Burnout in Healthcare

In this episode of PodMD, experienced Rehabilitation Physician and life coach Dr Jo Braid will be discussing the topic of burnout in healthcare, including what burnout actually is, why does it happen in healthcare, the warning signs you can look out form, the role of a coach in addressing burnout and more.

Jo is a coach for overwhelmed doctors who want to enjoy the journey and live the life they have worked for. To learn more about Jo and her work, please visit her website and social media profiles below.

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  • Transcript
    Please note this is a machine generated transcription and may contain some errors.
    *As always, all in this PODMD podcast is intended for health professionals and the comments are of a general nature. Information given is not intended as specific medical advice pertaining to any given patient. If you have a clinical issue with one of your patients please seek appropriate advice from a colleague with expertise in the area.

    Today I’d like to welcome to the PodMD studio Dr Jo Braid

    Dr Jo Braid is an Australian trained Rehabilitation Physician and Life coach, with a special interest in Burnout in Physicians. Jo is based in the Central West of NSW and works with the Mid Western Brain Injury Rehab team seeing patients with traumatic brain injury, stroke, aneurysms and malignancies.

    She is a coach for doctors with overwhelm and burnout, helping them get past perfectionism and procrastination to achieve their goals and enjoy the journey along the way. Jo experienced her own overwhelm and burnout while in her private medical practice. Through coaching she has regained the emotional strength she had lost, and now takes as good care of herself as she takes of her patients.

    Jo lives with her husband, an orthopaedic surgeon, and three boisterous sons, and she enjoys playing the violin, catching up with friends and getting outside in her free time.

    Today, we’ll be discussing the topic of burnout in healthcare.

    *We do hope you enjoy this podcast but please remember that the advice here is of a general nature and is not intended as specific advice about a given patient. The views and opinions expressed in this podcast are those of the doctor, not PodMD.
    If you do have a patient on whom you require specific advice, then please seek advice from a colleague with appropriate expertise in that area.

    Jo, thanks for talking with us on Pod MD today.

    Jo: Thank you for having me today.

    Question 1
    The topic of today’s discussion is burnout in healthcare. Jo, can you describe for our listeners what burnout in healthcare is?

    Jo: Yeah, so burnout in Healthcare is an occupational phenomenon that was first described in 1975. It has a high incidence even starting in medical students of around 50% and is higher in women. The three main areas that are identified are depersonalization and cynicism, emotional exhaustion, which is the most common area in physicians with burnout and reduced productivity.

    Question 2
    Why dose burnout happen in healthcare?

    Jo: So there are quite a few different reasons here. Doctors are and many health care workers are very high achievers and they are also perfectionists in their work. They have a high workload and a high level of responsibility. Time pressures can be high. The electronic medical record possibly is also contributing to burnout and the physical workspace that we’re in is a very indoor workspace, there can be lots of noises in the background with artificial light. There’s sometimes a lack of a social support system in the organization, and the conditions that we see we treat in medicine can be very emotionally draining.

    Question 3
    What are the typical symptoms and signs of burnout in healthcare?

    Jo: So in an individual person, burnout can present as overwhelm and exhaustion. Mood changes include irritability, an element of anxiety and depression. There can be sleep disturbance and sleepiness during the day. Cognitive changes include reduced nonverbal memory, visual and auditory attention and there can also be immune system suppression so it can really be quite a whole biopsychosocial effect.

    Question 4
    What are the risks of burnout?

    Jo: So health risks include an increased risk of cardiovascular disease and type 2 diabetes, raised lipids and lower cardiovascular fitness and then career risks or changes are that doctors with burnout are twice as likely as their peers to leave the organization. And as people would be aware, the replacement cost is huge between a quarter of a million to a million U.S. dollars from some research that was done in 2019.

    Question 5
    What are the main areas to address in burnout recovery?

    Jo: So no one size fits all this is individuals that we’re talking about here, but the three main areas that would benefit from being addressed include work factors, so what are the working conditions? I alluded to them before. What is an individual’s ability to take time off to have adequate break times during their shifts and having a space to mix with coworkers? What does the workplace culture look like? Secondly, we can look at stressors.

    Doctor Emily Nagoski has written an excellent book on burnout, which talks about the stress cycle and how to deal with your stressors. Individuals who have got through to the other side of burnout state these three strategies have been particularly helpful. Social connection, talking to somebody they trust and can confide in, exercising and taking a break from work, whether that’s short or longer term.

    And thirdly, we look at personality traits, so I’ve hinted before that met medics or physicians can really have quite a perfectionist tendency, and that can be a strength at times, but it can also lean towards being challenging and unhelpful. A quote here is that it’s better to do something imperfectly than to do nothing flawlessly, by Robert Schuller.

    So to deal with perfectionism, here are some suggestions. Focus on completing tasks rather than ensuring they will be perfect. Recognize that we’re all humans and we do have flaws and make mistakes sometimes. Look to streamline and declutter your life. Check your self-talk , how do you talk to yourself? And do you find fault in yourself and others? Overcome indecisiveness and prioritize action and ease back from that workaholism and consciously be in the moment with family and friends?

    Question 6
    Have there been any developments in approaches to burnout in the last few years?

    Jo: So in 2019, the JAMA, the Journal of American Medical Association published a randomized control trial of 88 physicians. In the intervention group, 6 coaching sessions over six months of individualized coaching were provided to help with burnout in physicians.

    The outcomes included reduced emotional exhaustion, reduced scores on the burnout scale that they used, and improved quality of life. In the control group who had no coaching sessions over the six months, they had worse emotional exhaustion and a lower quality of life.

    Recently there’s been a book titled Burnout, published by Professor Gordon Parker, who is a Sydney based psychiatrist and founder of the Black Dog Institute. This has some lovely case studies in and different ways to approach burnout.

    Question 7
    Are there any warning signs you can look out for?

    Jo: Sure, so burnout is not actually a medical diagnosis per say, it is an occupational phenomenon and it can overlay with some other conditions that a GP would be more familiar in looking out for, such as depression.

    But signs of burnout include social withdrawal from communicating with others, absences from their workplace, reduced productivity, and unsettled mood with irritability, anxiety or depressed mood, and sort of the most pervasive symptom or sign that a patient might have is exhaustion.

    Question 8
    What role does a coach play in addressing burnout?

    Jo: The podiatrist and the GP both play an important role in the management of Morton’s neuroma, not only in the diagnosis, but in the management.
    Most podiatrists will be able to prescribe orthoses and footwear advice, however, it may require an endorsed podiatrist to undertake injections such as corticosteroid injection into the area. Alternatively, GPs may refer independently to have these injections guided at, say, an interventional radiologist.

    Concluding Question
    Thank you for your time here today in the PodMD studio. To sum up for us, could you please identify the three key take home messages from today’s podcast on burnout in healthcare.

    Jo: Yes, so firstly, burnout is very common in health care with one in two practitioners likely affected rates are greatest in those with higher educational levels with their age in mid 30s or younger, and without a long term partner.

    Secondly, key features of burnout include depersonalization, emotional exhaustion and reduced productivity. Symptoms and signs can include impaired sleep, irritability, and cognitive changes.

    Thirdly, individuals can recover fully from burnout with adequate time, individual support, and addressing workplace issues, stressors and personality traits.

    Thanks for your time and the insights you’ve provided.

    Jo: Thanks very much.

*As always, all in this PODMD podcast is intended for health professionals and the comments are of a general nature. Information given is not intended as specific medical advice pertaining to any given patient. If you have a clinical issue with one of your patients please seek appropriate advice from a colleague with expertise in the area.
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