FEELING ALONE IN A VALLEY OF BURNOUT
Twelve years ago, I didn’t know that the symptoms I was suffering had a diagnosis of physician burnout. As a newly appointed faculty member in neurology at that time, no media headlines or studies were in existence to give my symptoms a name. Instead, I hoped that no one would find out the shame and struggles I was hiding underneath my starched white lab coat.
How do you know if you or a colleague is suffering from burnout? I always ask physician groups to look for the following: a feeling that the lights are on and no one is home. You may be going through the motions, struggling to keep up, and feeling disconnected from your life emotionally.
I just internalized the symptoms of emotional exhaustion and a low sense of personal accomplishment. I thought my problem was that I was a physician failure. I pushed myself to exceed RVU (relative value unit) expectations in the increasingly profit-driven world of medicine. I could never find the time in my 80- to 100-hour work week to catch up on research, medical records, or tend to my personal health.
YOU ARE NOT ALONE & YOU ARE NOT A STATISTIC
Fast forward to 2018, the topic of burnout seems to be overused yet ineffectively addressed. According to the Medscape 2018 report, the number of physicians experiencing burnout continues to be on the rise with an average of 42 percent of physicians having burnout. A 2017 Mayo Clinic study reports the numbers are higher than 53%. It is commonplace to disassociate intellectually from statistics, assume you are "one of them", and then feel stuck in your current state of mind. The danger of just intellectualizing these studies is that we can dismiss our health return to work feeling hopeless.
Neither you nor I are a statistic, we are humans. Until we bring humanity back into medicine, we will feel alone against the uphill battle of electronic health records, relative value units, patient satisfaction surveys, and medical insurance challenges.
To shift from burnout to a state of balance and healing healthcare, we must address the internal state of being as well as change external circumstances. Healing needs to occur on an individual level before we can create organizational change.
CONSEQUENCES OF BURNOUT ON MENTAL & PHYSICAL HEALTH
Burnout among doctors is generally described in terms of a loss of enthusiasm for one’s work, a decline in satisfaction and joy, and an increase in detachment, emotional exhaustion, and cynicism. It manifests in disproportionately high rates of depression, substance abuse, and suicide. Annually, approximately 400 physicians take their own lives in the United States.
My passion as a neurologist to help patients with epilepsy had long extinguished, and now physical symptoms had me fighting for survival. When I couldn’t take the stress or had difficulty focusing, I would turn to meditation and mindfulness-based stress reduction techniques. I would close my office door and practice pranayama breathing exercises, hoping that no one would see me.
I started to research why I felt less anxious and reduced pain with my yoga and meditation practice. I traveled the country and the world learning various meditation techniques. I also discovered that there is a wealth of research on the scientific evidence behind the benefits of meditation and mindfulness-based stress reduction on physical and mental health.
THE ROLE OF MEDITATION AND MINDFULNESS FOR HEALING
The majority of us physicians never learn about mindfulness and meditation research in medical school or residency training. Our first introduction to the research is either through headlines in mainstream media or in our own personal journeys of healing.
Fast forward to 2018 where mindfulness-based programs are a part of the curriculum in the top business and law schools, and shifting into corporate cultures of Fortune 500 companies. As I travel the United States teaching corporate clients, I wonder daily why is healthcare and specifically physicians lagging behind in this movement?
In a highly-publicized study from the Annals of Family Medicine in 2014, researchers at Meriter Medical Group in Madison, Wisc. taught physicians simple mindful meditation techniques. These mindful breathing techniques were used to help physicians feel centered and more present with each patient interaction. Results showed decreased symptoms of burnout, stress, depression, and anxiety.
HEALING BURNOUT IS AN INTERNAL PROCESS
I disagree with the opinions of colleagues who dismiss physician wellness and mindfulness programs. As a medical community, we need to understand the importance of prioritizing our physical and mental health. Self-care is not selfish, self-care is essential for maintaining our health and peak performance as physicians. Once we reach symptoms of burnout, mindfulness is a path to heal. Mindfulness-based practices have been clinically proven to heal symptoms of depression, insomnia, anxiety, and burnout.
PREVENTING BURNOUT IS AN EXTERNAL JOB
One cannot run into a forest fire without first protective gear, supportive team members and a plan of action. Trying to transform the toxic medical system can feel like you are a physician heading into the forest fire alone, unprotected, and without a plan of action.
Without healing our individual symptoms of burnout, how can we be expected to have the mindset and physical health to lead change. Mindful-based techniques improve leadership, communication, and our ability to create solutions calmly. As a professional speaker and consultant, I work with executive teams of Fortune 500 companies and professional athletes who all realize that to transform a toxic workplace, they must first change their mindset. By healing burnout, we replace anger, cynicism, and despair with hope, creative thinking, and compassion.
When we control our minds, we can then control a situation. Through mindful leadership techniques, physicians can and must the lead change on the external issues contributing to physician burnout.
I left the traditional practice of medicine, not because I gave up on the system. I left clinical medicine because I believe in my mission to change the workplace. I will not give up hope for your ability to heal yourself and then together we can and must heal healthcare.
Will you join me?
Dr. Romie Mushtaq, MD is a traditionally trained neurologist with additional board certification in Integrative Medicine. Dr. Romie combines her unique expertise in neuroscience & mindfulness as a highly sought-after speaker to teach stress management and mindful leadership to Fortune 500 companies, Universities and associations around the globe. Dr. Romie currently serves as Chief Wellness Officer for Evolution Hospitality bringing meditation and mindfulness to an organization of 6000 employees.