ASH Clinical News September 2015 | Page 71

FEATURE [CME] and helplines for students and residents, geared toward physician wellness.” Physician self-awareness about stress and burnout should be part of an open dialogue from the beginning of medical school, she contended, and physicians should be made aware of the available resources for managing burnout, such as helplines and professional associations and societies. Personally, Dr. Trollope-Kumar has found peer support to be an invaluable tool for building resilience. “I belong to a CME group where we talk about advancing medical education, but we inevitably talk about our stressful cases or professional issues that we are having difficulty with,” she said. “A support system doesn’t have to be formal; it can be done informally with a small group of physicians who meet on a regular basis.” Are You and Your Job Compatible? Finding the right fit is also key to preventing burnout. Before settling on hematology/ oncology, Dr. Goldsborough considered lifestyle and potential emotional involvement when choosing her specialty, also taking into account the daily schedule and pace of the various specialties. “I am fairly comfortable with end-of-life appear to be concerns for all transplant physicians, regardless of type of practice,” she said. “The issues leading to burnout – including the complexity of patients, high number of working hours and nights on call, and amount of administrative tasks – are common among all types of practice.” However, she noted, “transplant is somewhat unique in that, although it is curative therapy for many patients, it raises patients’ risk for treatment-related morbidity and mortality at the same time – particularly for those patients undergoing allogeneic transplant.” Risks for relapse or late complications could lead to the need for ongoing chronic care. Indeed, for survey respondents who were dissatisfied with their career, “excessive hours, insufficient salary, and the emotional drain of caring for transplant recipients” were the most commonly cited causes. “While a long-term physician-patient relationship is one of the joys of being a transplanter, it is also emotionally difficult when a patient struggles with or dies from complications,” Dr. Burns added. Crafting a Personal Prevention Plan The first step to preventing burnout: Educating people about what it is and what causes it. “In training, the stress was mainly from trying to impress attendings. As a practicing physician, the stress is from trying to always make the right recommendations for patients.” —KATY H. GOLDSBOROUGH, MD prove efficiency, provide flexibility and control over work, and help clinicians cultivate and recognize meaning in their work can be useful,” Dr. Shanafelt said. “The behaviors of organizational leaders have also been found to be a critical factor on the personal satisfaction and burnout of the physicians working within the organization.” Dr. Shanafelt urges physicians not just to rely on the organizations they work for to manage and mitigate burnout, but to step up and address its causes on a personal level. All of the clinicians we spoke with had a common strategy to avoiding burnout: Spending meaningful time outside of work with family and friends. For Dr. Goldsborough, that means striking the right balance between work and life. “While I devote some time to professional reading and paperwork at home after my children go to bed, it’s important that I reserve at least an hour in the evening to unwind and do something I enjoy.” Dr. Linzer’s personal burnout prevention plan, in addition to putting his 10-step plan into practice, involves running multiple times a week “by the lakes and streams of Minnesota, and playing in our hospital band, the New Prescriptions.” For Dr. Burns, “my family helps me mitigate burnout, as well as making time for exercise, gardening, reading, and maintaining friendships.” “At the individual lev