The Journal of the Arkansas Medical Society Med Journal July 2019 Final 2 | Page 18

by Casey L. Penn
Physician Wellness and Burnout
Presenter: Erick Messias, MD, MPH, PhD
Associate Dean for Faculty Affairs
UAMS College of Medicine
A
psychiatrist and epidemiolo-
gist, Erick Messias, MD, MPH,
PhD, has devoted years to un-
derstanding the issue of professional
burnout in medicine. During his educational
seminar at this year’s annual meeting, the associate
dean for faculty affairs at the UAMS College of Medi-
cine shared detailed information on a topic that affects
physicians deeply.
Consequences of burnout can be grave, as docu-
mented in several studies to date. On the personal
side, they may include broken relationships, a rising
divorce rate, alcoholism and drug abuse, depression,
and physician suicide. On the professional side, they
include decreased quality of care, increased medical
errors, decreased patient satisfaction, decreased pro-
ductivity, and increased turnover.
“So, we have a problem. No matter how we look
at this issue, it is affecting you at a personal level,”
said Dr. Messias. “It’s also affect-
ing your institutions and practices
from a professional perspective.”
Starting from the broad
perspective of the planet itself
and its population, Dr. Messias
shared his conviction that we all
Glad to share a bright spot,
(the world over) have a respon-
he added, “Some new data has
sibility to pay attention to the
just come out that is some good
problem of professional burnout.
news to share with you. The same
“Globally, 24% of the world’s
survey that was repeated in 2011
population (1 in 4) is ‘actively
and 2014, was repeated in 2017. It
disengaged’ in what they do,”
showed that the levels of profes-
he explained, sharing data from
sional burnout seem to be coming
a Gallup Engagement Survey.
back down to the levels of 2011.”
“Further, about 63% (about two-
Erick Messias, MD, MPH, PhD
A slight reversal notwith-
thirds) are not engaged and are
standing,
burnout
is
a
serious
problem that affects all
just clocking in and clocking out. Only the remaining
areas
of
medicine
–
some
more
than others. High-risk
13% are actively engaged in what they do. They find
categories
correlated
with
specialties
at the forefront
purpose, they’re in control, they believe that what they
of patient care (emergency medicine, OB/GYN, family
do matters.”
physician, neurology, physical medicine, and rehab),
Calling these statistics a “crisis,” he summed, while the lowest burn-
“As a species, we’ve never had it so good materially, out levels found were in
but we are disengaged.”
pediatric subspecialties,
Narrowing his focus, Dr. Messias pointed out the preventive medicine, and
severity of professional burnout among the health psychiatry.
care population in the U.S. “How bad is it? Headlines
show this problem is everywhere,” he said. “In 2014,
over 50% of physicians had symptoms of professional
burnout.”
Defining burnout as “an experience in response
to chronic job stressors,” the doctor shared three
main components to it: exhaustion, or the physical
response; cynicism, the psychological response; and
inefficacy, a negative response leading one to think
that, no matter how hard you work, there’s always a
task left to do.
likely to be married (about 80% compared to 66%
in the general population). They work on average 52
hours a week, which is about 12 hours more than the
average American worker.
“In surveys, physicians are more likely to strongly
disagree that ‘my work schedule leaves me enough-
time for my personal and family life,’” said Dr. Mes-
sias. “Only 10% of physicians said yes to that. This is
clearly a problem that needs to be addressed.”
He also found that, in professional health care
categories, the most burnt out population is not phy-
sicians, but nurses. On the personal side, this is fol-
lowed by residents, technologists, APRNs, and then
physicians. On the work side, residents experienced
burnout the most followed by APRNs, technologists
and nurses, and then physicians. “The lesson here is
that you cannot address burnout in a health care orga-
nization without addressing nurse burnout,” he said.
Narrowing his focus yet again, Dr. Messias turned
his attention to health care professionals in Arkansas
alone. Getting even more specific, he shared results
of a study he did at UAMS. Using the Copenhagen
Burnout Inventory, a research survey developed in
Denmark, Dr. Messias gauged burnout. He found that
at UAMS, 53% of physicians and nurses were burnt
on the personal side, 48% were burnt out on the work
side, and 18% on the patient-related side.
Looking closer at
physicians as a U.S. work
group, Dr. Messias noted
that they tend to be more
male (about 57% of phy-
sicians in practice in the
U.S. are male compared
to 52% of workers in the
US), about 50 years old
(younger than the aver-
age population) and more
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