of time. Turning the emotional and sometimes traumatic aspect of our jobs into the privilege of having a "front seat" to the awe and mystery of patient care, as coined by Rachel Remen, can also help to shift the perspective and lead to resiliency and joy in our work. Self care and relationships is equally important. Having a "3 AM friend" for instance. We are all human and have times in our lives when we need to purge.
Recognition of value in promoting self-resilience is the first step, followed by setting a goal to do this, and then actually executing it. Whether it's a book club, a running club, gardening, etc.
While the individual is key to their own resilience, coping with and preventing burnout, we can lean on one another as well. Schwarz Rounds and peer support networks are great mechanisms to empower and lift-up the individual.
Dr. Laurie Drill-Mellum discusses the "thread" in our lives. Something that gets us from point A to point B, and through the "snow storm". What do we hold onto and what motivates us? What is it that feeds our sense of purpose? In our work, and in our personal lives. In addition, the Hopi elder metaphor of being in a canoe and getting somewhere relates that it is not so much the point of the destination, as much as who you're with on the journey.
Thanks for listening.