Burnout: Cultural Shift Needed

It is very heartening to know that physician burnout has drawn the attention of our profession and that multiple efforts are being made to address it.

The term “burnout” originated in literature describing the phenomenon among public welfare workers in New York City a century ago, attributing it to frustration and despair among intelligent, dedicated professionals who had high personal standards and expectations and were faced daily with an impossible task. The needs were unlimited, but workers lacked not only resources, but also the power to improve their working situation and solve their problems to achieve satisfying outcomes. Furthermore, they were isolated, with neither a supportive community of peers, nor supervisors who offered constructive and encouraging feedback.

Faced with similar obstacles in the medical culture, be it in a training or working situation, we can expect similar burnout among physicians. It is as predictable as a tuberculosis epidemic if the conditions are right. Treatment after the fact is appropriate, as is shoring up personal resilience, but we need to change the working culture to prevent more casualties. Perhaps the most critical deficit in a physician’s life is an inability to control one’s time. Along with our special expertise, our time with our patients—allowing us to know them and form the physician-patient relationship, which is the catalyst to healing—is our most valuable asset. But even more fundamental is the power and support within the culture of medicine to manage one’s personal time and relationships, which if undercut can be literally fatal. - Nancy T. Block, M.D. (Berkeley Heights, N.J.) ■