The Journal of the Arkansas Medical Society Med Journal July 2019 Final 2 | Page 19
Meaning is another key to job satisfaction.
“Meaning is a key driver for us humans,” said Dr.
Messias. “Victor Frankl was a Holocaust survivor
who was trained in medicine and psychiatry and
lost his whole family in concentration camps. He
wrote that ‘Striving to find meaning in one’s life is
the primary motivational force in man.’ And it is. We
have to find a sense of meaning in our lives.
Key drivers of burnout and engagement in physicians.
What’s Driving Physician Burnout?
No matter how you look at professional burnout
– globally, as a nation, or here in Arkansas – health
care sectors seem the most prone to it. Dr. Messias
addressed reasons for these very real findings.
“There are several drivers, if you will,” he ex-
plained, pulling from research done at the Mayo clinic
to reveal culprits like heavy workload, increasing
job demands, changes to the health care system,
increased access, increased workload, and – per-
haps because of all of these – a lack of work-life bal-
ance. “Physicians, by nature, are hard-working and
demanding of themselves, but at some point, we need
some boundaries around clinical time and patient de-
mands, so that we can have our own lives, too.”
Honing in on electronic medical records as a
connected factor, Dr. Messias said, frankly, “These
have not been designed for us. They promise us a
lot and have delivered little so far. We need to have
better systems that work for physicians and nurses.
Without that, burnout is not going to go away. I tell
you, efficiency and resources are key factors. Data
from EPIC, the largest electronic medical record sys-
tem in the country, shows that in a typical day, peak
EMR times are from 10 a.m. to 2 p.m. Lunch time is
a big time for EPIC, and there are peak times also on
Saturday and Sunday nights. This is not an efficient
system. In fact, a recent piece in the New Yorker** by
surgeon Atul Gawande was titled ‘Why Doctors Hate
their Computers.’”
What Can Be Done?
Turning to solutions, Dr. Messias shared with at-
tendees what was being done at UAMS to address
professional burnout. The University’s wellness pro-
grams are patterned on research by The Mayo Clinic*
and focus on promoting positive engagement and
reducing burnout by acknowledging and assessing
problems, implementing interventions and cultivating
community, providing resources that promote work-
life balance and self-care, and more.
NUMBER 1
“I’m not here today to sell you a mindfulness
program,” said Dr. Messias, boiling down his thoughts
on personal solutions. “I do not believe, and there is
data to prove, that you cannot do this alone. You can-
not, by yourself, be mindful, be present, and solve your
own professional burnout problem. Your professional
burnout problem must have organizational changes.
There are individual interventions and there are or-
ganizational changes to propose. I have also become
convinced that there’s a leadership component.
“To address professional burnout in health care,
we need a more supportive, transparent, and less hi-
erarchical model of organization. Professionals want,
and need, to see meaning and purpose in what they
do and to have a sense of control of their work pro-
cesses. This will reduce burnout and increase engage-
ment. We need to show that we care for each other.”
Meaning & Control at Work
According to Dr. Messias, it’s not news that job
control affects job satisfaction. Citing studies conduct-
ed as far back as the 1970s, he said, “This has been
known in HR for 40 years, and about a year ago, Har-
vard Business Review had a front-page article on ‘To
Reduce Burnout on Your Team, Give People a Sense
of Control.’ Can we give physicians a sense of con-
trol? We must, because without that sense of control,
we’re all going to be burnt out. I can show you the
relationship between a sense of control and burnout.
The more burnout, the less control.
“It’s funny that physicians would be the people
complaining about a lack of control, but the truth is
that the changes in health care in the last 30 years
have eroded the sense of control that physicians used
to have. To an extent, we have contributed to that by
giving away some of the key leadership positions in
health care organizations and in health care - policy
making circles to either non-health care workers al-
together or to non-physicians. That’s why associations
like the Arkansas Medical Society are important, so
that physicians can retake their place at these tables.
“That’s good. As a psychiatrist, I can use that.
As an epidemiologist, I have a couple of questions
about it in my survey, and now I’m putting them
together with my burnout data … People that said
they always found a sense of meaning in their day,
the level of burnout was about 20%, but people
with the least amount of meaning in their work had
the highest level of burnout. So, finding that mean-
ing back in what we do, in the value of our profes-
sion, and in our mission, will help us with this.”
To find out how to add more meaning at work,
UAMS asked their clinicians to share, in 10 words,
what makes their days meaningful. “The number
one word was patients,” he said. “Being able to
help patients. Being able to care for patients. That’s
what makes health care meaningful. So, going back
to this basic value of health care will help us ad-
dress this.”
Conclusions
“From global statistics down to Arkansas phy-
sicians,” said Dr. Messias, “it’s clear that the more
we find purpose and control in our work, the less
we experience professional burnout. The more we
can focus on caring for patients, the more purpose
we find in our work.”
Dr. Messias is happy to talk to you about start-
ing wellness interventions in your institution. “I
think it is part of UAMS to create and use studies
like we did, but also to disseminate that knowledge
to others,” he said. “I would love to see some of this
done at a statewide level. I’d love to engage with
you. I respect what you do.” To get the conversation
started, email him at [email protected].
*To find the full report on the Mayo Clinic’s
organizational strategies, search mayoclin-
icproceedings.org for the article, “Executive
Leadership and Physician Well-being: Nine
Organizational Strategies to Promote Engage-
ment and Reduce Burnout.” Also find “Burnout
Among Physicians Compared With Individu-
als With a Professional or Doctoral Degree in a
Field Outside of Medicine.”
**https://www.newyorker.com/magazine/2018/
11/12/ why-doctors-hate-their-computers
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