Have You Lost That Burning Desire?

Professional, occupational or job burnout is short-term exhaustion, lack of enthusiasm/motivation, feeling drained and most times there is negative emotions and cynical behavior that result in reduced professional efficacy within the workplace. 

The article Is Technology to Blame for Physician Burnout analyzes the Medscape Physician Lifestyle Report, which states the electronic health record is a factor in physician burnout.  The data identifies three key factors: insufficient income due to reimbursement cuts, extended hours to maintain the status quo, and the negative impact of technology (time, money, and more staff).  When is the last time you had someone smile when the acronym EHR is mentioned??

It is no secret that physicians, as well as all other health-care providers, have been endlessly bombarded with massive political, economic, and social change.  Simply for survival, most every physician and provider has had to rethink priorities just to keep afloat. 

The EHR was once touted as a solution to the chaos in health-care. Instead of being an answer, it has become an added burden for providers'.  Why?  One thing, lack of standardization has created an additional unknown in a providers' environment.  What problems is this thing going to give  me today?  Even physicians who practice every day in the same location, are face with technological impediments.  Those who work at different sites, often have to readjust to a different interface on the fly.  Such impediments include surprise updates, new facility and regulatory requirements, restructured workflows, unpredictable interfaces, and software that is anything but friendly. Add to all that the failed pledge of interoperability- my system will talk with your system- and it is easy to see why the EHR simply has not lived up to its promise--Not even close!  These studies show that a majority of physicians have felt that the presence of EHR technology decreased face-to-face time and the ability to see patients, while only a minority felt that the quality of their practice was improved.

Burnout is a major potential problem for the health-care system, for patient care as well as for the individual provider that may fall prey.  In this environment, the EHR is a natural scapegoat for the deeply entrenched ills of the system.  With the rapidly aging physician population, once can understand that doctors are expressing a desire to get out of the click race.  Hopefully, the next generation EHR will be better than the current one.  Maybe the psychological and emotional contribution to the specter of burnout will perhaps lessen, if not disappear.

Getting the Dread On!

My long-time Emergency department colleagues collectively called the anxiety and anticipation about having to perform perfectly on the next shift "Getting the Dread On".  This implied that the worry about the stresses of the next stint could begin any time from when the last shift ended.  The definition of dread is great fear or apprehension.  Common synonyms include fear, apprehension, trepidation, anxiety, worry concern unease, angst- you get the picture. 

After reading these descriptions, one would wonder why anybody would work at this job.  We'll save that for a another blog.

Some shift work health consequences include:

• Sleep disorders
• Diabetes Mellitus
• Headaches
• Ischemic heart disease
• Fatigue
• Stress
• Poor appetite control
• Substance abuse
• Problems with medications
• Problems with interpersonal relationships

The biggest fear is making mistakes leading to poor patient outcomes.  This coupled with volume and performance pressures, patient satisfaction scores, the ever-looming threat of malpractice suits, and chronic self-doubt can immobilize an individual.

It is probably time to retire or find a less stressful career than Emergency Medicine if getting the dread on is a recurring theme in your life.  Fortunately, most people learn to deal with the stresses and overwhelmingly positive side to the job, and they soldier on!