A Review on Strategies to Manage Physician Burnout.

Physician burnout is an emerging condition that can adversely affect the performance of modern-day medicine. Its three domains are emotional exhaustion, depersonalization, and a sense of reduced accomplishment among physicians, with the Maslach Burnout Inventory (MBI) being the gold standard questionnaire used to scale physician burnout. This concern not only impacts physicians but the entire healthcare system in general. There is growing awareness regarding the mental health of physicians and the consequences faced by the healthcare system as a result of burnout. According to a recent study, more than 50% of physicians reported suffering from at least one burnout symptom. In this review article, we aim to identify the causes leading to burnout, its impact on physicians, and hospital management as well as interventions to reduce this work-related syndrome. Some contributing factors leading to burnout are poor working conditions with long work shifts, stressful on-call duties, lack of appreciation, and poor social interactions. Burnout can lead to adverse consequences, such as depression, substance use, and suicidal ideation in physicians and residents. This can result in poor patient care increasing total length of stay, re-admissions, and major medical errors. Due to increased scrutiny of patient and healthcare costs, along with increased lawsuits as a result of major medical errors, it is crucial for both the hospital management and physicians to recognize and address burnout among physicians. Comprehensive professional training such as Cognitive behavioral therapy (CBT), stress-reducing activities such as mindfulness and group activities, and strict implementation of work-hour limitations recommended by Accreditation Council for Graduate Medical Education (ACGME) for residents are a few methods that may help to manage burnout and increase productivity in hospitals.

Resident Attitudes About Mental Health: a Real-Time Smart Phone Survey.

BACKGROUND: Residents in training have high rates of depression and are reluctant to seek treatment. The goal of the study was to conduct a survey with a high response rate to better understand resident attitudes about mental health. METHODS: A multi-site study of residents from three teaching hospitals in the USA completed a 21-item anonymous questionnaire, on their smartphones, during mandatory lecture sessions. RESULTS: Three-hundred and sixteen resident surveys were completed during 24 didactic sessions. The overall response rate from resident-only presentations was 87.8% and ranged from 76.9% to 100% in presentations that included both residents and other attendees. A significant majority of residents indicated that physicians who seek treatment for medical conditions would not seek treatment for depression (87.7%), physicians do not see acceptance of mental health treatment as a sign of strength (80.1%), and most residents with depression cope with it alone (69.0%). Factors that would encourage residents to seek treatment, including easy access to mental healthcare and acceptance of treatment in the workplace environment, varied significantly when residents were grouped by age and gender. CONCLUSIONS: While residents believe that physicians are highly resistant to mental health treatment, targeted strategies may increase the acceptance of treatment. Administration of surveys to physicians on smartphones at the time of lecture or presentation may improve the response rate.

"Time to Talk About It: Physician Depression and Suicide" Video/Discussion Session for Interns, Residents, and Fellows.

INTRODUCTION: Physician wellness has garnered significant recent national attention within graduate medical education (GME). Unfortunately, the resources to proactively address burnout, depression, and suicide are lacking. The "Time to Talk About It: Physician Depression and Suicide" video/discussion session is specifically designed for the GME community. METHODS: The primary focus of this 60-minute video/discussion session is to promote an open dialogue among interns, residents, and fellows about depression and suicide within the profession of medicine. The centerpiece of the session is a 7-minute video featuring personal accounts from physicians at the San Antonio Uniformed Services Health Education Consortium (SAUSHEC). The materials associated with the publication include the video, a guide for facilitating group discussion following the video, a list of questions to guide small-group discussions, a session evaluation form, and examples of mental health resources for distribution at the end of the session. RESULTS: A field test of the video/discussion session with 22 trainees from the pediatrics residency program at SAUSHEC was very well received. Their average response to "This session was an effective first step in promoting an open dialogue among physicians about depression and suicide within the profession" was 4.5 out of 5 (i.e., Strongly Agree). One hundred percent of participants answered "Yes" to the question "Would you recommend this session to other physicians?" DISCUSSION: We hope that this resource will be useful to other institutions around the country as they confront physician burnout, depression, and suicide.

Physician Depression and Suicide: A Shared Responsibility.

ISSUE: Although the exact number is often disputed, it has been reported that approximately 300 to 400 physicians in the United States take their own lives annually. Despite calls from key interest groups for prevention and treatment protocols of physician suicide, little systematic change has taken place. EVIDENCE: Research on suicide risk factors among physicians has expanded. Increasing reports are surfacing that highlight suicidal ideation and depression in medical school, residency training, and later professional practice. IMPLICATIONS: The purpose of this article is to draw attention to the problem of physician suicide with an emphasis on the role of medical education. Multiple accreditation bodies should be involved to effect a change in physician suicide prevalence. Thirty years have demonstrated that without mandates, large-scale change will not occur. We adapted some of the 2012 National Strategy for Suicide Prevention goals to medical education as a guide.