Q&A: Combating burnout in dermatology

Burnout is a growing problem in the medical community and, as pressure builds, has a negative impact on practitioners.

It was previously thought to affect dermatologists less than other specialists due to fewer emergencies and better working hours, but recent research has found dermatologists are increasingly experiencing burnout at high rates.

Healio spoke with William W. Huang, MD, MPH, FAAD, associate professor of dermatology at Wake Forest School of Medicine, who has completed research on this topic, about what dermatologists should know about burnout and how to best combat it in their professional lives.

Healio: What are some of the main factors contributing to burnout in dermatologists?

Huang: In general, burnout is a syndrome of emotional exhaustion, loss of meaning in work, feelings of ineffectiveness and a tendency to view people as objects rather than as human beings (depersonalization). It is important as it has effects on an individual’s personal life, the quality of care they are able to provide, patient care errors and physician turnover.

The main drivers of burnout typically fall into one of the following categories (job/employee mismatches) that contribute to job-related burnout: work overload, lack of control, insufficient reward, breakdown of community, absence of fairness and conflicting values.

Our research has shown that a variety of factors are contributing to burnout among dermatologists, including excessive documentation and time spent on the electronic medical record, lack of protected time for pursuing academic interests such as research or teaching, increased administrative demand for productivity causing a sense that institutions value finances over proper patient care and academic pursuits, bureaucratic tasks especially concerning insurance matters, and lack of support or appreciation shown by administrative bodies to the physicians.

Healio: How does burnout affect dermatologists in comparison to other specialists?

Huang: For me, burnout has been one of those epidemics among physicians that was forgotten during the COVID-19 pandemic. There is evidence that burnout among dermatologists is rising and rising at a rate faster than any other medical specialty. The COVID-19 pandemic has only made this concerning trend worse.

Healio: When an individual is suffering from burnout, what effects can that have on their productivity and work?

Huang: Burnout is an innate hazard of our profession and tends to be progressive in nature. Physicians tend to take individual blame for their own burnout. However, in general, 10% of the time, individuals burn themselves out, and 90% of the time, the work environment burns out individuals.

Burnout causes additional strain on the provider, decreasing their productivity and increasing their patient care errors. In addition, burnout has effects on a physician’s personal life and leads to increased physician turnover.

Healio: What effect can it have on patient satisfaction?

Huang: Burnout can often lead to decreased patient satisfaction as physicians exhibit emotional exhaustion, loss of meaning in work, feelings of ineffectiveness and a tendency to view people as objects rather than as human beings.

Healio: How can dermatologists best combat burnout?

Huang: Burnout will occur anytime, anywhere there is a major mismatch between the nature of the job and the nature of the person who does the job. Burnout is impossible to alleviate unless the underlying causes are correctly identified and addressed. At an individual level, dermatologists can nourish their physical, emotional, mental and spiritual well-being. At an employer level, organizations can survey the workplace for the presence of the six major job/employee mismatches that lead to job-related burnout.

Healio: How important is it for practitioners to recognize when their own mental health is in danger from stress/burnout?

Huang: Vitally important. Providers often confuse stress and burnout, but they are different. With stress, the damage is primarily physical. With burnout, the damage is primarily emotional. Burnout can lead to disengagement, feelings of helplessness/hopelessness, loss of motivation, anxiety, detachment and depression. Physicians in general are already at higher risk for substance abuse and suicide, and burnout only compounds the issue.

Healio: What are some ideas on how physicians can reduce that stress to avoid burning out?

Huang: First, if you are feeling burned out, please seek help. Do not go it alone. Speak with a trusted colleague, mentor or friend.

Of course, you can nourish your physical, emotional, mental and spiritual well-being, but often it is the work environment that burns out an individual. Talk with your employer about ways to institute programs and take steps necessary to eliminate or mitigate any job/employee mismatches. Find ways to change the work environment to one that prevents job-related burnout while fostering engagement.