Recognizing Decline in Physician Wellbeing: When to Seek Help or Intervene

ABSTRACT

Burnout is the result of chronic work-related stress and is characterized by emotional exhaustion, low sense of personal accomplishment, cynicism, and detachment from patients.3 Burnout can occur in any occupation but has been found in most studies of physicians to be as high as 50%.4 Burnout is a distinct phenomenon from other well-understood mental health disturbances such as depression or anxiety disorders.5 While burnout typically only occurs in the setting of chronic workrelated stress, depressive and anxiety disorders may arise in the absence of any external stressors. [...]confounding the disorder is increasing severity of burnout has been strongly associated with increased likelihood of major depression and suicidal thoughts.6 As burnout is a risk factor for other mental health conditions, understanding symptoms and warning signs might facilitate prevention and earlier physician intervention before mental health problems develop. Medical students during training develop higher rates of suicidality compared to their age-matched peers.16 While the baseline mental health of physicians was already poor, the significant stressors of COVID-19 compounded these numbers.2 Frontline workers in New York City had high rates of psychological symptoms of distress, including acute stress in 57%, depressive symptoms in 48%, and anxiety symptoms in 33%.17 Thirteen percent of frontline healthcare workers reported receiving mental health services or medication due to stress related to the pandemic.18 One in five healthcare workers reported needing services and not receiving them.19 It is extraordinarily important for healthcare workers, especially physicians, to recognize their own mental health needs and know when they require help. Because many physicians struggle to recognize their own psychological problems, it is critical to have objective measures available for increasing selfawareness of burnout, depression, suicide ideation, and related symptoms.