Chapters Video Audio Description Preview logo. ST David's Healthcare title. Physician Burnout Disclaimer. ST. David's health cast is an educational resource. ST. David's health Care does not endorse or promote products, equipment, drugs or companies if friends are included. This is not an endorsement Parish K gag Nadja M D. No disclosures. Thank you, Ken. Thank you. Leadership team at North Austin and the CMI Committee for having me too. Give us can eluded a very timely topic on how to prevent burnout, balancing work and personal life. I got interested in this topic about two years ago when American College of Gastroenterology, uh, convened a task force because Bernard was being very common. And why participated in that And at the same time, um, one of my friends were going through some burnout symptoms and trying to help him. So I learned more and more about and s O. I found this, uh, opportunity to talk about my colleagues in Austin. So here we are. So, as you know, I'm from Austin gastroenterology. Our goal for today is defined. What work Life balance is define the burnout in scope of the problem. This because the interventions to deal with the burnout and some tips for a good work life balance and to prevent burnout. What does work life, balance, work? Life balance is really a term, not balance, between workplace obligation, personal responsibility. It was going to address the unhealthy life choices that many people were making, and then they were choosing to neglect the personal, uh, personal self. Learn a skill balance, but it is a skilled a picture of an elephant balancing on a beach ball, the lie, Lama said. When asked what surprised him most about humanity. He answered man, because he sacrifices his health in order to make money. Then he sacrifices money to recuperate his health. And then he's so anxious about the future that he does not enjoy the present, the result being that he does not live in the present or the future. He lives as if he is never going to die and die, having really never lived. It's very deep meditating cartoon man in half business and half casual attire. All work and no play makes Jack a dull boy. But I say I'll play. And no work makes Jack a really dull on. Poor boy. Uh huh. My dad, uh, passed away about six years ago Before they came to United States. About 26 25 years ago. He gave me advice. You know, you wanna be a great doctor. You don't do very well financially. And you wanna be good family person. But, son, pick two out of three. Is there a great doctor spending a lot of time with the patients? It might want to do well financially. Then you probably not gonna spend too much time with your family. If you do too much time with your family, you wanna do well financially. That means you're a commie doctor. You're just rushing through the motions. Same things. You're a great doctor and good family person. Then you probably have a modest means to live. Yeah, but I think all three can be done. It can be done with the balance. We'll talk about that. So when we talk about work, life work, life balance is not just working. Life is really a triangle triangle of self care. Your own personal self, your health, your physical health. You're spiritually healthier. Intellectual health, your work, your patients procedures, your competition, your professional development, your management of the workplace and your relationships especially with your significant others with Children's your partners, your friends. So it's really a triangle is not just working life. There are a lot of myths about working life. First, methods that work life balance means spending 50% your time, awake time at work and 50% home. Not true, balanced and unbalanced scales. It is really a finite amount of time we have, which we can allocate our either personal or professional goals that personal professional goals really differ. For every single person it is unrewarding and unrealistic to talk about. Okay, 50% doesn't work that way. For some people, it's 70 30 for some public 80 24. It depends on which family obligations you have, what other obligations you have. So it will also very over time. It's not. It's all the time. It's a constant 50 50 or 70 30 or whatever you wanna have for you today, it may be different. I'm very busy at work tomorrow. I may take just half. They often just spend the whole day with my family, so it's very different and the same thing in your phases of life. 10 years ago, my kids were younger. It was much different markets that now out in college. But I'm almost empty nesters things very different now. So it is not at any given time that okay, it's just this percentage of work you have to spend is different. Same thing I said before, if you're married with kids or unmarried or single is different and, uh, there's no perfect size, which fits all reality number one really very important thing is that there's two important elements. One is achievement. You work hard to achieve something, but second is enjoyment. It's not. Enjoyment is very short lived. Actually. Interestingly, I was driving down to Kyle this morning for some patients and on NPR, there is, Ah, 7 56 50 in the morning. There is a 10 minute topic. Comes every Friday, two guys on your head. Today's topic waas happiness and achievement. It was very timely. They're talking about this and if you achieve something, the happiness, what we see and modern society is very short lived a day or two and now let's move on to something achieved that I think once you achieve something, whatever it is, enjoyment of that achievement is very important. If you don't enjoy that, then you're gonna burn out. Myth number two Women desire More work Life balance than men. That's a myth. I just want you to read that modern woman traits reality to one third of men would quit their job to stay at home if they could afford that. Myth. Number three, uh, is not synonymous with work, family balance or family support. Again, it's not work. Life is a lot more to it. Just work and family life. Reality Number three. What happens is if you talk about work, life and work family. Then there is a wrong assumption that people with families on Lee desire work like balance. Single people desire that two people that without any kids, desire that, too. So it's very important, so that if you start talking about because that's, um, it, then organizations can start discriminate against those people. Okay, you can stay later. You don't have any any child at home or you don't have any. You can work another over. So then discrimination issues can come into place. It's very important that it is for universal for everybody, and not just people with family mean with illustrated man throwing papers, moving on to next goal, which is to define burnout. What is the burnout? It is a condition marked by emotional exhaustion. It's basically it's a lot off. Lots of enthusiasm. I just can't do it anymore. Just throw everything. I'm done. Low sense of personal accomplishment. No matter how hard I work, nothing improved. And that's very this one thing is very commonly heard and seen. I'm talking about physician physician friends. Talk about this a lot and you'll see the numbers in a minute and that the two numbers depersonalization. Basically, I'm not in control. Somebody else's controlling my life. So all these components of burnout leads to decrease effectiveness at work. So if you look at Medscape physician report Lifestyle Report, which comes every year, the latest in 2016, based on almost 1000 responses, the top five reasons for physician burnout in the satisfaction are increased bureaucracy and regulatory demands, and please computerization of practice. E. M. R are the biggest burnout factors these days for physicians decreasing reimbursements. We all know that spending too many hours at work and feeling like this is one of the biggest things people complain about, just a cog in the wheel. Hey, I'm just their toe. I can't do anything. I can't do anything. Other reasons for burnout. Other reasons are, of course, competition and usually carried ambitions, dealing with difficult patients, spending more time in the car changing, especially in Austin nowadays, um, malpractice suits, uh, suits and then keeping up with the embassy requirements. So that's all. Add to the burnout chart, burnout and gender. It is universal. It is not whether it's early stage or middle stage carrier relate stages universal early, middle or late women or men doesn't matter your primary care, your surgical specialty or your internal medicine. It's all across the board Wall Street Journal article. Even the popular media is picking up on this, and there's quite a few top articles coming in New York Times. You can read actually, it there's a on weekend section. There's wellness. Well, think Well, A New York Times. Invariably, every month there's some article about physician burnout. How to prevent how to think. That's there. Um, there's another I don't know that you know this website called a life hack dot org like that's another multiple time. You get a weekly up there's on that. And it's always something that talking about physician burnout and how it's impacting the practice off medicine. Widespread effects. So it is really a serious public health issue, and that's why it's important toe talk about this. And actually, um, it's a little bit preliminary will tell you that, but Travis County Medical Society is also looking into this very in detail, and they have a steering committee is gonna be a physician wellness steering committee, and we're gonna be rolling out some some program from Travis County Medical Society soon. So, Bernard position at high risk for substance abuse, mental health issues. Um, you know, they leave the profession Suicide risk. Very high relationship issues. Motor regular accident, thinking something texting in there because now phone calls coming is all happening. Scope of problem. So when I said I showed you a numbers, these are numbers. They're very high and alarming numbers. Burnout. 4500%. This is, uh, Shannon felt from, uh, from his mayoclinic, his archives of internal medicine paper in 2012, 4500% emotional exhaustion, 37.9% and depersonalization, 29.4%. This is a middle clinic study, 54% physician experience, at least one symptom of our now. And there's a 10% increase since 2011. Yeah, has any association between physician burnout and changes and professional work effort? It's a two year study again by Schoenefeld Mayo Clinic proceedings actually just came 34 months ago. Um, subjects who experienced an increase in emotional exhaustion were more likely to reduce full time employment over the following 12 months. So there is a really exit is going on cartoon of exhausted nurse. Either you can intervene or you can have more coffee. Pepsi Red Bull on, given working right Burnout, resilience, continuum. So when you start looking into this topic, there really is a continuum, and we our duty is to really get the people from the burnout continuum toe the resilience side from the Toronto present from really somebody's going through the motions, make sure they're fully engaged, and it is not responsibility of the individual. Only it is the responsibility for the organization, individual family, everybody around that person, just another person cannot do it by himself or herself. So there is light, and then the tunnel There's a lot of things, uh, a lot off Studies have published already. Mindful training, mindfulness training and physician burnout. Physician who received training in mindfulness techniques show a marked improvement symptoms of burnout. Both have been studied either intensive training or short term training, and it shows that both help. This is a study from University of Rochester done in 2009. It was a 12 month training eight weekly to point our five hour sessions of mindfulness training 18 hour seminar between sessions six and seven. It's only eight session total, and then they followed by 10 monthly sessions off 2.5 hours each. All physicians reported significant decrease and burnout symptoms, and this study, and which lasted for a year, follow up on a two year follow up. There's another study from Wisconsin. 30 physicians, 14 hour weekend course Friday to Sunday. Basically, he also gave him some city after that to listen toe all participants achieved significant reduction in symptoms of burnout maintained for nine months. Follow up. The study was a nine month follow up, so it maintain those, uh, significant reduction in symptoms I love. This is very timely for Labor Day weekend, Meme reads. The only thing better than a long weekend is a short work week. So what can we do about it? I think we need to change our statement. I have a stressful life. No, I will learn how to come back on track and live a balanced life without stress. That should be over mantra tips. So there's some tips. How do we do this? I think it's very important. Toe plan and privatize. Be smart. Smart stands for specific, measurable, attainable, realistic, timely. A lot of good APS available nowadays. A lot of good Elektronik. If you can really get attuned to using the electronic media, it will help you and hurt you. Accept EMR, of course. Hmm. It is all about flexibility, structure, tools. Resource is at your disposal, I think, utilizing mid levels. It really has helped me a lot personally, a lot off the mundane. I'm not demeaning. Anybody here but really, truly is. If you're talking physicians, time, mundane tasks are done and everything is done. Vacation. They're done. I have calling for patients. I think it's really, really helpful. If people are resistant, do not using mid levels. They're they're behind times laptop in remote access. I think it's important when you have family and, uh ah, young kids. Now I'm going to get to their practice that they're going to get to their play or get by the time you're done at five o'clock, there's no way you can, because if your EMR unless you're seeing six patients, only you can finish everything. If you're seeing more than that, you gotta go work afterwards. You have to. So this is a reality, right? So instead off just staying at work and missing everything and coming home, you leave that both. Do whatever you need to do with your family and then at night, maybe spend hour, hour and a half finished what you need to do. That's the reality. But that's how how you gonna do it? Dips continued. Okay, good time management is important. I think nowadays a lot of time is spent on social media. That's really a waste of a lot of time. I personally do it myself also, but I think I trying to cut down as much as they can. Facebook. What's up? There's a lot of stuff messages coming, that's that's just a waste of time off. I think it's time management is very, very key important. So I think schedule your priorities is more important than just prioritize what's on your schedule. It's important to figure out what you really want to do with your life. This is very, um not very, but this is controversial. Have the people agree with me on this other half this year? No, no, no, you you're full of it. You can't know. I think it's important to bring some of your home toe work some of your work to home because you live in both worlds. Look for ways to bring them together in today's day and age when everything happened. Technology. When your emails 24 someone is there any way that you can be cut off from York is going anywhere? No, it doesn't work that way when I say that going home toe work bringing some home to work. Example. Last week, um, I had a patient canceled 11. 30 on uh, I had no From 11. 30 to 1 15, I had a free time. Call my wife. Hey, are you available? He says. Yes, let's have lunch. So went our lunch That's really bringing home to work with a nice lunch. And I went back and work other days. There were some issue with their dish network and the issue with Time Warner cable and all those things and I have to call deal with, um I'm not gonna do that at night. I wanna talk to somebody who manage. Bring those all those stuff work in between your When you have time, you start doing those kind of things right now that Zatz example. Same thing I told you with the kids thing when you're taking work to home People said, No, no, no, no, no. I finished. I never open anything. No, that's baloney. That don't happen that no, you have to do interest the N h. So get your they have time with your family And then before you go to bed, hour, hour and a half, whatever you need to do, finish your work. I even actually, personally, I know a lot of people don't agree with this, but I do it and I find I personally find it very, um, beneficial for me, even on vacation. Longtime, If I'm going on a weekend vacation like Friday, then I don't worry about nothing. I don't do anything because only long weekend, a big deal. Long vacation before everybody gets ready to get up and morning one hour, I log on and just quickly answered a few things and tell people what to do. And it's not as long as if your personality is such that it doesn't bother you all day long. That's different story. But I tell them, Hey, this person don't call, let him know what my P is doing that for me Here. I do that. I don't give you example. Actually, this position sitting in this room. I was in Niece not too long ago, I was having a glass of wine with my wife and phone rang and our name Alvin. Answer that. That person is in the phone. Pick up the phone. This person in the O. R. Uh, or really and finding out that there's a patient groans these who had a very significant currency in the terminal. A Liam. But there's little involvement in the sigmoid question was whether you take the sigmoid calling out or not. Immigrants report. A report was not available that time in the O. R by just speaking of the phone call for two minute only I would have said okay if something else comes up. Hey, I'm gonna call. No problem. We'll do it later. Save that person Sigmoid Colon. And on Lee, termination was taken out. If you don't do that, I mean, that gives you so much satisfaction. My vacation isn't better than what I was doing at that. I mean, that's just the example. I know it doesn't work for everybody, but it works for me. Tips for work Life balance continued. A lot of resource is available. Videos, YouTube on effective time management and goal setting. Just a lot of stuff available online. If you just want to search, start searching this video after video after video will tell you stuff how to do it or not to do it. And there are one on one training sessions available, but, uh, have this place in, uh, San Diego. They do a lot of meditation stuff. There's a lot of other show you some websites. So if you have any issues, you can always first thing you wanna do is really goto a Maslakh inventory for burnout. Figure out whether you really are close to that or not. And if you wanna change something, then I'll give you some websites. You can go check it out again. I said before take holidays. Um, because the nice I started thinking about this stuff I mean, I used to take less holidays. Now I take quite a bit of time off because that's important. That's rejuvenates you. Ah, photo of Dr Gagged Ijaz family at Machu Pichu Family vacations we've taken in last 34 years. Dips continued. Reward yourself something extra you have been working towards. It's not a bad thing. Hey, I wanna, you know, buy something shiny laptop. Sure something. Watch your because you're working some for something. Reward yourself. That really gives you some more satisfaction. But again, you achieve something that enjoy it. Don't just Okay, this is this is one more thing. Things that China for me, But personally, the materialistic side of me is just going away. I'm trying to get into more in tow experience side of things. So whatever works for you, it's fine. Me. I need a job working one hour a week at $1000 a minute. That's true dip. Health is wealth. Most important thing is that a lot of people really neglect themselves. The top of the triangle, remember? I showed you the triangle. The top of the triangle is very, very important. You know, you spend a lot of time in the car is okay to have a good, comfortable car you don't have really drive. It's fine. Photo of women protesting dip Learn to say no. This I personally have a hard time with this. I'm pumped, changing. But it's personally hard time with this because this is very one thing you will take home and this is very, very important. But what we do is we keep on piling up, piling up, piling up, and then we're just gather the weight under the weight of that and straw them. No one is indispensable. Procrastinator, meme. Procrastination is a big problem. Used to be big with me. I'm getting getting better, learning more and more. This is the illustrated clock with last few hours squeezed together, slow down, one step at a time dip. Be passionate and enthusiastic, mixed with positive people. See the opportunity, not the obstacles. Try to see the positive everything there is very important technique. There's videos available. You talk about this videos on happy m. D. I think. Happy MD dot com If you start talking about positive self talk, Hey, I'm a great person. I'm valuable. I'm a good at what I do. And I'm excited about my work, my goals, my life, whether your end goal that helps, rather than just doing every day, same thing over and over again, meme reads. There comes an unproductive point in the workday. That moment was 9:13 a.m. That's my thing. I really think that anything you do in life, if you do a passion you do a quality work doesn't matter. You have a trailer somewhere. You can charge a lot of money, but if you're passionate about it, you're doing with the quality you're doing integrity. World is yours. You will always be successful. Love your life. Enjoy the journey between to yourself again. Personal development studies have shown that attending even professional meetings prevent burnout. Not one, not two. Multiple studies showing that go because you learn something. Evenings. You have some nice dinner mingled with friends that gets you out of daily routine. It helps. I do attend at least two or three meetings a year. Sometimes four small things. Big difference. Small little things make a big difference and go for a walk. Just watch a comedy. Listen to music. Long bat Sometimes that's a thinking place, right? Bubble bath. Um, go shopping with the family. Hey, why not? Why not? Somebody was saying me today. Is that after this, they're gonna have a one half of spa? Why not? That's fine. Uh huh. So make a list. Your thanks for thankful for learned the breathing The breathing really helped really slows you down Visualize your end goal. So, as I said before, I think it's very important for the organizations for the leadership team here that they really step their game up. Need to step their game up for this particular issue role of organizations organizations need to promote values off the profession off the organization provide adequate resource is is very important that if you're efficient, work at unit level or at all levels. This this concept off dream team like from a gastroenterologist If I have an issue with scheduling, if I have an issue with anesthesia sport issue with access. It is not available to me, that's all frustrating. The frustration, frustration, frustration. What happens? You burn out. So really, I think organizations really need to look into that and really provide support to physicians to help them toe. Because the physician, they're happy organization. They're happy. If happy troops on the ground are gonna be most productive troops on the ground, that's the bottom line. So this concept of dream team attack who knows what they're doing now also knows what they're doing. Anesthesia and all available to help you. I think organization need to promote that. To help our physicians to prevent burnout rolls continued again provide work, life integration, promote meaning in work, support, autonomy. Iran is important. Sometimes flexibility is important. Sometimes I have this issues you're working in a three o'clock, they will tell me Oh, you cannot schedule. You cannot schedule any patient after three o'clock outpatient. Yeah, I get that. That there is a work life balance for the physicians. People who are working there too. But they could be staggered shifts as well. So there a lot of different things can be done. I think organizations need toe get more into this They are, and my my opinion not doing much for the physicians intervention trial. So that's all the information trial from the organization perspective on There was a 90 minute every other week with 60 minutes protected time they looked at, or just 60 minutes protected. I'm only every other week just to do some administrative things conclusions. People who had more productive time as well as some intervention. For 90 minutes they were They had a better, uh, outcome. Other programs, these are some universities were really doing, Ah, a lot of work in this field. There's some resource is for us thinking the slide. If you don't take a picture of the slide, you can take a picture, or I think it's gonna be available online. Um, this, uh, program resource is for physicians links. So at another day, your competitors can copy your work. Sure, your style, your procedure. But no one can copy your passion, your sincerity and your honesty. If you hold onto them firmly. World is yours. Our against they follow your principles. Follow your principles, illustrated equation. Work hard, play harder and pretty hard. You have identified what is important. You're making it happen? You're in control and you're enjoying at this top of it. Follow up for you. Thank you. Logo. ST David's Healthcare Title. Physician Burnout. Published Created by
