Jullia A. Rosdahl, MD, PhD, on protecting your colleagues: Recognize the signs of burnout

Hi everyone. Welcome to another episode of season two of "Our View," our Healio vlog focusing on physician wellness. And we're joined today by Dr. Rosdahl from Duke. Dr. Rosdahl, can you tell us about your roles at Duke?

Thank you so much. I'm so excited to be here. I'm a glaucoma specialist at the Duke Eye Center, and I also help with our medical student program, but one of my favorite things that I do is I'm our wellness champion for our department.

And how did you get involved in this role?

So, I think I kind of forced myself upon my chairman. I've been interested in the topic of wellness pretty much since I finished my training back in 2011. I'm an MD-PhD, so I'm a little older, and by the time I finished, I realized that I needed to make sure that I was going to last a long time after investing all of that in my training. And I got interested in wellness and did a lot of things with our residents and other faculty. And I think it was in maybe 2017 when I went to my chairman and I said, "Hey, I think we need a wellness program in our department." And he said, "Okay." And then I said, "I need a title” a couple years later. And he said, "Okay, well, what title do you want?" And so here I am.

Great.

That's fantastic. You know, I think wellness is definitely a buzzword amongst, I think, a lot of society, but, you know, especially in medicine where for so much of our careers, we've just been taught, put your head down, work harder. We have a duty, an obligation. We took an oath. And so many of us now are burning out, leaving medicine. All of those other things. If you could just give us three pearls of kind of things to be aware of, things to look to, or things that we can do for ourselves. I know that's kind of a broad topic, but however you want to take that. We love all your experience and knowledge, so thank you.

Oh, thanks. So, I would say number one would be to define wellness for yourself. I think that sometimes it's a turnoff for some people when I start talking about wellness and wellbeing and they think, "Oh gosh, you know, that's not for me. I don't want to go and get a massage and that sort of thing. Like, that's a waste of time." And so, I would say, well, first, define wellness and wellbeing for yourself and what you need for yourself. And then a second, I think one of my big pearls in the thing that I find useful for myself is the idea of boundaries. Really understanding what's important to you and trying to put boundaries around that to protect it so that you have the time and energy for those things. And then the third I would say is, you know, to really care about your colleagues. Wellbeing is certainly about taking care of ourselves and boundaries and protecting the things that we care about. But I think the third thing is we're all in this together, and our colleagues are so, so important to us. And so, I guess related to that would be, you know, what are the signs of burnout? And so, exhaustion, irritability, you know, really when colleagues kind of stop showing how much they care about their patients, you know, that's a red flag. So, paying attention to our colleagues and helping them.

Yeah, we have to take care of one another as much as we have to take care of our patients, right?

Yep.

Just gets worse when one of us leaves, three of us leave, five of us leave, and then the rest of us who have to take care of the same number of patients. So, we're all in this together. Thank you for that.

Yeah. You've hit the nail on the head how it benefits each other, but really, it benefits all of us, including ourselves when we're caring for each other.
Yeah. It's a community, right? We need each other. And it is a tragedy, right? When we lose physicians, it's just so sad. I personally lost four colleagues in 2022, and you know, we all thought, how could we have reached out? Or what did we miss? You know, it's a lurking feeling, right?

Yeah. Oh, I'm so sorry to hear about your loss.

Jullia, you've written articles, and I've heard your lecture about this very topic, loss of physicians and suicide among ophthalmologists. Would you, as the final question, be able to touch on that point for us, please?

Yeah. So, suicide is so important because of the importance of it. So, you know, some of the things to look for are colleagues who are showing increased use of substances, mood swings, sleep changes, loss of interest, withdrawal, talking about being a burden, talking about self-harm, really showing anxious, reckless behavior. So those are the things to look for in colleagues. And then when you are fighting this, you know, we're not psychologists. We're not equipped for this. And so really, it's about getting help: Getting help for our colleague and ourselves to help that colleague. So, I know at Duke, we have a physician assistive service to tap into. And I have other people that I can call on, here at my institution to help. And so, I encourage everyone to find out who to call to get help so that you're not in this alone and taking responsibility. And encourage your colleague who might be suffering to reach out, to talk to a therapist, you know, even to go to the hospital if it's really a situation where they're thinking about harm. But really letting people know that they're not alone, that you're with them. So, I think knowing about it and talking about it on, you know, organizations like this is so important because it happens, and it's just horrible to think about losing one of us.

Thank you very much, Jullia, for sharing your thoughts on this very sensitive topic. Obviously, it's not easy to talk about it, and I thank you for your courage to open up this topic and be able to talk about it and let us learn from you. Thank you very much.

Thanks, I really appreciate you covering this topic. It's so important for people who are struggling a little bit, struggling a lot or not struggling at all, and really with their hand out to help us. So, I appreciate you guys doing this topic. Thank you.