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Mar 1 2017

Resolve to fight burnout and reclaim satisfaction in life, work

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The Board recently surveyed a random sample of its licensees to get input on a range of topics related to the practice of medicine, including professional burnout. About 45 percent of survey respondents indicated they have experienced symptoms of burnout that lasted more than three months, which is consistent with national trends. More eye-opening was a related question that asked licensees with burnout to say whether they had sought assistance. Some 67 percent indicated that they did nothing to alleviate their burnout. When asked why, the most common response was that burnout is “just part of the job.”

A few years ago, I would probably have agreed with that statement. As an obstetrician and gynecologist, I worked long hours and was frequently called to the hospital at night to deliver babies. I rarely got enough sleep, didn’t have time to exercise and wasn’t eating well. I’d started noticing that my knees and back ached if I spent more than an hour or so on my feet, and I was pretty sure surgery was in my future. My blood sugar level and blood pressure were creeping up. I started to ask myself, “How do I get off this merry-go-round?”

I knew I needed to make some changes. I did not want to continue on a path to burnout and further deterioration of my physical and emotional health. So, I took three months off to self-reflect, travel and put my desires and interests first for once. I knew I had to put my own health first – advice I often gave my patients but was not, in fact, following. I got a personal trainer and started to work out regularly and make healthier meal choices. I made the difficult decision to give up obstetrics, to make it possible to get better sleep. After three months, I reopened my practice but changed the focus to women’s health and wellness, and I reduced to part time hours. With the help of my doctor, I was able to lose 50 pounds over a period of three years. Losing weight and exercising resolved the knee and back pain, returned my blood sugar and blood pressure to normal and my sleep apnea went away. Most important, I’m enjoying practicing medicine again, and I’m much happier.

I recognize that I’m fortunate that I am at a point in life where it was possible to make drastic changes to improve my life and practice. Not everyone can do that. At the same time, I want to encourage you, my colleagues, to reject the notion that burnout is inevitable and inescapable.

NCMB hosted a roundtable discussion on physician wellness in 2015, in response to rising rates of physician burnout. One of the actions the Board took after that meeting was to collect and post wellness resources, particularly resources related to identifying and addressing symptoms of burnout, on its website, as www.ncmedboard.org/wellness. I hope you’ll take a few minutes to review them. You may just find something that inspires you to make some positive changes.

Also in 2015, NCMB joined the NC Consortium for Physician Resilience and Retention, which brings together stakeholders, including the NC Medical Society, Cone Health, the NC Physicians Health Program, and other organizations that deal with the impact of rising physician burnout. The Consortium is committed to identifying opportunities to address mental health, wellness, and burnout among medical professionals in the state. Participation in the Consortium influenced NCMB’s recent decision to stop asking licensees completing annual renewal to disclose medical conditions that might impair or limit ability to practice. NCMB hopes this change will encourage licensees who need help to obtain it, without fear of attracting Board scrutiny.

If you’re interested in viewing summary results from the recent licensee survey, you’ll find a feature by clicking here.

Be well,
Eleanor E. Greene, MD, MPH
Board President

 Comments on this article:

Very accurate and timely discussion.  It is so important to realize that if we take care of ourselves, we will be much better able to care for our patients.  Taking time off to rejuvenate and enjoy other aspects of life should be an expectation not only of providers themselves, but needs to be accepted and encouraged by administrators, office managers, support staff and most importantly one’s significant other, family and social network.

By Gary Bawtinhimer, MD on Mar 02, 2017 at 4:04pm

  Dear Dr. Greene

It was refreshing to hear of another physician who believes in the Maxim “physician heal thy self”
Best Regards
Marc

By Marc Notrica MD on Mar 02, 2017 at 4:35pm

Healthy living is a great idea, as is seeking help when it is needed. But I submit that one of the major contributors to physician burnout is the unending proliferation of nitpicking requirements by state medical boards. The locum tenens coverage I provide as a semi-retirement job requires me to be licensed in multiple states, and hardly a week goes by without some new CME requirement (bloodborne pathogens, opioid prescribing, pain management, elder abuse, partner abuse, child abuse, end-of-life management, the list goes on and on), or prescription drug monitoring program registry. Almost none of it has any bearing on anything I do as a physician, but all of it eats time and money. Burnout has many more causes, of course, but if regulatory agencies would only do a cost-benefit analysis, not just monetary cost but psychological and morale cost on physicians, before spewing ever more regulations, there would be a lot less burnout.

By Stephen D Leonard MD on Mar 02, 2017 at 10:33pm

This is a huge issue. Thank you for looking to tackle it NCMB! I think a lot of it has to do with patient expectation—- that anything can be cured, which simply isn’t true.
We cannot cure or heal anyone. I often have to remind myself this.

JP

By Jonathan R. Prentice PA-C on Mar 03, 2017 at 12:16pm

Dr. Leonard, There’s no question that medicine is one of the most regulated professions in existence, and as you note, it is well documented that dealing with bureaucracy and mandates is a significant contributor to burnout. NCMB can’t speak for other regulators, but this Board tries to be very thoughtful in how it approaches any new mandate. The new CME requirement for controlled substances prescribers was deliberately implemented as part of - not in addition to - the existing CME requirement for physicians and PAs, and NCMB did not require licensees to complete specific courses, which should allow many to claim credit for CME they have already completed as part of their professional development. It’s doubtful that medicine will become less regulated. NCMB is serious about commonsense regulation, however, and will do what it can not to add to the problem of burnout.

- Forum editor

By Jean Fisher Brinkley on Mar 03, 2017 at 3:33pm

If a man is doing the same thing at sixty as he was at thirty, he was not doing much at thirty - and we all do a lot in our thirties. We cannot continue to heal the wounded without tending to the wounds of the healers!

There is no future in an early exit (pun intended), and career phase transitions are a form of preventive career maintenance - so phase shift before you burnout. Think of each shift as an advance. I’m on my third career phase with three decades of medicine behind me, and look forward to advancing to my next “retirement” - it gets better each time!

By O'Neill D'Cruz, MD, MBA on Mar 05, 2017 at 6:36pm
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